1
|
Savin L, Pinteala T, Mihai DN, Mihailescu D, Miu SS, Sirbu MT, Veliceasa B, Popescu DC, Sirbu PD, Forna N. Updates on Biomaterials Used in Total Hip Arthroplasty (THA). Polymers (Basel) 2023; 15:3278. [PMID: 37571172 PMCID: PMC10422432 DOI: 10.3390/polym15153278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
One of the most popular and effective orthopedic surgical interventions for treating a variety of hip diseases is total hip arthroplasty. Despite being a radical procedure that involves replacing bone and cartilaginous surfaces with biomaterials, it produces excellent outcomes that significantly increase the patient's quality of life. Patient factors and surgical technique, as well as biomaterials, play a role in prosthetic survival, with aseptic loosening (one of the most common causes of total hip arthroplasty failure) being linked to the quality of biomaterials utilized. Over the years, various biomaterials have been developed to limit the amount of wear particles generated over time by friction between the prosthetic head (metal alloys or ceramic) and the insert fixed in the acetabular component (polyethylene or ceramic). An ideal biomaterial must be biocompatible, have a low coefficient of friction, be corrosion resistant, and have great mechanical power. Comprehensive knowledge regarding what causes hip arthroplasty failure, as well as improvements in biomaterial quality and surgical technique, will influence the survivability of the prosthetic implant. The purpose of this article was to assess the benefits and drawbacks of various biomaterial and friction couples used in total hip arthroplasties by reviewing the scientific literature published over the last 10 years.
Collapse
Affiliation(s)
- Liliana Savin
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
| | - Tudor Pinteala
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
| | - Dana Nicoleta Mihai
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
- Department of Protheses Technology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dan Mihailescu
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
| | - Smaranda Stefana Miu
- Department of Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
| | - Mihnea Theodor Sirbu
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
| | - Bogdan Veliceasa
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
| | - Dragos Cristian Popescu
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
| | - Paul Dan Sirbu
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
| | - Norin Forna
- Department of Orthopedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.S.); (D.M.); (M.T.S.); (B.V.); (D.C.P.); (P.D.S.); (N.F.)
- Department of Orthopedics, Clinical Rehabilitation Hospital, 700661 Iasi, Romania;
| |
Collapse
|
2
|
Park JW, Ko YS, Park S, Kim SH, Lee YK, Koo KH. Cemented versus Cementless Total Hip Arthroplasty for Femoral Head Osteonecrosis: A Study Based on National Claim Data in South Korea. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202305000-00001. [PMID: 37134143 PMCID: PMC10155893 DOI: 10.5435/jaaosglobal-d-23-00029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 02/12/2023] [Indexed: 05/05/2023]
Abstract
INTRODUCTION The purpose of this study was to compare the rates of revision, periprosthetic joint infection (PJI), and periprosthetic fracture (PPF) between patients with osteonecrosis of the femoral head (ONFH) undergoing noncemented total hip arthroplasty (THA) and cemented THA using a national claim data in South Korea. METHODS We identified patients who received THA for ONFH from January 2007 to December 2018 using ICD diagnosis codes and procedural codes. Patients were categorized into two groups according to the fixation method: with or without cement. The survivorship of THA was calculated using the following end points: revision of both the cup and stem, revision of the single component, any type of revision, PJI, and PPF. RESULTS A total of 40,606 patients: 3,738 patients (9.2%) with cement and 36,868 patients (90.7%) without cement, received THA for ONFH. The mean age of the noncemented fixation group (56.2 ± 13.2 years) was significantly lower than that of the cemented fixation group (57.0 ± 15.7 years, P = 0.003). The risk of revision and PJI was notably higher in cemented THA (hazard ratio: 1.44 [1.21 to 1.72] and 1.66 [1.36 to 2.04], respectively). Noncemented THA had a higher 12-year survivorship compared with cemented THA with any revision and PJI as the end point. DISCUSSION Noncemented fixation had better survivorship than cemented fixation in patients with ONFH.
Collapse
Affiliation(s)
- Jung-Wee Park
- From the Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea (Dr. J-W. Park, Dr. Ko, Dr. Lee, and Dr. Koo); the Data Science Team, Hanmi Pharm. Co., Ltd, Seoul, Korea (Ms. S. Park); the Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea (Mr. Kim); the Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea (Dr. Lee); and the Department of Orthopaedic Surgery, Kay Joint Center, Cheil Orthopaedic Hospital, Seoul, South Korea (Dr. Koo)
| | | | | | | | | | | |
Collapse
|
3
|
Brown ML, Dunn JM, Early S, Challa S, Ezzet KA. The impact of failed novel technology and technical errors on the revision burden in total hip arthroplasty: what percentage of revision hip arthroplasty was potentially avoidable? Hip Int 2022; 32:771-778. [PMID: 33736475 DOI: 10.1177/1120700021996654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Despite the high success rate of total hip arthroplasty (THA), new implant technologies continue to be developed. Although potentially useful, such novel developments may result in unintended consequences, leading to revision surgery, often prematurely. In several instances, new technology that appeared promising was later found to be inferior to existing technology and resulting in early revision surgery. Additionally, technical surgical errors may also lead to early revisions. Some have argued that revisions related to such phenomena are potentially avoidable. The present analysis investigates to what extent the contribution of "failed new technology" and "technical errors" contributes to the revision burden and to the need for premature revision arthroplasty. METHODS We retrospectively analysed 432 revision THAs and categorised them as either "late revisions" based on survivorship of 10 years or "premature revisions". Among both cohorts, we determined what percentage of revisions were potentially avoidable and due to failed novel technologies and technical errors, and what percent were "unavoidable". RESULTS Of the 432 revisions, 267 (62%) were considered premature and 38% were considered late. Of the premature revisions, 108 were considered potentially avoidable (81 failed novel technologies, 27 technical errors). CONCLUSIONS Our data demonstrates that new technology and surgical techniques can result in premature failure of THA. Surgeons should take caution when incorporating new implant technology or surgical techniques into their practice.
Collapse
Affiliation(s)
- Matthew L Brown
- Department of Orthopaedic Surgery, St Luke's University Health Network, Fountain Hill, PA, USA
| | | | - Samuel Early
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA, USA
| | - Sravya Challa
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA, USA
| | - Kace A Ezzet
- Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA, USA
| |
Collapse
|
4
|
El-Othmani MM, Zalikha AK, Cooper HJ, Shah RP. Femoral Stem Cementation in Primary Total Hip Arthroplasty. JBJS Rev 2022; 10:01874474-202210000-00005. [PMID: 36215391 DOI: 10.2106/jbjs.rvw.22.00111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
➢ Femoral stem cementation has undergone considerable investigation since bone cement was first used in arthroplasty, leading to the evolution of modern femoral stem cementation techniques. ➢ Although there is a worldwide trend toward the use of cementless components, cemented femoral stems have shown superiority in some studies and have clear indications in specific populations. ➢ There is a large evidence base regarding cement properties, preparation, and application techniques that underlie current beliefs and practice, but considerable controversy still exists. ➢ Although the cementing process adds technical complexity to total hip arthroplasty, growing evidence supports its use in certain cohorts. As such, it is critical that orthopaedic surgeons and investigators have a thorough understanding of the fundamentals and evidence underlying modern cementation techniques.
Collapse
Affiliation(s)
- Mouhanad M El-Othmani
- Department of Orthopaedic Surgery, Columbia University Medical Center, New York, New York
| | - Abdul K Zalikha
- Department of Orthopaedic Surgery and Sports Medicine, Detroit Medical Center, Detroit, Michigan
| | - H John Cooper
- Department of Orthopaedic Surgery, Columbia University Medical Center, New York, New York
| | - Roshan P Shah
- Department of Orthopaedic Surgery, Columbia University Medical Center, New York, New York
| |
Collapse
|
5
|
Backstein DJ. Editorial Comment: 2016 Knee Society Proceedings. Clin Orthop Relat Res 2017; 475:43-44. [PMID: 27646417 PMCID: PMC5174049 DOI: 10.1007/s11999-016-5062-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 08/26/2016] [Indexed: 01/31/2023]
Affiliation(s)
- David J Backstein
- Granovsky Gluskin Division of Orthopaedic Surgery, Sinai Health System, Mount Sinai Hospital, University of Toronto, 600 University Ave, Suite 476D, Toronto, ON, M5G 1X5, Canada.
| |
Collapse
|
6
|
Physicochemical properties and mineralization assessment of porous polymethylmethacrylate cement loaded with hydroxyapatite in simulated body fluid. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 61:190-8. [DOI: 10.1016/j.msec.2015.12.040] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 12/01/2015] [Accepted: 12/18/2015] [Indexed: 11/17/2022]
|
7
|
Yoon BH, Ha YC, Lee YK, Koo KH. Postoperative Deep Infection After Cemented Versus Cementless Total Hip Arthroplasty: A Meta-Analysis. J Arthroplasty 2015; 30:1823-7. [PMID: 26021907 DOI: 10.1016/j.arth.2015.04.041] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 03/30/2015] [Accepted: 04/20/2015] [Indexed: 02/01/2023] Open
Abstract
Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). The objective of this meta-analysis was to compare the PJI rate between cemented and cementless THAs. Eight clinical studies (2 randomized controlled trials and 6 observational studies) were available for the analysis. Meta-analysis (with a fixed-effects model) and subgroup analysis were performed by research design and meta-regression was performed by continuous moderator. The overall incidence of PJI was 0.4% (357/84,200). The incidence was 0.5% (310/67,531) in cemented group, and 0.3% (47/16,669) in cementless group (P=0.008). The meta-analysis revealed that the use of cement in THA was associated with an increased risk of PJI (odds ratio 1.53; 95% confidence interval 1.120 to 2.100; P=0.008).
Collapse
Affiliation(s)
- Byung-Ho Yoon
- Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyung-Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| |
Collapse
|
8
|
Sa Y, Wang M, Deng H, Wang Y, Jiang T. Beneficial effects of biomimetic nano-sized hydroxyapatite/antibiotic gentamicin enriched chitosan–glycerophosphate hydrogel on the performance of injectable polymethylmethacrylate. RSC Adv 2015. [DOI: 10.1039/c5ra15915f] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Preparation and characterization and injectable p-PMMA/CS-GP/nano-HA/GM cements.
Collapse
Affiliation(s)
- Yue Sa
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education
- School & Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
| | - Man Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education
- School & Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
| | - Hongbing Deng
- Department of Environmental Science
- College of Resource and Environmental Science
- Wuhan University
- Wuhan 430079
- PR China
| | - Yining Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education
- School & Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
| | - Tao Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education
- School & Hospital of Stomatology
- Wuhan University
- Wuhan 430079
- PR China
| |
Collapse
|
9
|
Sa Y, Yang F, Leeuwenburgh SCG, Wolke JGC, Ye G, de Wijn JR, Jansen JA, Wang Y. Physicochemical properties and
in vitro
mineralization of porous polymethylmethacrylate cement loaded with calcium phosphate particles. J Biomed Mater Res B Appl Biomater 2014; 103:548-55. [DOI: 10.1002/jbm.b.33233] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 05/06/2014] [Accepted: 06/05/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Yue Sa
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) and Key Laboratory of Oral Biomedicine Ministry of EducationSchool and Hospital of Stomatology, Wuhan University People's Republic of China
- Department of BiomaterialsRadboud University Medical CenterNijmegen The Netherlands
| | - Fang Yang
- Department of BiomaterialsRadboud University Medical CenterNijmegen The Netherlands
| | | | - Joop G. C. Wolke
- Department of BiomaterialsRadboud University Medical CenterNijmegen The Netherlands
| | - Guang Ye
- MicrolabDelft University of Technology The Netherlands
| | - Joost R. de Wijn
- Department of BiomaterialsRadboud University Medical CenterNijmegen The Netherlands
| | - John A. Jansen
- Department of BiomaterialsRadboud University Medical CenterNijmegen The Netherlands
| | - Yining Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) and Key Laboratory of Oral Biomedicine Ministry of EducationSchool and Hospital of Stomatology, Wuhan University People's Republic of China
| |
Collapse
|
10
|
Köster U, Jaeger R, Bardts M, Wahnes C, Büchner H, Kühn KD, Vogt S. Creep and fatigue behavior of a novel 2-component paste-like formulation of acrylic bone cements. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2013; 24:1395-1406. [PMID: 23563979 DOI: 10.1007/s10856-013-4909-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 03/08/2013] [Indexed: 06/02/2023]
Abstract
The fatigue and creep performance of two novel acrylic bone cement formulations (one bone cement without antibiotics, one with antibiotics) was compared to the performance of clinically used bone cements (Osteopal V, Palacos R, Simplex P, SmartSet GHV, Palacos R+G and CMW1 with Gentamicin). The preparation of the novel bone cement formulations involves the mixing of two paste-like substances in a static mixer integrated into the cartridge which is used to apply the bone cement. The fatigue performance of the two novel bone cement formulations is comparable to the performance of the reference bone cements. The creep compliance of the bone cements is significantly influenced by the effects of physical ageing. The model parameters of Struik's creep law are used to compare the creep behavior of different bone cements. The novel 2-component paste-like bone cement formulations are in the group of bone cements which exhibit a higher creep resistance.
Collapse
Affiliation(s)
- Ulrike Köster
- Biomedical Materials and Implants Group, Fraunhofer Institute for Mechanics of Materials IWM, Wöhlerstraße 11, 79108 Freiburg, Germany
| | | | | | | | | | | | | |
Collapse
|
11
|
Webb JCJ, Spencer RF. The role of polymethylmethacrylate bone cement in modern orthopaedic surgery. ACTA ACUST UNITED AC 2007; 89:851-7. [PMID: 17673574 DOI: 10.1302/0301-620x.89b7.19148] [Citation(s) in RCA: 202] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Polymethylmethacrylate remains one of the most enduring materials in orthopaedic surgery. It has a central role in the success of total joint replacement and is also used in newer techniques such as percutaneous vertebroplasty and kyphoplasty. This article describes the current uses and limitations of polymethylmethacrylate in orthopaedic surgery. It focuses on its mechanical and chemical properties and links these to its clinical performance. The behaviour of antibiotic-loaded bone cement are discussed, together with areas of research that are now shedding light upon the behaviour of this unique biomaterial.
Collapse
Affiliation(s)
- J C J Webb
- Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK.
| | | |
Collapse
|
12
|
Kwong FNK, Power RA. A comparison of the shrinkage of commercial bone cements when mixed under vacuum. ACTA ACUST UNITED AC 2006; 88:120-2. [PMID: 16365134 DOI: 10.1302/0301-620x.88b1.16600] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The outcome of a cemented hip arthroplasty is partly dependent on the type of cement which is used. The production of an interface gap between the stem and the cement mantle as a result of shrinkage of the cement, may be a factor involved. Palacos R, Palacos LV (both with gentamicin), CMW 1, CMW 2, CMW Endurance (CMWE) and Simplex were prepared under vacuum and allowed to cure overnight in similar cylinders. The next day this volume was determined by the displacement of water. Shrinkage varied between 3.82% and 7.08% with CMWE having the lowest and Palacos LV the highest. This could be a factor to consider when choosing a cement for a shape-closed stem.
Collapse
Affiliation(s)
- F N K Kwong
- Department of Orthopaedics Glenfield Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, UK.
| | | |
Collapse
|
13
|
Dalén T, Nilsson KG. VersaBond bone cement prospective randomized study of the clinical properties of a new bone cement in total knee replacement. Knee 2005; 12:311-7. [PMID: 16026700 DOI: 10.1016/j.knee.2004.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2004] [Revised: 11/04/2004] [Accepted: 11/04/2004] [Indexed: 02/02/2023]
Abstract
VersaBond is a newly developed bone cement. To investigate its clinical performance, VersaBond was compared to Palacos R in a prospective randomized study in total knee replacement. Fifty-nine patients (61 knees) undergoing total knee replacement were randomized to either VersaBond or Palacos R bone cement and followed for 24 months using radiostereometric analysis (RSA). Up to 2 years there were no significant differences in clinical performance between the two cements. The mean/median values for implant migration were very similar for the two bone cements, as were the dispersion, and distribution of outliers. Also the proportion "stable" and "continuously migrating" implants was similar between the two cements. The result of this study indicates that VersaBond bone cement will perform at least equally as well as Palacos R in total knee replacement as regards as aseptic loosening.
Collapse
Affiliation(s)
- Tore Dalén
- Implant Research Unit, Department of Orthopaedics, Umeå University Hospital, Umeå S-901 85, Sweden.
| | | |
Collapse
|
14
|
Van Jonbergen JPW, Anderson PG, Faber FWM. Total hip arthroplasty with Boneloc cement: Unsatisfactory results in 163 hips after 9 to 11 years. Hip Int 2004; 14:229-232. [PMID: 28247396 DOI: 10.1177/112070000401400403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Boneloc bone cement was introduced in the Netherlands in 1992. Inferior short-term results were reported which led to the withdrawal of Boneloc from clinical use in 1995. However, little is known about the long-term outcome of hip arthroplasties with Boneloc. Between April 1992 and August 1994, Boneloc was used in 163 Mallory-Head primary total hip arthroplasties in 163 patients. Follow-up analysis was performed in 2003. To date, 27 hips (17%) have been revised for aseptic loosening of the femoral component. Median time to revision was 5.5 years. Survival analysis based on revision for aseptic loosening showed 77% cumulative survival at 11 years. With revision for aseptic loosening and/or definite radiological loosening according to Harris as endpoint, cumulative survival was 59% at 11 years. In 27 of 43 patients with definite radiological loosening, a cement fracture was seen at a median of 2.9 years. These results show failure of Boneloc cemented total hip arthroplasties occurring even during the later follow-up. Continuing periodic clinical and radiological examination is recommended. (Hip International 2004; 14: 229-32).
Collapse
|
15
|
Vasudev DV, Ricci JL, Sabatino C, Li P, Parsons JR. In vivo evaluation of a biomimetic apatite coating grown on titanium surfaces. ACTA ACUST UNITED AC 2004; 69:629-36. [PMID: 15162404 DOI: 10.1002/jbm.a.30028] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Osteoconductive mineral coatings represent an established technology for enhancing the integration of orthopedic implants with living bone. However, current coatings have limitations related to fabrication methods, attachment strength to metal substrates, and in vivo performance. Low temperature biomimetic growth is a coating technique wherein the device to be coated is immersed in a meta-stable saturated solution of the coating constituents and growth of the coating is then allowed to proceed on the surface of the device. This study focused on the in vivo evaluation of a biomimetic apatite coating fabricated under these conditions. The experiment was designed to specifically test the amount of bone ingrowth into the coated channels versus the uncoated channels of an established bone chamber system, with emphasis placed on the amount of bone present on the coupon surface. Three types of measurements were taken on each channel: linear ingrowth %, area ingrowth %, and continuous bone apposition %. The experiments demonstrated that under controlled conditions, the apatite coating appears to resorb in 8 weeks and did stimulate early osseointegration with the metal surface with a reduction in fibrous tissue encapsulation. This coating may, therefore, be useful in facilitating early bone ingrowth into porous surfaces without the potential for coating debris, macrophage infiltration, fibrous tissue encapsulation, and eventual coating failure as may occur with current plasma-sprayed hydroxapatite coating techniques.
Collapse
Affiliation(s)
- Deepta Vani Vasudev
- Department of Orthopaedics, UMDNJ-New Jersey Medical School, 185 South Orange Avenue, MSB G-574, Newark, NJ 07103, USA
| | | | | | | | | |
Collapse
|