Assessment of cup position from plain radiographs: impact of pelvic tilting

The acetabular cup position after total hip arthroplasty (THA) regarding its inclination and version angles are influential parameters concerning the postoperative range of motion and dislocation stability. Standard anterior-posterior X-rays remain an important diagnostic instrument to observe the postoperative outcome and to secure quality control after THA, where an optimal positioning of the patient is recommended when taking these X-rays. The purpose of this preliminary study was to determine the effect of pelvic tilting regarding the positioning calculation of the acetabular cup from standard radiographs using a modified method according to Pettersson et al. (Acta Radiol Diagn, 23:259-263, 1982). In our model experiment, we were able to show that pelvic tilting to either side causes a considerable difference between the radiographic and calculated version angles following approximately linear functions. However, pelvic tilting to either side, leads, regarding the calculation of the inclination, to an average deviation between radiographic and calculated inclination angles less than 2 degrees .

A novel antibacterial titania coating: metal ion toxicity and in vitro surface colonization

Postoperative implant-associated infection is still an unresolved and serious complication in modern surgery. Antibacterial and biocompatible surfaces could both reduce infection rates and promote tissue integration. In this respect, a comparative study of the antibacterial as well as the biocompatible potential of different metal ions in vitro is presented. The assays used were growth inhibition tests with different metal salts carried out with tissue cells and bacteria under corresponding culture conditions. Additionally, in vitro tests in direct surface contact with tissue cells and bacteria onto a novel copper containing sol-gel derived titanium dioxide coating (Cu-TiO2) and a fourfold Cu-TiO2 coating were performed. The values were compared to a non-filled titanium dioxide coating and standard Ti6Al4V alloy. SEM-investigations were performed to approve the results of the in vitro tests. Among Ag+, Zn2+, Co2+, Al3+ and Hg2+, the growth inhibition tests revealed an outstanding position of copper ions as antibacterial but nevertheless bio-tolerant additive. These results were affirmed by the cell tests in direct surface contact and SEM-investigations, where best cell growth was found on the Cu-TiO2 coatings. Highest antibacterial properties with a tolerable cytocompatibility could be observed on the fourfold Cu-TiO2 coatings. Consequently, surfaces with custom-tailored antibacterial properties may be established and could be of particular interest in revision and tumor arthroplasty.