Using a femoral head from one manufacturer on the stem of another manufacturer poses the risk that the taper interface between the components do not contact correctly and the performance of the joint will be impaired. The cohorts in this study are a combination of modular Birmingham Hip Resurfacing (BHR) and Adept femoral heads on CPT stems. The study reviews the geometry of the taper interfaces to establish if the taper clearance angles was outside of the normal range for other taper interfaces. In addition the rates of material loss from the bearings and taper and a ranking of the stem damage were reviewed to determine if the levels of loss were above that seen for other similar joints. The material loss analysis demonstrated that the rates or levels of loss from the bearings, taper and stem are no different to levels published for manufacturer matched joints and in many cases are lower. The results demonstrate that the taper clearance angles for the mixed manufacturer joints (BHR-CPT: 0.067 to −0.116, Adept-CPT: 0.101 to −0.056) were within the range of other studies and manufacturer matched clearances (0.134 to −0.149). Using components from different manufacturers has not in this instance increased the level of material loss from the joints, when compared to other similar manufacturer matched joints.
{"title":"THE PERFORMANCE OF MIXED MANUFACTURER METAL ON METAL TOTAL HIP REPLACEMENTS","authors":"R. Cook, B. Bolland, S. Tilley, J. Latham","doi":"10.15438/RR.7.2.165","DOIUrl":"https://doi.org/10.15438/RR.7.2.165","url":null,"abstract":"Using a femoral head from one manufacturer on the stem of another manufacturer poses the risk that the taper interface between the components do not contact correctly and the performance of the joint will be impaired. The cohorts in this study are a combination of modular Birmingham Hip Resurfacing (BHR) and Adept femoral heads on CPT stems. The study reviews the geometry of the taper interfaces to establish if the taper clearance angles was outside of the normal range for other taper interfaces. In addition the rates of material loss from the bearings and taper and a ranking of the stem damage were reviewed to determine if the levels of loss were above that seen for other similar joints. The material loss analysis demonstrated that the rates or levels of loss from the bearings, taper and stem are no different to levels published for manufacturer matched joints and in many cases are lower. The results demonstrate that the taper clearance angles for the mixed manufacturer joints (BHR-CPT: 0.067 to −0.116, Adept-CPT: 0.101 to −0.056) were within the range of other studies and manufacturer matched clearances (0.134 to −0.149). Using components from different manufacturers has not in this instance increased the level of material loss from the joints, when compared to other similar manufacturer matched joints.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"103 1","pages":"8-8"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90075383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-05-01DOI: 10.1299/JSMEBIO.2015.27.43
Masaki Nakao, K. Uchida, R. Sakai, Kouji Naruse, M. Takaso, K. Mabuchi
Background Residual stress remains in bone tissues after press-fit-fixation of a joint prosthesis, recently employed for joint arthroplasty. The response of bone tissues to the residual stress is, however, unknown because it is not physiological. This unnatural stimulus may have adverse effects on bone tissues, including causing thigh pain or bone resorption. In the present study, we designed an experimental method to apply a stationary load from inside an animal femur using a loop spring of titanium alloy with super elasticity. The femoral response was assessed based on the migration of the wire into bone twelve weeks after implantation. As the results, wire migration was noted in 10 of 11 cases. Methods We developed a method using a loop spring made of super elastic titanium alloy, which can maintain sufficient stress in a rat femur for a prolonged period. This titanium alloy, which contains 43.94% titanium and 56.06% nickel, was supplied as a wire (WDL1, Actment Co., Ltd., Kasukabe, Japan). In the present study, an experimental method was designed to apply a stationary load from inside a rat femur by inserting a loop spring made of super elastic wire. Results Ten weeks after implantation, migration of the spring wire into the cortical bone was noted in 10 of 11 cases. To assess spring migration in cortical bone, we measured the distance from the endocortical surface to the tip of springs on micro-CT images. The line of the endocortical surface was extrapolated from the adjacent to the wire contact area. The estimated load was distributed from 1.19 to 3.28 N. The migration depth on anterior and posterior sides was not associated with the estimated load. Discussion In the present study, we developed a method of generating a stationary stress field in a rat femur using a loop spring made from Ni-Ti alloy with super ermore, implantation of the pin was presumed to be able to interpretation by the thelasticity. The load that originated from elastic deformation was large enough to apply mechanical stimulation to bone tissue. The estimated load was distributed from 1.19 to 3.28 N. Migration of the implanted loop spring in the femur was observed in ten of the eleven. The migration depth apparently did not increase with the increase in estimated load. Therefore, regardless of the load, that is stationary load is applied has been suggested to be involved in the migration of the pin. Furtheory of bone remodeling. n a state where the pin load of is applied, the bone implanted pin to which was destroyed by osteoclasts, was presumed to occur is bone formation in the implanted state. Interpretation The present findings suggest that an excessive stationary load at the implant surface induces endosteal bone resorption together with the migration or protrusion of a prosthesis.
{"title":"RESPONSE OF BONE ON STATIONARY LOAD FROM THE INPLANT","authors":"Masaki Nakao, K. Uchida, R. Sakai, Kouji Naruse, M. Takaso, K. Mabuchi","doi":"10.1299/JSMEBIO.2015.27.43","DOIUrl":"https://doi.org/10.1299/JSMEBIO.2015.27.43","url":null,"abstract":"Background Residual stress remains in bone tissues after press-fit-fixation of a joint prosthesis, recently employed for joint arthroplasty. The response of bone tissues to the residual stress is, however, unknown because it is not physiological. This unnatural stimulus may have adverse effects on bone tissues, including causing thigh pain or bone resorption. In the present study, we designed an experimental method to apply a stationary load from inside an animal femur using a loop spring of titanium alloy with super elasticity. The femoral response was assessed based on the migration of the wire into bone twelve weeks after implantation. As the results, wire migration was noted in 10 of 11 cases. Methods We developed a method using a loop spring made of super elastic titanium alloy, which can maintain sufficient stress in a rat femur for a prolonged period. This titanium alloy, which contains 43.94% titanium and 56.06% nickel, was supplied as a wire (WDL1, Actment Co., Ltd., Kasukabe, Japan). In the present study, an experimental method was designed to apply a stationary load from inside a rat femur by inserting a loop spring made of super elastic wire. Results Ten weeks after implantation, migration of the spring wire into the cortical bone was noted in 10 of 11 cases. To assess spring migration in cortical bone, we measured the distance from the endocortical surface to the tip of springs on micro-CT images. The line of the endocortical surface was extrapolated from the adjacent to the wire contact area. The estimated load was distributed from 1.19 to 3.28 N. The migration depth on anterior and posterior sides was not associated with the estimated load. Discussion In the present study, we developed a method of generating a stationary stress field in a rat femur using a loop spring made from Ni-Ti alloy with super ermore, implantation of the pin was presumed to be able to interpretation by the thelasticity. The load that originated from elastic deformation was large enough to apply mechanical stimulation to bone tissue. The estimated load was distributed from 1.19 to 3.28 N. Migration of the implanted loop spring in the femur was observed in ten of the eleven. The migration depth apparently did not increase with the increase in estimated load. Therefore, regardless of the load, that is stationary load is applied has been suggested to be involved in the migration of the pin. Furtheory of bone remodeling. n a state where the pin load of is applied, the bone implanted pin to which was destroyed by osteoclasts, was presumed to occur is bone formation in the implanted state. Interpretation The present findings suggest that an excessive stationary load at the implant surface induces endosteal bone resorption together with the migration or protrusion of a prosthesis.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"311 1","pages":"76-76"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78274722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-05-01DOI: 10.1016/j.asmart.2017.05.128
A. Sato, H. Takagi, S. Asai
{"title":"SING CONTRAST ENHANCED CT AND VENOUS ULTRASONOGRAPHY IN JAPANESE PATIENTS","authors":"A. Sato, H. Takagi, S. Asai","doi":"10.1016/j.asmart.2017.05.128","DOIUrl":"https://doi.org/10.1016/j.asmart.2017.05.128","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"123 1","pages":"16-16"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85688974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective The purpose of this study was to evaluate the efficacy and safety of the drained-clamped method with intra-articular infusion of tranexamic acid (TA) for reducing blood loss in total knee arthroplasty (TKA). Material and Methods From November 2011 to July 2014 inclusive, 72 patients with a diagnosis of osteoarthritis underwent unilateral primary TKA using a computed tomography (CT) free navigation system. Patients were randomly divided into two groups: group T (n=40) was given 2000 mg (40 ml) of TA and group W (n=32) was given 40 ml sterile saline only. All operations were performed under total anaesthesia through the medial mid-vastus approach. Cemented posterior stabilised or cruciate retaining prostheses were used. The patella was resurfaced. After tourniquet release and wound suture, TA or saline was infused into the knee joint in addition to the drained-clamped method for 2 hours. For VTE prophylaxis, all patients received bilateral intermittent pneumatic calf compressors, thromboembolic deterrent stockings, and subcutaneous injection of enoxaparin (4000IU daily). We evaluated the hematocrit, hemoglobin and the postoperative estimate of bleeding. At postoperative days 4, extremity venous ultrasonography was performed for the investigation of venous thromboembolism in the latest 40 patients and contrast-enhanced CT was performed in the latest 34 patients without a previous history of asthma and diminished renal function. The present study received institutional review board approval, and informed consent was obtained from all patients. Results Group T had lower hematocrit and hemoglobin levels at postoperative day 1. Group T had higher hemoglobin levels at postoperative days 3 and 7, respectively. The postoperative estimate of bleeding in group T was 739.2 ± 318.9 ml on average, which was significantly less than group W which was 999.8 ± 414.1 ml (p The rate of asymptomatic deep vein thrombosis and pulmonary embolism was 57.1% and 29.4% in group T, and 36.8% and 11.8% in group W, respectively. There were no significant differences between the two groups. Conclusion The drain-clamped method with intra-articular infusion of TA was safe and effective for reducing the amount of blood loss in TKA, without increasing the risk of VTE.
目的评价氨甲环酸(TA)关节内灌注引流夹紧法在全膝关节置换术(TKA)中减少失血量的疗效和安全性。材料与方法2011年11月至2014年7月，72例诊断为骨关节炎的患者采用计算机断层扫描(CT)自由导航系统行单侧原发性TKA。将患者随机分为两组:T组(n=40)给予TA 2000 mg (40 ml)， W组(n=32)给予无菌生理盐水40 ml。所有手术均在全麻醉下通过内侧股中入路进行。使用骨水泥后固定或十字保留假体。髌骨重新铺面。止血带解除，伤口缝合后，在引流夹紧法的基础上，向膝关节内灌注TA或生理盐水2小时。对于静脉血栓栓塞预防，所有患者均接受双侧间歇气动小腿压缩机、血栓栓塞威慑长袜和皮下注射依诺肝素(每天4000IU)。我们评估了红细胞压积、血红蛋白和术后出血的估计。术后第4天，最近40例患者行下肢静脉超声检查静脉血栓栓塞，最近34例无哮喘和肾功能减退病史的患者行增强CT检查。本研究获得了机构审查委员会的批准，并获得了所有患者的知情同意。结果T组术后第1天红细胞压积和血红蛋白水平较低。T组术后第3天和第7天血红蛋白水平分别较高。T组术后估计出血平均为739.2±318.9 ml，明显低于W组的999.8±414.1 ml (p)。T组无症状深静脉血栓和肺栓塞发生率分别为57.1%和29.4%，W组为36.8%和11.8%。两组间无显著差异。结论引流夹紧法关节内灌注TA安全有效，可减少TKA出血量，不增加VTE的发生风险。
{"title":"EFFECT OF THE DRAINED-CLAMPED METHOD WITH INTRA-ARTICULAR INFUSION OF TRANEXAMIC ACID IN TOTAL KNEE ARTHROPLASTY - A RANDOMIZED PROSPECTIVE STUDY","authors":"S. Asai, H. Takagi","doi":"10.11551/JSJD.34.67","DOIUrl":"https://doi.org/10.11551/JSJD.34.67","url":null,"abstract":"Objective The purpose of this study was to evaluate the efficacy and safety of the drained-clamped method with intra-articular infusion of tranexamic acid (TA) for reducing blood loss in total knee arthroplasty (TKA). Material and Methods From November 2011 to July 2014 inclusive, 72 patients with a diagnosis of osteoarthritis underwent unilateral primary TKA using a computed tomography (CT) free navigation system. Patients were randomly divided into two groups: group T (n=40) was given 2000 mg (40 ml) of TA and group W (n=32) was given 40 ml sterile saline only. All operations were performed under total anaesthesia through the medial mid-vastus approach. Cemented posterior stabilised or cruciate retaining prostheses were used. The patella was resurfaced. After tourniquet release and wound suture, TA or saline was infused into the knee joint in addition to the drained-clamped method for 2 hours. For VTE prophylaxis, all patients received bilateral intermittent pneumatic calf compressors, thromboembolic deterrent stockings, and subcutaneous injection of enoxaparin (4000IU daily). We evaluated the hematocrit, hemoglobin and the postoperative estimate of bleeding. At postoperative days 4, extremity venous ultrasonography was performed for the investigation of venous thromboembolism in the latest 40 patients and contrast-enhanced CT was performed in the latest 34 patients without a previous history of asthma and diminished renal function. The present study received institutional review board approval, and informed consent was obtained from all patients. Results Group T had lower hematocrit and hemoglobin levels at postoperative day 1. Group T had higher hemoglobin levels at postoperative days 3 and 7, respectively. The postoperative estimate of bleeding in group T was 739.2 ± 318.9 ml on average, which was significantly less than group W which was 999.8 ± 414.1 ml (p The rate of asymptomatic deep vein thrombosis and pulmonary embolism was 57.1% and 29.4% in group T, and 36.8% and 11.8% in group W, respectively. There were no significant differences between the two groups. Conclusion The drain-clamped method with intra-articular infusion of TA was safe and effective for reducing the amount of blood loss in TKA, without increasing the risk of VTE.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"116 8 1","pages":"24-24"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84241346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-05-01DOI: 10.1016/j.joca.2017.02.739
S. Tsuji
{"title":"THE NEW METHOD OF ADJUSTING THE GAP FOR UKA","authors":"S. Tsuji","doi":"10.1016/j.joca.2017.02.739","DOIUrl":"https://doi.org/10.1016/j.joca.2017.02.739","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"249 1","pages":"86-86"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77875804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-03-30DOI: 10.3389/conf.FBIOE.2016.01.01375
N. V. Gestel, J. Arts, D. Hulsen, J. Geurts, Keita Ito, B. Rietbergen
Background Bio-Active Glass (BAG) is a promising bone graft substitute for large bone defect reconstruction because of its favourable osteoconductive, antibacterial and angiogenic properties. Potentially, it could also mechanically reinforce the defect, thus making it suitable for load-bearing defects. However, the mechanical properties of the reconstructive layer consisting of BAG/bone allograft mixtures are unknown. The goals of this study therefore were, first, to measure the mechanical properties of different BAG/bone graft mixtures and, second, to investigate to what extent such mixtures could reinforce distal tibial defects using micro-FE analysis and high-resolution CT scans. Materials and Methods Four different BAG/bone graft mixtures were impacted in a cylindrical holder, mechanically tested in confined compression and scanned with micro-CT. From these images, bone graft material and glass were segmented using two different threshold values. The interface between bone and BAG was modelled separately by dilating the glass phase. Micro-Finite-Element (FE) models of the composites were made using a Young9s modulus of 2.5 GPa for bone and 35 GPa for BAG. The Young9s modulus for the interface region was determined by fitting experimental and micro-FE results for the same specimens. (82 μm resolution) CT scans of a 9 mm region of the distal tibia of 3 subjects were used. Micro-FE models of this region were made to determine its stiffness in the original state, with a simulated cortical defect and after a mixture of BAG/bone was modelled in the defect. Results The confined compression tests showed a strong dependence of the modulus of the BAG/bone composite on the amount of BAG, ranging from 116.7 ± 18.2 to 654.2 ± 35.2 MPa. The micro-FE results could well reproduce these measured moduli, when using a stiffness of 25 MPa for the interface layer. The micro-FE analyses of the cortical defect demonstrated that the stiffness of the tibial segment would be reduced by 13 ± 3 % with the defect. Treatment with the BAG/bone composite could restore the stiffness to 101 ± 6 % of its original value. Discussion The experiments demonstrate that BAG/bone mixtures have a composition-dependent stiffness, in the range of that of trabecular bone, which can be well estimated from micro-FE analyses. Furthermore, the tibial micro-FE analyses demonstrate that these mixtures potentially can restore the stiffness of large bone defects at this site. Future development of the model may predict mechanical behaviour of BAG/bone mixtures patient specifically.
{"title":"BIOACTIVE GLASS CAN POTENTIALLY REINFORCE LARGE BONE DEFECTS","authors":"N. V. Gestel, J. Arts, D. Hulsen, J. Geurts, Keita Ito, B. Rietbergen","doi":"10.3389/conf.FBIOE.2016.01.01375","DOIUrl":"https://doi.org/10.3389/conf.FBIOE.2016.01.01375","url":null,"abstract":"Background Bio-Active Glass (BAG) is a promising bone graft substitute for large bone defect reconstruction because of its favourable osteoconductive, antibacterial and angiogenic properties. Potentially, it could also mechanically reinforce the defect, thus making it suitable for load-bearing defects. However, the mechanical properties of the reconstructive layer consisting of BAG/bone allograft mixtures are unknown. The goals of this study therefore were, first, to measure the mechanical properties of different BAG/bone graft mixtures and, second, to investigate to what extent such mixtures could reinforce distal tibial defects using micro-FE analysis and high-resolution CT scans. Materials and Methods Four different BAG/bone graft mixtures were impacted in a cylindrical holder, mechanically tested in confined compression and scanned with micro-CT. From these images, bone graft material and glass were segmented using two different threshold values. The interface between bone and BAG was modelled separately by dilating the glass phase. Micro-Finite-Element (FE) models of the composites were made using a Young9s modulus of 2.5 GPa for bone and 35 GPa for BAG. The Young9s modulus for the interface region was determined by fitting experimental and micro-FE results for the same specimens. (82 μm resolution) CT scans of a 9 mm region of the distal tibia of 3 subjects were used. Micro-FE models of this region were made to determine its stiffness in the original state, with a simulated cortical defect and after a mixture of BAG/bone was modelled in the defect. Results The confined compression tests showed a strong dependence of the modulus of the BAG/bone composite on the amount of BAG, ranging from 116.7 ± 18.2 to 654.2 ± 35.2 MPa. The micro-FE results could well reproduce these measured moduli, when using a stiffness of 25 MPa for the interface layer. The micro-FE analyses of the cortical defect demonstrated that the stiffness of the tibial segment would be reduced by 13 ± 3 % with the defect. Treatment with the BAG/bone composite could restore the stiffness to 101 ± 6 % of its original value. Discussion The experiments demonstrate that BAG/bone mixtures have a composition-dependent stiffness, in the range of that of trabecular bone, which can be well estimated from micro-FE analyses. Furthermore, the tibial micro-FE analyses demonstrate that these mixtures potentially can restore the stiffness of large bone defects at this site. Future development of the model may predict mechanical behaviour of BAG/bone mixtures patient specifically.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"2 1","pages":"73-73"},"PeriodicalIF":0.0,"publicationDate":"2016-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82868076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-01DOI: 10.17265/2328-2150/2016.08.008
B. Gaechter, S. Schlunke, P. Biegger
Diabetic foot syndrome with osteomyelitis of metatarsal head show frequent recurrence and need a very long antibiotic treatment, often only to see the inflammation flare up once antibiotic are dismissed. We present our initial experience about 3 patients presenting a clinical and radiologically confirmed osteomyelitis of the metatarsal head. We treated them with limited resection of metatarsal head, microbiologic sample and filling of the remaining metatarsal canal by means of an absorbable antibiotic loaded bone graft substitute, packing an absorbable antibiotic sponge (Gentamycin) in place of the metatarsal head and direct skin closure. All patients had an orthesis avoiding fore-foot weight bearing during the first month, but allowing them to walk normally. Follow up took place on a weekly rhythm during the first month, every fortnight during the 2° month and after this once a month. Actually the follow up period extends from 4 – 7 months. None of the treated 3 patients did need any second look operation nor did they present any local complications. Due to the type of resorbable implant used, some oozing of transparent liquid during the first 4 weeks may present and is to be considered normal. This new method presents a valid alternative to the more classic “two step cement nail” procedure of active osteomyelitis treatment. We consider planing long term study and a multicenter randomized trial.
{"title":"ANTIBIOTIC-LOADED RESORBABLE BONE-GRAFT SUBSTITUTE: A NEW TREATMENT FOR OSTEOMYELITIS IN DIABETIC FOOT SYNDROME","authors":"B. Gaechter, S. Schlunke, P. Biegger","doi":"10.17265/2328-2150/2016.08.008","DOIUrl":"https://doi.org/10.17265/2328-2150/2016.08.008","url":null,"abstract":"Diabetic foot syndrome with osteomyelitis of metatarsal head show frequent recurrence and need a very long antibiotic treatment, often only to see the inflammation flare up once antibiotic are dismissed. We present our initial experience about 3 patients presenting a clinical and radiologically confirmed osteomyelitis of the metatarsal head. We treated them with limited resection of metatarsal head, microbiologic sample and filling of the remaining metatarsal canal by means of an absorbable antibiotic loaded bone graft substitute, packing an absorbable antibiotic sponge (Gentamycin) in place of the metatarsal head and direct skin closure. All patients had an orthesis avoiding fore-foot weight bearing during the first month, but allowing them to walk normally. Follow up took place on a weekly rhythm during the first month, every fortnight during the 2° month and after this once a month. Actually the follow up period extends from 4 – 7 months. None of the treated 3 patients did need any second look operation nor did they present any local complications. Due to the type of resorbable implant used, some oozing of transparent liquid during the first 4 weeks may present and is to be considered normal. This new method presents a valid alternative to the more classic “two step cement nail” procedure of active osteomyelitis treatment. We consider planing long term study and a multicenter randomized trial.","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"15 1","pages":"116-116"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75117519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-11-01DOI: 10.1016/J.IJSU.2015.07.383
R. Alho, F. Henderson, P. Rowe, A. Deakin, J. Clarke, F. Picard
{"title":"ASSESSMENT OF ANTEROPOSTERIOR [AP] KNEE JOINT LAXITY USING NON-INVASIVE NAVIGATION IN HEALTHY VOLUNTEERS","authors":"R. Alho, F. Henderson, P. Rowe, A. Deakin, J. Clarke, F. Picard","doi":"10.1016/J.IJSU.2015.07.383","DOIUrl":"https://doi.org/10.1016/J.IJSU.2015.07.383","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"52 1","pages":"20-20"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76609639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Rajkumar, S. Thiagaraj, A Ghoz, R. Dodds, S. Tavares
{"title":"DOES INTRAMEDULLARY PLUGGING REDUCE BLOOD TRANSFUSION REQUIREMENTS IN TOTAL KNEE REPLACEMENT?: A RANDOMISED CONTROLLED TRIAL","authors":"S. Rajkumar, S. Thiagaraj, A Ghoz, R. Dodds, S. Tavares","doi":"10.1186/isrctn94713892","DOIUrl":"https://doi.org/10.1186/isrctn94713892","url":null,"abstract":"","PeriodicalId":15048,"journal":{"name":"Journal of Bone and Joint Surgery-british Volume","volume":"21 1","pages":"24-24"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76672376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-09-14DOI: 10.3389/CONF.FBIOE.2016.01.02282
Ajami Sara, Coathup Melanie, Khoury Joseph, Blunn Gordon
Background Polyetheretherketone (PEEK) may be advantageous as an alternative material to metal alloys in some orthopaedic applications. However, it is bioinert and does not osseointegrate1. A novel accelerated neutral atom beam technique (ANAB) has been developed to improve the bioactivity of PEEK where the surface is modified to a depth of 5 nm without affecting the integrity of the underlying PEEK structure2. Aim The aim of this study was to investigate the growth of human Mesenchymal Stem Cells (hMSCs), adult human Osteoblasts (hOB) and skin Fibroblasts (BR3G) on PEEK and ANAB treated PEEK. Materials and Methods The surface properties of PEEK and ANAB PEEK were characterized by measuring surface roughness and contact angle. Cells were seeded at a density of 10,000/cm2 on PEEK, ANAB PEEK and a Thermonox control. Cell proliferation, attachment, and alkaline phosphatase (ALP) activity on these surfaces was quantified at 7 and 14 days (n = 2). Cell attachment was measured by staining adhesion plaques with anti-vinculin and counting the number of plaques in cells at day 3. As the data was non parametric a Mann Whitney-U test was used to compare groups where p values Results ANAB treatment increased the hydrophilicity of the PEEK surface (91.74 ± 4.80° (PEEK) vs 74.82 ± 2.70° (ANAB PEEK), P Conclusion ANAB increased the bioactivity and enhanced the differentiation of osteoblasts on PEEK. This method may improve the osseointegration of PEEK implants. Acknowledgements ORUK Exogenesis
背景聚醚醚酮(PEEK)作为金属合金的替代材料在某些骨科应用中具有优势。然而，它是生物惰性的，不能骨整合。一种新的加速中性原子束技术(ANAB)已经被开发出来以提高PEEK的生物活性，其中表面被修饰到5nm深度而不影响PEEK底层结构的完整性2。目的研究人间充质干细胞(hMSCs)、成人成骨细胞(hOB)和皮肤成纤维细胞(BR3G)在PEEK和ANAB处理的PEEK上的生长情况。材料与方法通过测量表面粗糙度和接触角来表征PEEK和ANAB PEEK的表面性能。细胞以10,000/cm2的密度接种在PEEK、ANAB PEEK和Thermonox对照上。在第7天和第14天(n = 2)，对这些表面的细胞增殖、附着和碱性磷酸酶(ALP)活性进行量化。在第3天，用抗血管素染色粘附斑块并计数细胞中斑块的数量，以测量细胞的附着。结果ANAB处理增加了PEEK表面的亲水性(91.74±4.80°(PEEK) vs 74.82±2.70°(ANAB PEEK)， p结论ANAB增加了PEEK表面的生物活性并促进了成骨细胞的分化。该方法可改善PEEK种植体的骨整合。ORUK Exogenesis
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