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Alicja J Bojan, Anders Jönsson, Hans Granhed, Carl Ekholm, Johan Kärrholm
Cut-out complication remains a major unsolved problem in the treatment of trochanteric hip fractures. A better understanding of the three-dimensional fracture-implant motions is needed to enable further development of clinical strategies and countermeasures. The aim of this clinical study was to characterise and quantify three-dimensional motions between the implant and the bone and between the lag screw and nail of the Gamma nail. Radiostereometry Analysis (RSA) analysis was applied in 20 patients with trochanteric hip fractures treated with an intramedullary nail...
March 2018: Injury
Vasileios Zampelis, Ola Belfrage, Magnus Tägil, Martin Sundberg, Gunnar Flivik
Background and purpose - Impaction bone grafting (IBG) in revision hip surgery is an established method in restoring bone stock deficiencies. We hypothesized that local treatment of the morsellized allograft with a bisphosphonate in cemented revision would, in addition to increased bone density, also reduce the early migration of the cup as measured by radiostereometry (RSA). Patients and methods - 20 patients with aseptic cup loosening underwent revision using the IBG technique. The patients were randomized to either clodronate (10 patients) or saline (10 patients, control group) as local adjunct to the morsellized bone...
February 2018: Acta Orthopaedica
M Mohaddes, B Shareghi, J Kärrholm
AIMS: The aim of this study was to compare the incidence of aseptic loosening after the use of a cemented acetabular component and a Trabecular Metal (TM) acetabular component (Zimmer Inc., Warsaw, Indiana) at acetabular revision with bone impaction grafting. PATIENTS AND METHODS: A total of 42 patients were included in the study. Patients were randomised to receive an all- polyethylene cemented acetabular component (n = 19) or a TM component (n = 23). Radiostereometric analysis and conventional radiographic examinations were performed regularly up to two years post-operatively or until further revision...
July 2017: Bone & Joint Journal
Kristian Horsager, Bart L Kaptein, Peter B Jørgensen, Claus F Jepsen, Maiken Stilling
The Oxford medial unicompartmental knee is designed fully congruent, with the purpose of maintaining a large contact-area throughout motion and minimize wear. No other study has investigated this design feature in-vivo. We aimed to evaluate if contact-loss was introduced between the articulating surfaces of the Oxford medial unicompartmental knee during bicycle- and step-cycle motion, and whether this correlated with essential implant parameters, such as polyethylene (PE) wear, knee-loadings, and clinical outcome...
January 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Asgeir Gudnason, Gunnar Adalberth, Kjell-Gunnar Nilsson, Nils P Hailer
Background and purpose - Maximal total point motion (MTPM) measured by radiostereometry (RSA) is widely used as a predictor of total knee arthroplasty (TKA) loosening. We compared the ability of different RSA measurements at different time points to predict loosening of tibial TKA components in the long term. Patients and methods - 116 TKAs in 116 patients were included in our analysis. 16 (14.8-17.4) years after surgery, 5 tibial components had been revised due to aseptic loosening. Receiver operating characteristic curves were calculated in order to investigate the specificity and sensitivity of different RSA parameters at different thresholds...
June 2017: Acta Orthopaedica
Volker Otten, Gerald Q Maguire, Marilyn E Noz, Michael P Zeleznik, Kjell G Nilsson, Henrik Olivecrona
As part of the 14-year follow-up of a prospectively randomized radiostereometry (RSA) study on uncemented cup fixation, two pairs of stereo radiographs and a CT scan of 46 hips were compared. Tantalum beads, inserted during the primary operation, were detected in the CT volume and the stereo radiographs and used to produce datasets of 3D coordinates. The limit of agreement between the combined CT and RSA datasets was calculated in the same way as the precision of the double RSA examination. The precision of RSA corresponding to the 99% confidence interval was 1...
2017: BioMed Research International
A Senioris, T Rousseau, M L'Hermette, S Gouzy, F Duparc, F Dujardin
BACKGROUND: In current practice, anterior cruciate ligament (ACL) tears can be diagnosed using several devices to measure anterior tibial translation and rotational knee laxity, but these measures are never collected together. The Rotab®, which yields simultaneous measurements of anterior tibial translation and passive lower limb rotation under stress, would therefore be advantageous in current practice, but its reliability has never been tested. AIM OF STUDY: To evaluate the accuracy and reliability of the Rotab® compared to the reference system, radiostereometric analysis (RSA)...
March 2017: Knee
Maziar Mohaddes, Peter Herberts, Henrik Malchau, Per-Erik Johanson, Johan Kärrholm
BACKGROUND: Bone impaction grafting is a biologically and mechanically appealing option in acetabular revision surgery, allowing restitution of the bone stock and restoration of the biomechanics. We analysed differences in proximal migration of the revision acetabular components when bone impaction grafting is used together with a cemented or an uncemented cup. PATIENTS AND METHODS: 43 patients (47 hips), revised due to acetabular loosening and judged to have less than 50% host bone-implant contact were included...
May 12, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Cyrus Brodén, Henrik Olivecrona, Gerald Q Maguire, Marilyn E Noz, Michael P Zeleznik, Olof Sköldenberg
Background and Purpose. The gold standard for detection of implant wear and migration is currently radiostereometry (RSA). The purpose of this study is to compare a three-dimensional computed tomography technique (3D CT) to standard RSA as an alternative technique for measuring migration of acetabular cups in total hip arthroplasty. Materials and Methods. With tantalum beads, we marked one cemented and one uncemented cup and mounted these on a similarly marked pelvic model. A comparison was made between 3D CT and standard RSA for measuring migration...
2016: BioMed Research International
Olof Sköldenberg, Agata Rysinska, Ghazi Chammout, Mats Salemyr, Olle Muren, Henrik Bodén, Thomas Eisler
INTRODUCTION: In vitro, Vitamin-E-diffused, highly cross-linked polyethylene (PE) has been shown to have superior wear resistance and improved mechanical properties when compared to those of standard highly cross-linked PE liners used in total hip arthroplasty (THA). The aim of the study is to evaluate the safety of a new cemented acetabular cup with Vitamin-E-doped PE regarding migration, head penetration and clinical results. METHODS AND ANALYSIS: In this single-centre, double-blinded, randomised controlled trial, we will include 50 patients with primary hip osteoarthritis scheduled for THA and randomise them in a 1:1 ratio to a cemented cup with either argon gas-sterilised PE (control group) or Vitamin-E-diffused PE (vitamin-e group)...
July 7, 2016: BMJ Open
Paul Axelsson, Björn Strömqvist
Background and purpose - Randomized trials have found that treating spinal burst fractures with reduction and posterior fixation is adequate without the use of bone grafting for definitive fusion. Restitution of intervertebral mobility of such an unfused segment after fracture healing may unload the adjacent parts of the spine and reduce the risk of degeneration of these segments. We used radiostereometry (RSA) to study whether late implant removal would restore the intervertebral mobility of a thoracolumbar segment treated with posterior instrumentation but no bone grafting for unstable spinal fracture...
October 2016: Acta Orthopaedica
Per-Erik Johanson, Martin Antonsson, Bita Shareghi, Johan Kärrholm
BACKGROUND: Radiostereometry (RSA) measurements of early micromotion can predict later failure in hip and knee prostheses. In hip implants, RSA has been particularly helpful in the evaluation of composite-beam stem designs. The Spectron EF Primary stem (Smith & Nephew, London, UK) has shown inferior performance compared with its predecessors in both clinical studies and registry reports. Early RSA studies have shown somewhat greater subsidence for the Spectron EF Primary stem compared with the earlier Spectron EF, but still within boundaries considered to be safe...
October 2016: Clinical Orthopaedics and related Research
Bernhard Flatøy, Stephan M Röhrl, Berte Bøe, Lars Nordsletten
BACKGROUND AND PURPOSE: Hydroxyapatite has been used for a long time as an adjunct to enhance cementless fixation. The benefit of this is still debated, but new methods of hydroxyapatite deposition have emerged, offering possible gains. In order to investigate this further, we compared the migration pattern and periprosthetic bone remodeling in a cementless femoral stem with either electrochemically deposited hydroxyapatite-called Bonemaster (BM)-or a conventional plasma-sprayed hydroxyapatite (HA) coating...
February 2016: Acta Orthopaedica
Monique A E Schoeman, Bart G Pijls, Angela E Oostlander, Johan C Keurentjes, Edward R Valstar, Rob G H H Nelissen, Ingrid Meulenbelt
To allow prediction of the risk of loosening prior to surgery, we investigated the relationship between innate immune cytokine response via TLR2 stimulation and early migration of six different knee prostheses using RSA (radiostereometry). This study included 114 patients of a prospective RSA-cohort who received a total knee arthroplasty. Whole blood cytokine responses were obtained by ex vivo stimulation with tripalmitoyl-S-glycerylcysteine (Pam3Cys-SK4) for assessment of the TLR2 immune response. Early migration was calculated using the maximum total point motion (MTPM) 1 year post surgery...
January 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Bernhard Flatøy, Jonas Rydinge, Jon Dahl, Stephan M Röhrl, Lars Nordsletten
PURPOSE: Cross-linking has proven effective in reducing polyethylene wear in total hip replacements. However, increasing the amount of cross-links will impair other mechanical properties of the polyethylene. The optimal threshold of crosslinking has still not been established. This led to the development of a moderately cross-linked (5 Mrad) cemented cup in which wear and stability is yet to be determined. METHODS: A total of, 70 hips were included in this case series on the cemented Marathon® cup...
May 2015: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Einar Lindalen, Lars Nordsletten, Øystein Høvik, Stephan M Röhrl
BACKGROUND: Polyethylene wear has been a major cause of revision of cementless total hip replacements. Highly cross-linked polyethylene has been developed to increase mechanical resistance to wear. However, cross-linking from irradiation of the polyethylene generates free radicals and these can oxidise in vivo and might over time alter the initial mechanical properties. Vitamin-E infused highly cross-linked polyethylene has been developed to reduce the amount of free radicals without compromising the mechanical properties...
January 2015: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Mats Salemyr, Olle Muren, Torbjörn Ahl, Henrik Bodén, Ghazi Chammout, André Stark, Olof Sköldenberg
PURPOSE: We hypothesized that a vitamin E-treated polyethylene articulating liner had lower femoral head penetration than a conventional liner. METHODS: Fifty-one patients with primary hip osteoarthritis were randomized to an uncemented cup with either vitamin E-treated highly cross-linked polyethylene (HXLPE) (vitamin-e group, n = 25) or a standard HXLPE liner (control group, n = 26) and followed for two years after surgery. The outcome variable was polyethylene (PE) linear head penetration, measured with radiostereometry (RSA)...
August 2015: International Orthopaedics
Mats Salemyr, Olle Muren, Thomas Eisler, Henrik Bodén, Ghazi Chammout, André Stark, Olof Sköldenberg
PURPOSE: The purpose of this study was to determine if a new titanium cup with increased porosity resulted in different periacetabular bone loss and migration compared to a porous coated cup. METHODS: Fifty-one patients with primary hip osteoarthritis were randomized to either a cup with porous titanium construct backside (porous titanium group, n = 25) or a conventional porous coated titanium cup (control group, n = 26). The primary outcome variable was change in periacetabular bone mineral density two years after surgery measured with dual energy X-ray absorptiometry (DXA)...
May 2015: International Orthopaedics
Inger Mechlenburg, Thomas M Klebe, Kaj V Døssing, Anders Amstrup, Kjeld Søballe, Maiken Stilling
BACKGROUND: Implant migration, bone mineral density (BMD), length of glenohumeral offset (LGHO), and clinical results were compared for the Copeland (Biomet Inc, Warsaw, IN, USA) and the Global C.A.P. (DePuy Int, Warsaw, IN, USA) humeral head resurfacing implants (HHRIs). METHODS: The study randomly allocated 32 patients (13 women), mean age 63 years (range, 39-82 years), with shoulder osteoarthritis to a Copeland (n = 14) or Global C.A.P. (n = 18) HHRI. Patients were monitored for 2 years with radiostereometry, dual-energy X-ray absorptiometry, Constant Shoulder Score (CSS), and the Western Ontario Osteoarthritis of the Shoulder Index (WOOS)...
October 2014: Journal of Shoulder and Elbow Surgery
Erik Weber, Martin Sundberg, Gunnar Flivik
BACKGROUND AND PURPOSE: Even small design modifications of uncemented hip stems may alter the postoperative 3-D migration pattern. The Furlong Active is an uncemented femoral stem which, in terms of design, is based on its precursor-the well-proven Furlong HAC-but has undergone several design changes. The collar has been removed on the Active stem along with the lateral fin; it is shorter and has more rounded edges in the proximal part. We compared the migration patterns of the uncemented Furlong HAC stem and the modified Furlong Active stem in a randomized, controlled trial over 5 years using radiostereometry (RSA)...
December 2014: Acta Orthopaedica
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