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Nicholas Greco, Keith Berend
The case of an atraumatic dislocation of a fixed bearing in a medial unicompartmental arthroplasty with an oxinium femoral component is presented. A review of the literature pertaining to knee arthroplasty locking mechanisms is discussed. Potential modes of locking mechanisms failure are reviewed including the recognition of such failures in the clinical setting. This is the first report of a dislocated fixed-bearing medial oxinium unicompartmental arthroplasty and consequent metal arthrogram.
March 7, 2018: Knee
Christopher J Vertullo, Peter L Lewis, Yi Peng, Stephen E Graves, Richard N de Steiger
BACKGROUND: The effect of alternative bearing materials on the risk of revision due to infection after total knee replacement remains uncertain. By reducing the immunomodulating polyethylene wear-particle burden and with different substrate bacterial adhesion properties, Oxinium oxidized zirconium and cross-linked polyethylene (XLPE) could alter infection risk. The purpose of the current study was to analyze the risk of revision for infection in 3 comparisons of bearing combinations. METHODS: To evaluate the risk of revision for infection with XLPE, cobalt-chromium (CoCr) on XLPE was compared with CoCr on non-cross-linked polyethylene (NXLPE)...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
Christopher J Vertullo, Peter L Lewis, Stephen Graves, Lan Kelly, Michelle Lorimer, Peter Myers
BACKGROUND: Oxidized zirconium (Oxinium) was introduced as an alternative bearing surface to cobalt-chromium (CoCr) in an attempt to reduce polyethylene wear and decrease aseptic mechanical failure of total knee replacements. While noncomparative reports have been described as promising, we were aware of no short or long-term clinical studies showing the superiority of Oxinium on polyethylene as a bearing surface. Using data from a comprehensive national joint replacement registry, we compared the long-term outcomes after cruciate-retaining total knee arthroplasty (TKA) with an Oxinium femoral component and those with the same prosthetic design but with a CoCr femoral component...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
Julien Girard
BACKGROUND: The hip resurfacing concept was developed for young and active patients, especially for femoral bone stock preservation. However, concerns about metal-on-metal bearings with adverse reactions to metal debris have led to a drop off in hip-resurfacing procedures. QUESTIONS/PURPOSES: The goal of this review is to evaluate our current knowledge of survivorship of second-generation hip resurfacing devices and elaborate international perspectives for product improvement...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
C H Lohmann, R Hameister, G Singh
Hypersensitivity reactions to implants in orthopaedic and trauma surgery are a rare but devastating complication. They are considered as a delayed-type of hypersensitivity reaction (type IV), characterized by an antigen activation of sensitized T-lymphocytes releasing various cytokines and may result in osteoclast activation and bone resorption. Potential haptens are originated from metal alloys or bone-cement. A meta-analysis has confirmed a higher probability of developing a metal hypersensitivity postoperatively and noted a greater risk of failed replacements compared to stable implants...
February 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
V E Ozden, N Saglam, G Dikmen, I R Tozun
Oxidized zirconium (Oxinium™; Smith & Nephew, Memphis, TN, USA) articulated with polyethylene in total hip arthroplasty (THA) appeared to have the potential to reduce wear dramatically. The thermally oxidized metal zirconium surface is transformed into ceramic-like hard surface that is resistant to abrasion. The exposure of soft zirconium metal under hard coverage surface after the damage of oxidized zirconium femoral head has been described. It occurred following joint dislocation or in situ succeeding disengagement of polyethylene liner...
February 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Nathanael Ahearn, Andrew J Metcalfe, Mohammed A Hassaballa, Andrew J Porteous, James R Robinson, James R Murray, John H Newman
BACKGROUND: The Journey patellofemoral joint arthroplasty (PFA) was designed to improve patient outcomes following surgical management of patellofemoral joint osteoarthritis. It is based on the asymmetric trochlear geometry of the Genesis II total knee arthroplasty, with Oxinium components, to provide a reliable treatment option in an often young, high demand group of patients. METHODS: We report the minimum five year functional outcome and survivorship of the Journey PFA performed at our institution between October 2005 and September 2009...
October 2016: Knee
Sok Chuen Tan, Adrian C K Lau, Christopher Del Balso, James L Howard, Brent A Lanting, Matthew G Teeter
BACKGROUND: This matched-cohort study aims to compare tribocorrosion between matched ceramic and cobalt-chromium femoral head trunnions and between matched Oxinium and cobalt-chromium femoral head trunnions. Secondary objectives were to investigate whether taper design, depth of trunnion, implantation time, age, body mass index, and gender have an effect on fretting and corrosion. METHODS: All hip prostheses retrieved between 1999 and 2015 at one center were reviewed, giving a total of 52 ceramic heads...
September 2016: Journal of Arthroplasty
Adrian J Cassar-Gheiti, Dennis Collins, Tom McCarthy
The use of alternative bearing surfaces for total hip arthroplasty has become popular to minimize wear and increase longevity, especially in young patients. Oxidized zirconium (Oxinium; Smith & Nephew, Memphis, Tennessee) femoral heads were introduced in the past decade for use in total hip arthroplasty. The advantages of oxidized zirconium include less risk of fracture compared with traditional ceramic heads. This case report describes a patient with a history of bilateral avascular necrosis of the femoral head after chemotherapy for acute lymphoblastic leukemia...
January 2016: Orthopedics
B A Jonsson, T Kadar, L I Havelin, K Haugan, B Espehaug, K Indrekvam, O Furnes, G Hallan
We report the five-year outcome of a randomised controlled trial which used radiostereometric analysis (RSA) to assess the influence of surface oxidised zirconium (OxZr, Oxinium) on polyethylene wear in vivo. A total of 120 patients, 85 women and 35 men with a mean age of 70 years (59 to 80) who were scheduled for primary cemented total hip arthroplasty were randomly allocated to four study groups. Patients were blinded to their group assignment and received either a conventional polyethylene (CPE) or a highly cross-linked (HXL) acetabular component of identical design...
November 2015: Bone & Joint Journal
Emmanuel Thienpont
BACKGROUND: Metal allergy in total knee arthroplasty (TKA) is still a controversial topic. Oxinium, ceramic or titanium niobium nitride (TiNbN) coated implants are available for some knee systems. The hypothesis of this study was that the use of TiNbN-coated components would not lead to inferior results compared to conventional implants and that none of the allergic patients receiving TiNbN-coated implants would require revision for metal allergy. MATERIALS AND METHODS: This study was a retrospective, 2 to 1 matched pairs study with 40 titanium niobium nitride-coated TKA compared with 80 conventional cobalt chrome implants...
December 2015: Archives of Orthopaedic and Trauma Surgery
George K Karidakis, Theofilos Karachalios
BACKGROUND: Osteolysis resulting from wear debris production from the bearing surfaces is a major factor limiting long-term survival of hip implants. Oxidized zirconium head on crosslinked polyethylene (XLPE) is a modern bearing coupling. However, midterm in vivo wear data of this coupling are not known. QUESTIONS/PURPOSES: The purpose of this study was to investigate in vivo whether the combination of an oxidized zirconium femoral head on XLPE produces less wear than a ceramic head on XLPE or a ceramic head on conventional polyethylene (CPE) couplings and whether any of these bearing combinations results in higher hip scores...
December 2015: Clinical Orthopaedics and related Research
Denis Nam, James A Keeney, Ryan M Nunley, Staci R Johnson, John C Clohisy, Robert L Barrack
The purpose of this study was to compare whole blood metal ion levels in young, active patients undergoing primary total hip arthroplasty with the use of a cobalt-alloy (ten patients), ceramic (15 patients), or oxinium (11 patients) femoral head and highly crosslinked polyethylene acetabular liner. At 2 years postoperatively, mean cobalt concentrations were 3.0 times higher in the cobalt-alloy cohort versus the ceramic cohort, and 2.3 times higher versus the oxinium cohort (P=0.3-0.5). Titanium levels were consistently elevated at all postoperative time points versus preoperatively in all cohorts...
December 2015: Journal of Arthroplasty
Kevin L Garvin, Tyler C White, Anand Dusad, Curtis W Hartman, John Martell
BACKGROUND: Patients 50 years or younger are at high risk for wear-related complications of their total hip arthroplasty (THA) because of their generally higher levels of activity. Highly crosslinked polyethylene (HXLPE) is believed to be more durable for this population than conventional polyethylene because of its improved wear; however, limited information is available on the wear of HXLPE in this population, particularly the wear of HXLPE when it articulates with alternative bearings like Oxinium (Smith & Nephew, Memphis, TN, USA)...
December 2015: Clinical Orthopaedics and related Research
Peter Thomas, Christine von der Helm, Christoph Schopf, Farhad Mazoochian, Lars Frommelt, Hans Gollwitzer, Josef Schneider, Michael Flaig, Veit Krenn, Benjamin Thomas, Burkhard Summer
We performed a combined approach to identify suspected allergy to knee arthroplasty (TKR): patch test (PT), lymphocyte transformation test (LTT), histopathology (overall grading; T- and B-lymphocytes, macrophages, and neutrophils), and semiquantitative Real-time-PCR-based periprosthetic inflammatory mediator analysis (IFNγ, TNFα, IL1-β, IL-2, IL-6, IL-8, IL-10, IL17, and TGFβ). We analyzed 25 TKR patients with yet unexplained complications like pain, effusion, and reduced range of motion. They consisted of 20 patients with proven metal sensitization (11 with PT reactions; 9 with only LTT reactivity)...
2015: BioMed Research International
James Min-Leong Wong, Yen-Liang Liu, Stephen Graves, Richard de Steiger
BACKGROUND: More than 15,000 primary hip resurfacing arthroplasties have been recorded by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) with 884 primary procedures requiring revision for reasons other than infection, a cumulative percent revision rate at 12 years of 11%. However, few studies have reported the survivorship of these revision procedures. QUESTIONS/PURPOSES: (1) What is the cumulative percent rerevision rate for revision procedures for failed hip resurfacings? (2) Is there a difference in rerevision rate among different types of revision or bearing surfaces? METHODS: The AOANJRR collects data on all primary and revision hip joint arthroplasties performed in Australia and after verification against health department data, checking of unmatched procedures, and subsequent retrieval of unreported procedures is able to obtain an almost complete data set relating to hip arthroplasty in Australia...
November 2015: Clinical Orthopaedics and related Research
Itaru Yoda, Hironobu Koseki, Masato Tomita, Takayuki Shida, Hidehiko Horiuchi, Hideyuki Sakoda, Makoto Osaki
BACKGROUND: Implant-related infections are caused by adhesion of bacteria to the surface of biomaterials. In this in vitro research, we evaluated the ability of Staphylococcus epidermidis (ATCC35984) to adhere to the surface of solid biomaterials at different levels of roughness below 30 nm Ra and investigated the minimum level of roughness required to promote bacterial adhesion on five kinds of biomaterials: oxidized zirconium-niobium alloy (Oxinium), cobalt-chromium-molybdenum alloy (Co-Cr-Mo), titanium alloy (Ti-6Al-4 V), commercially pure titanium (Cp-Ti) and stainless steel (SUS316L), samples of which were categorized into a fine group and a coarse group according to surface roughness...
2014: BMC Microbiology
Zachary A Morison, Sunit Patil, Habeeb A Khan, Earl R Bogoch, Emil H Schemitsch, James P Waddell
The purpose of the investigation was to assess the clinical and radiographic outcomes in four bearing surfaces. Eighty patients (91 hips) undergoing total hip arthroplasty between 2004 and 2007 were randomized to one of four bearing surfaces: (1) cobalt-chrome (CoCr) and ultra-high molecular weight polyethylene (UHMWPE); (2) CoCr and XLPE; (3) Oxinium and UHMWPE; and (4) Oxinium and XLPE. The mean follow-up for this study was 6.8 years. There were no significant differences in clinical outcomes. The linear wear rates for the four groups were 0...
September 2014: Journal of Arthroplasty
Derek H Park, Julian Leong, Stephen J Palmer
PURPOSE: To report the early results of the Oxinium Genesis II prosthesis with an oxidised zirconium femoral component in 55 patients. METHODS: 71 knees in 21 men and 34 women aged 32 to 75 (mean, 55) years were evaluated; 16 of the patients had bilateral staged total knee replacements with a mean interval of 9 (range, 6-16) months between surgeries. The indications for surgery included osteoarthritis (n=57), rheumatoid arthritis (n=13) and revision from a unicompartmental knee replacement for osteoarthritis (n=1)...
April 2014: Journal of Orthopaedic Surgery
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