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Femoral stem design

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https://www.readbyqxmd.com/read/28462906/biomimetic-design-and-fabrication-of-multilayered-osteochondral-scaffolds-by-low-temperature-deposition-manufacturing-and-thermal-induced-phase-separation-techniques
#1
Ting Zhang, Hefeng Zhang, Laquan Zhang, Shuaijun Jia, Jian Liu, Zhuo Xiong, Wei Sun
Integrative osteochondral repair is a useful strategy for cartilage-defect repair. To mimic the microenvironment, it is necessary that scaffolds effectively mimic the extracellular matrix of natural cartilage and subchondral bone. In this study, biomimetic osteochondral scaffolds containing an oriented cartilage layer, a compact layer, and a three-dimensional (3D)-printed core-sheath structured-bone layer were developed. The oriented cartilage layer was designed to mimic the structural and material characteristics of native cartilage tissue and was fabricated with cartilage matrix-chitosan materials, using thermal-induced phase-separation technology...
May 2, 2017: Biofabrication
https://www.readbyqxmd.com/read/28457199/bone-regeneration-mediated-by-a-bioactive-and-biodegradable-ecm-like-hydrogel-based-on-elastin-like-recombinamers
#2
Dante J Coletta, Arturo Ibáñez-Fonseca, Liliana R Missana, María V Jammal, Ezequiel J Vitelli, Mariangeles Aimone, Facundo Zabalza, João Paulo Mardegan Issa, Matilde Alonso, José Carlos Rodríguez-Cabello, Sara Feldman
The morbidity of bone fractures and defects is steadily increasing due to changes in the age pyramid. As such, novel biomaterials that are able to promote the healing and regeneration of injured bones are needed in order to overcome the limitations of auto-, allo-, and xenografts, while providing a ready-to-use product that may help to minimize surgical invasiveness and duration. In this regard, recombinant biomaterials, such as elastin-like recombinamers (ELRs), are very promising as their design can be tailored by genetic engineering, thus allowing scalable production and batch-to-batch consistency, amongst others...
April 29, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28442161/zurich-cementless-total-hip-replacement
#3
REVIEW
David Hummel
Total hip replacement (THR) is the gold standard treatment of intractable pain from hip dysplasia. THR procedures are divided into 2 main categories: cemented and cementless, with hybrid a combination. The Zurich Cementless THR system uses a combination of press-fit (acetabular component) and locking screw (femoral component) fixation designed to address the main challenge facing cemented systems (aseptic loosening) while providing the benefit of immediate stability with its novel locking screw implantation system for the femoral stem...
April 22, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28418269/is-a-hollow-centralizer-necessary-when-using-a-polished-tapered-cemented-femoral-stem
#4
Erik Weber, Christer Olsson, Uldis Kesteris, Gunnar Flivik
Background and purpose - A tapered, polished and collarless stem is normally equipped with a hollow centralizer to prevent the stem from becoming end-bearing in the cement as the stem subsides. In a randomized clinical trial, we evaluated such a stem (MS-30), which was initially introduced with a solid centralizer but was later recommended to be fitted with a hollow centralizer. We hypothesized that while the stem would sink more, it would become rotationally stable and have less retroversion with a hollow centralizer than with a solid centralizer...
April 18, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28395391/dual-mobility-acetabular-cups-in-primary-total-hip-arthroplasty-in-patients-at-high-risk-for-dislocation
#5
Steven F Harwin, Jaydev B Mistry, Morad Chughtai, Anton Khlopas, Chukwuweike Gwam, Jared M Newman, Carlos A Higuera, Peter M Bonutti, Arthur L Malkani, Frank R Kolisek, Ronald E Delanois, Michael A Mont
INTRODUCTION: Postoperative dislocation occurs in approximately 2% of primary total hip arthroplasties (THAs). Risk factors associated with dislocation include: age of 70 years or older, body mass index (BMI) of 30 kg/m2 or greater, alcohol abuse, and neuro-degenerative diseases such as multiple sclerosis or Parkinson's disease. As a result, dual-mobility articulations, which have been typically used for revision procedures, have become an increasingly popular option for these "at risk" primary THAs...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28392688/evaluation-of-zinc-doped-mesoporous-hydroxyapatite-microspheres-for-the-construction-of-a-novel-biomimetic-scaffold-optimized-for-bone-augmentation
#6
Weilin Yu, Tuan-Wei Sun, Chao Qi, Zhenyu Ding, Huakun Zhao, Shichang Zhao, Zhongmin Shi, Ying-Jie Zhu, Daoyun Chen, Yaohua He
Biomaterials with high osteogenic activity are desirable for sufficient healing of bone defects resulting from trauma, tumor, infection, and congenital abnormalities. Synthetic materials mimicking the structure and composition of human trabecular bone are of considerable potential in bone augmentation. In the present study, a zinc (Zn)-doped mesoporous hydroxyapatite microspheres (Zn-MHMs)/collagen scaffold (Zn-MHMs/Coll) was developed through a lyophilization fabrication process and designed to mimic the trabecular bone...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28391517/preoperative-digital-planning-versus-postoperative-outcomes-in-total-hip-arthroplasty-using-a-calcar-guided-short-stem-frequent-valgization-can-be-avoided
#7
Karl Philipp Kutzner, Joachim Pfeil, Mark Predrag Kovacevic
INTRODUCTION: Modern total hip arthroplasty is largely dependent on the successful preservation of hip geometry. Thus, a successful implementation of the preoperative planning is of great importance. The present study evaluates the accuracy of anatomic hip reconstruction predicted by 2D digital planning using a calcar-guided short stem of the newest generation. METHODS: A calcar-guided short stem was implanted in 109 patients in combination with a cementless cup using the modified anterolateral approach...
April 8, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28385929/cemented-versus-cementless-hemiarthroplasty-for-a-displaced-fracture-of-the-femoral-neck-a-systematic-review-and-meta-analysis-of-current-generation-hip-stems
#8
REVIEW
H D Veldman, I C Heyligers, B Grimm, T A E J Boymans
AIMS: Our aim was to prepare a systematic review and meta-analysis to compare the outcomes of cemented and cementless hemiarthroplasty of the hip, in elderly patients with a fracture of the femoral neck, to investigate the mortality, complications, length of stay in hospital, blood loss, operating time and functional results. MATERIALS AND METHODS: A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines on randomised controlled trials (RCTs), studying current generation designs of stem only...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28375671/outcome-in-design-specific-comparisons-between-highly-crosslinked-and-conventional-polyethylene-in-total-hip-arthroplasty
#9
Per-Erik Johanson, Ove Furnes, Leif Ivar Havelin, Anne Marie Fenstad, Alma B Pedersen, Søren Overgaard, Göran Garellick, Keijo Mäkelä, Johan Kärrholm
Background and purpose - Most registry studies regarding highly crosslinked polyethylene (XLPE) have focused on the overall revision risk. We compared the risk of cup and/or liner revision for specific cup and liner designs made of either XLPE or conventional polyethylene (CPE), regarding revision for any reason and revision due to aseptic loosening and/or osteolysis. Patients and methods - Using the Nordic Arthroplasty Register Association (NARA) database, we identified cup and liner designs where either XLPE or CPE had been used in more than 500 THAs performed for primary hip osteoarthritis...
April 4, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28363891/cement-in-cement-revision-of-the-femoral-stem-analysis-of-1179-first-time-revisions-in-the-swedish-hip-arthroplasty-register
#10
COMPARATIVE STUDY
P H J Cnudde, J Kärrholm, O Rolfson, A J Timperley, M Mohaddes
AIMS: Compared with primary total hip arthroplasty (THA), revision surgery can be challenging. The cement-in-cement femoral revision technique involves removing a femoral component from a well-fixed femoral cement mantle and cementing a new stem into the original mantle. This technique is widely used and when carried out for the correct indications, is fast, relatively inexpensive and carries a reduced short-term risk for the patient compared with the alternative of removing well-fixed cement...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28300706/tapered-stems-one-third-proximally-coated-have-higher-complication-rates-than-cylindrical-two-third-coated-stems-in-patients-with-high-hip-dislocation-undergoing-total-hip-arthroplasty-with-step-cut-shortening-osteotomy
#11
V Emre Ozden, G Dikmen, B Beksac, I Remzi Tozun
BACKGROUND: The results of cementless stems in total hip arthroplasty (THA) done because of congenital dislocation with step-cut osteotomy is not well known, particularly the influence of the design and the role of extent of porous coating. Therefore we performed a retrospective study to evaluate the mid to long-term results THA performed with a single type acetabular component and different geometry and fixation type stems with ceramic bearings in the setting of step-cut subtrochanteric osteotomy in high hip dislocated (HHD) patients...
March 11, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28283706/three-dimensional-analysis-of-the-proximal-anterior-femoral-flare-and-torsion-anatomic-bases-for-metaphyseally-fixed-short-stems-design
#12
Elhadi Sariali, Yohan Knaffo
PURPOSE: The use of femoral stems with a short metaphyseal fixation may lead to fractures or subsidence. Such failures may be related to a mismatch between the torsions or the sagittal flares of the stem and the femur. The goal of our study was to perform a 3D analysis of the proximal metaphyseal femur anatomy with a special focus on the anterior proximal flare and torsion. Such data may help to detect the outlier patients for whom a short metaphyseal fixation should be avoided. METHODS: A prospective study included 80 consecutive patients who underwent a primary cementless THA with a 3D CT-scan based pre-operative planning...
March 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28271719/micromotion-induced-peri-prosthetic-fluid-flow-around-a-cementless-femoral-stem
#13
Valérie Malfroy Camine, Alexandre Terrier, Dominique P Pioletti
Micromotion-induced interstitial fluid flow at the bone-implant interface has been proposed to play an important role in aseptic loosening of cementless implants. High fluid velocities are thought to promote aseptic loosening through activation of osteoclasts, shear stress induced control of mesenchymal stem cells differentiation, or transport of molecules. In this study, our objectives were to characterize and quantify micromotion-induced fluid flow around a cementless femoral stem using finite element modeling...
May 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28262457/trochantoplasty-for-total-hip-arthroplasty-in-patients-with-coxa-vara-deformity
#14
Jun-Il Yoo, Javad Parvizi, Ji-Ung Song, Yong-Chan Ha, Young-Kyun Lee, Kyung-Hoi Koo
BACKGROUND: In total hip arthroplasty (THA) of hips with coxa vara, the femoral stems might be inserted in a varus alignment. To avoid varus insertion, we designed a technique, which we termed "trochantoplasty." In this procedure, the medial half of the greater trochanter was removed during THA. METHODS: We evaluated 30 patients (31 hips) who had coxa vara deformity and underwent THA using trochantoplasty at the mean follow-up of 5 years (range, 3-9 years). RESULTS: All stems were inserted in the neutral position...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28249969/assessment-of-the-equivalence-of-a-generic-to-a-branded-femoral-stem
#15
COMPARATIVE STUDY
H Hothi, J Henckel, P Shearing, T Holme, A Cerquiglini, A Di Laura, A Atrey, J Skinner, A Hart
AIMS: The aim of this study was to compare the design of the generic OptiStem XTR femoral stem with the established Exeter femoral stem. MATERIALS AND METHODS: We obtained five boxed, as manufactured, implants of both designs at random (ten in total). Two examiners were blinded to the implant design and independently measured the mass, volume, trunnion surface topography, trunnion roughness, trunnion cone angle, Caput-Collum-Diaphyseal (CCD) angle, femoral offset, stem length, neck length, and the width and roughness of the polished stem shaft using peer-reviewed methods...
March 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28194710/exchangeable-femoral-neck-dual-modular-tha-prostheses-have-poorer-survivorship-than-other-designs-a-nationwide-cohort-of-324-108-patients
#16
Sandrine Colas, Assia Allalou, Antoine Poichotte, Philippe Piriou, Rosemary Dray-Spira, Mahmoud Zureik
BACKGROUND: Exchangeable neck stems, defined as those with a dual taper (that is, a modular junction between the femoral head and the femoral neck and an additional junction between the neck and the stem body), were introduced in THA to improve restoration of joint biomechanics (restoring anteversion, offset, and limb length) and reduce the risk of dislocation. However exchangeable necks have been reported to result in adverse effects such as stem fractures and acute local tissue reaction...
February 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28176355/strain-shielding-inspired-re-design-of-proximal-femoral-stems-for-total-hip-arthroplasty
#17
Myriam Cilla, Sara Checa, Georg N Duda
A large number of hip prosthesis with different designs have been developed. However, the influence of hip implant design changes on the strains induced in the bone remains unclear. The purpose of this study is to better understand the mechanics of short stem total hip arthroplasty. Specifically, it investigates whether strain shielding can be avoided by changing implant shape and/or material properties. It is hypothesized that the re-design of existing implant designs can result in further reduction of strain shielding and thus keep bone loss minimal following total hip replacement...
February 8, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28167872/characterization-of-femoral-head-taper-corrosion-features-using-a-22-year-retrieval-database
#18
Jacob Cartner, Patrick Aldinger, Chenxi Li, David Collins
BACKGROUND: Modularity in total hip arthroplasty has been used for decades with great success, but new findings regarding corrosion artifacts have caused a resurgence in tapered junction research. Mechanically assisted crevice corrosion (MACC) is thought to be the mechanism by which corrosive attack occurs. Myriad multi-factorial variables are known to influence the susceptibility of a modular taper junction to MACC. Some of these variables are design and manufacture related and others can be controlled by the surgeon...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28165591/stable-migration-pattern-of-an-ultra-short-anatomical-uncemented-hip-stem-a-prospective-study-with-2-years-radiostereometric-analysis-follow-up
#19
Ahmed Nageeb Mahmoud, Uldis Kesteris, Gunnar Flivik
INTRODUCTION: Shorter, anatomically shaped and proximally loading stems have been developed to achieve better stress distribution and be more bone preserving. The purpose of this prospective study was to evaluate the migration pattern of the Proxima™ ultra-short uncemented stem using radiostereometric analysis (RSA), and to review the literature regarding the migration of short stemmed hip arthroplasty. METHODS: 25 patients (28 hips) with hip osteoarthritis received a Proxima stem during total hip arthroplasty (THA)...
February 4, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28159679/is-there-a-role-for-femoral-offset-restoration-during-total-hip-arthroplasty-a-systematic-review
#20
REVIEW
M De Fine, M Romagnoli, A Toscano, A Bondi, M Nanni, S Zaffagnini
Benefits of femoral offset restoration during total hip arthroplasty should be the reduction of bearing surfaces wear, implant loosening and dislocation rates. Modular neck stems ensure offset customization but fretting corrosion and catastrophic failures are well-documented complications. Since clinical evidences are needed to substantiate the effectiveness of femoral offset restoration and promote modular neck choice, we systematically reviewed the literature to ascertain whether femoral offset itself has a proven clinical influence: (1) on bearing surfaces wear, (2) implant loosening, (3) and dislocation rates...
May 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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