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Sample records for cemented acetabular replacements

  1. Revision total hip replacement using the cement-in-cement technique for the acetabular component: technique and results for 60 hips.

    PubMed

    Brogan, K; Charity, J; Sheeraz, A; Whitehouse, S L; Timperley, A J; Howell, J R; Hubble, M J W

    2012-11-01

    The technique of femoral cement-in-cement revision is well established, but there are no previous series reporting its use on the acetabular side at the time of revision total hip replacement. We describe the technique and report the outcome of 60 consecutive acetabular cement-in-cement revisions in 59 patients at a mean follow-up of 8.5 years (5 to 12). All had a radiologically and clinically well-fixed acetabular cement mantle at the time of revision. During the follow-up 29 patients died, but no hips were lost to follow-up. The two most common indications for acetabular revision were recurrent dislocation (46, 77%) and to complement femoral revision (12, 20%). Of the 60 hips, there were two cases of aseptic loosening of the acetabular component (3.3%) requiring re-revision. No other hip was clinically or radiologically loose (96.7%) at the latest follow-up. One hip was re-revised for infection, four for recurrent dislocation and one for disarticulation of a constrained component. At five years the Kaplan-Meier survival rate was 100% for aseptic loosening and 92.2% (95% CI 84.8 to 99.6), with revision for any cause as the endpoint. These results support the use of cement-in-cement revision on the acetabular side in appropriate cases. Theoretical advantages include preservation of bone stock, reduced operating time, reduced risk of complications and durable fixation. PMID:23109626

  2. The long-term outcome of the cemented Weber acetabular component in total hip replacement using a second-generation cementing technique.

    PubMed

    de Jong, P T; de Man, F H R; Haverkamp, D; Marti, R K

    2009-01-01

    We report the long-term outcome of a modified second-generation cementing technique for fixation of the acetabular component of total hip replacement. An earlier report has shown the superiority of this technique assessed by improved survival compared with first-generation cementing. The acetabular preparation involved reaming only to the subchondral plate, followed by impaction of the bone in the anchorage holes. Between 1978 and 1993, 287 total hip replacements were undertaken in 244 patients with a mean age of 65.3 years (21 to 90) using a hemispherical Weber acetabular component with this modified technique for cementing and a cemented femoral component. The survival with acetabular revision for aseptic loosening as the endpoint was 99.1% (95% confidence interval 97.9 to 100 after ten years and 85.5% (95% confidence interval 74.7 to 96.2) at 20 years. Apart from contributing to a long-lasting fixation of the component, this technique also preserved bone, facilitating revision surgery when necessary. PMID:19092001

  3. Damage evolution in acetabular replacements under long-term physiological loading conditions.

    PubMed

    Wang, J-Y; Heaton-Adegbile, P; New, A; Hussell, J G; Tong, J

    2009-05-29

    Damage development in cemented acetabular replacements has been studied in bovine pelvic bones under long-term physiological loading conditions, including normal walking, stair climbing and a combined block loading with representative routine activities. The physiological loading conditions were achieved using a specially designed hip simulator for fixation endurance testing. Damage was detected and monitored using micro-CT scanning at regular intervals of the experiments, and verified by microscopic studies post testing. The results show that debonding at the bone-cement interface defined the failure of cement fixation in all cases, and debondings initiated near the dome of the acetabulum in the superior-posterior quadrant, consistent with the high-stress region identified from the finite element analysis of implanted acetabular models Zant, N.P., Heaton-Adegbile, P., Hussell, J.G., Tong, J., 2008b. In-vitro fatigue failure of cemented acetabular replacements-a hip simulator study. Journal of Biomechanical Engineering, Transactions of the ASME, 130, 021019-1-9]; [Tong, J., Zant, N.P., Wang, J-Y., Heaton-Adegbile, P., Hussell, J.G., 2008. Fatigue in cemented acetabulum. International Journal of Fatigue, 30(8), 1366-1375]. PMID:19345357

  4. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint (hemi-hip) acetabular metal cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip)...

  5. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint (hemi-hip) acetabular metal cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip)...

  6. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint (hemi-hip) acetabular metal cemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3370 Hip joint (hemi-hip) acetabular metal cemented prosthesis. (a) Identification. A hip joint (hemi-hip)...

  7. Displacement and Stress Analysis around the Artificial Acetabular Cup in a Total Hip Replacement

    NASA Astrophysics Data System (ADS)

    Kakunai, Satoshi; Tachibana, Hiroyuki; Sakamoto, Tohru; Abo, Masayoshi; Ikeda, Daisaku; Fujiwara, Hiroo

    In order to improve the service life of the artificial acetabular cup in a total hip replacement, it is important to determine the best material and design, and to assess the mechanical behavior around the cup. In this study, electronic speckle interferometry (ESPI) and the two-dimensional finite element method (FEM) are employed to investigate the mechanical behavior. The influence of the cancellous bone and cup thickness on mechanical behavior around the cup was investigated. Good agreement of the cup model was found between the ESPI measurements and FEM predictions. The following results were obtained. (1) Cancellous bone with a porous structure can be measured by the ESPI method. (2) There are discontinuities of the displacement distribution in the transverse direction in each boundary region of the cup, bone cement and cancellous bone. (3) The maximum shear stress exists in the boundary region of the cup and bone cement.

  8. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... for use with bone cement (§ 888.3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the... metal (hemi-hip) acetabular metal cemented prosthesis shall have an approved PMA or a declared...

  9. 21 CFR 888.3370 - Hip joint (hemi-hip) acetabular metal cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... for use with bone cement (§ 888.3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the... metal (hemi-hip) acetabular metal cemented prosthesis shall have an approved PMA or a declared...

  10. Cement as a locking mechanism for screw heads in acetabular revision shells - a biomechanical analysis.

    PubMed

    Laflamme, G Y; Alami, G B; Zhim, F

    2008-01-01

    In acetabular revisions, polyethylene (PE) liners are often cemented into metal shells on top of acetabular screw heads. This study investigates the possibility of using this technique to obtain fixed-angle acetabular screws Eth a concept that has not yet been reported in the literature. Two groups of screws (n=8) were inserted into Trabecular Metal revision shells (Zimmer), into which PE liners were then cemented. Screws in Group 1, inserted in the shell's pre-fabricated holes, were countersunk, whereas screws in Group 2 were inserted in custom-drilled holes that make their heads protrude into, and interdigitate with, the overlying cement mantle. Perpendicular loading was then applied to the screw shafts both statically to failure and cyclically. A greater stiffness was observed for the protruding screws upon static loading; and while the countersunk screws all failed at the screw-cement junction (53.44 + or - 8.33 N), the protruding screws all failed at the screw shaft (1049.79 + or - 32.12 N) a 20-fold difference (p< 0.05). Under cyclic loading, only the protruding screw head specimen did not fail, undergoing an overall displacement within the limits of osseointegration.These results support the hypothesis that the protrusion of an acetabular screw head into an overlying cement mantle significantly increases its angular stability. Provided other variables are favorable, this locking effect may increase the initial stability of the whole implant, thus improving the ultimate success of complex acetabular revisions. PMID:18645971

  11. Assessment of failure of cemented polyethylene acetabular component due to bone remodeling: A finite element study.

    PubMed

    Ghosh, Rajesh

    2016-09-01

    The aim of the study is to determine failure of the cemented polyethylene acetabular component, which might occur due to excessive bone resorption, cement-bone interface debonding and fatigue failure of the cement mantle. Three-dimensional finite element models of intact and implanted pelvic bone were developed and bone remodeling algorithm was implemented for present analysis. Soderberg fatigue failure diagram was used for fatigue assessment of the cement mantle. Hoffman failure criterion was considered for prediction of cement-bone interface debonding. Results indicate fatigue failure of the cement mantle and implant-bone interface debonding might not occur due to bone remodeling. PMID:27408485

  12. Using acetabular fossa as a guide for anticipated inclination of uncemented cup in total hip replacement

    PubMed Central

    Li, Junwei; Gao, Xu; Yang, Guanghui; Zhang, Yanru

    2015-01-01

    Positions of acetabular implant generally are considered to be major causative factors of dislocation. Accurate and consistent achievement of the preoperatively anticipated orientation of the acetabular cup is a great challenge in total hip replacement (THR). In the present study, we investigated the surgical application of acetabular fossa as a guide for anticipated inclination of uncemented cup, and evaluated its accuracy as an anatomic reference for achieving the preoperatively anticipated abduction of the acetabular cup in comparison with traditional device method on cadaveric specimens. Sixteen normal adult pelvic cadaveric specimens were collected. On each of the sixteen normal adult pelvic cadaveric specimens, acetabular fossa related anatomic sites were marked and studied on pelvic radiographs. Our results showed that there is close correlation between most medial aspect of acetabular sourcil and central axis of the acetabular cup at anticipated inclination of 40° ± 5°. And the fossa group can achieve the preoperatively anticipated cup abduction more accurately than the device group. The current results demonstrated that acetabular fossa can be a reasonable alternative, or as a complement to the currently used methods guiding total hip replacement. PMID:25784987

  13. The results of acetabular impaction grafting in 129 primary cemented total hip arthroplasties.

    PubMed

    Wilson, Matthew J; Whitehouse, Sarah L; Howell, Jonathan R; Hubble, Matthew J W; Timperley, A John; Gie, Graham A

    2013-09-01

    Between 1995 and 2003, 129 cemented primary THAs were performed using full acetabular impaction grafting to reconstruct acetabular deficiencies. These were classified as cavitary in 74 and segmental in 55 hips. Eighty-one patients were reviewed at mean 9.1 (6.2-14.3) years post-operatively. There were seven acetabular component revisions due to aseptic loosening, and a further 11 cases that had migrated >5mm or tilted >5° on radiological review - ten of which reported no symptoms. Kaplan-Meier analysis of revisions for aseptic loosening demonstrates 100% survival at nine years for cavitary defects compared to 82.6% for segmental defects. Our results suggest that the medium-term survival of this technique is excellent when used for purely cavitary defects but less predictable when used with large rim meshes in segmental defects. PMID:23523217

  14. The effect of cup outer sizes on the contact mechanics and cement fixation of cemented total hip replacements.

    PubMed

    Hua, Xijin; Li, Junyan; Wang, Ling; Wilcox, Ruth; Fisher, John; Jin, Zhongmin

    2015-10-01

    One important loosening mechanism of the cemented total hip arthroplasty is the mechanical overload at the bone-cement interface and consequent failure of the cement fixation. Clinical studies have revealed that the outer diameter of the acetabular component is a key factor in influencing aseptic loosening of the hip arthroplasty. The aim of the present study was to investigate the influence of the cup outer diameter on the contact mechanics and cement fixation of a cemented total hip replacement (THR) with different wear penetration depths and under different cup inclination angles using finite element (FE) method. A three-dimensional FE model was developed based on a typical Charnley hip prosthesis. Two acetabular cup designs with outer diameters of 40 and 43 mm were modelled and the effect of cup outer diameter, penetration depth and cup inclination angle on the contact mechanics and cement fixation stresses in the cemented THR were studied. The results showed that for all penetration depths and cup inclination angles considered, the contact mechanics in terms of peak von Mises stress in the acetabular cup and peak contact pressure at the bearing surface for the two cup designs were similar (within 5%). However, the peak von Mises stress, the peak maximum principal stress and peak shear stress in the cement mantle at the bone-cement interface for the 43 mm diameter cup design were predicted to be lower compared to those for the 40 mm diameter cup design. The differences were predicted to be 15-19%, 15-22% and 18-20% respectively for different cup penetration depths and inclination angles, which compares to the clinical difference of aseptic loosening incidence of about 20% between the two cup designs. PMID:26343226

  15. The biological approach in acetabular revision surgery: impaction bone grafting and a cemented cup.

    PubMed

    Colo, Ena; Rijnen, Wim H C; Schreurs, Berend Willem

    2015-01-01

    Acetabular impaction bone grafting (IBG) in combination with a cemented cup in revision total hip arthroplasty (THA) is a proven and well-recognised technique which has been used in clinical practice for more than 35 years. Nowadays, with cemented prostheses tending to lose a larger part of the THA market every year in primary and revision cases, and many young surgeons being only trained in implanting uncemented prostheses, this technique is considered by many as technically demanding and time consuming, making its use less appealing. Despite this image and many new innovative techniques using uncemented implants in acetabular revisions over the last 25 years, IBG with a cemented cup is still one of the few techniques that really can reconstitute bone and respects human biology. In this era of many biologically-based breakthroughs in medicine, it is hard to explain that the solution of most orthopaedic surgeons for the extensive bone defects as frequently seen during acetabular revision surgery, consists of implanting bigger and larger metal implants. This review aims to put the IBG method into a historical perspective, to describe the surgical technique and present the clinical results. PMID:26044533

  16. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented...

  17. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented...

  18. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented...

  19. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented...

  20. 21 CFR 888.3320 - Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hip joint metal/metal semi-constrained, with a... Devices § 888.3320 Hip joint metal/metal semi-constrained, with a cemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with a cemented...

  1. Evaluation of ranges of motion of a new constrained acetabular prosthesis for canine total hip replacement

    PubMed Central

    2013-01-01

    Background Total hip replacement (THR) is considered to be the most effective treatment option for advanced osteoarthritis of the hip in large breed dogs. However, a proportion of post-THR patients suffer prosthesis dislocation for various reasons, which may be addressed by a constrained acetabular prosthesis design. The study proposed a new THR with constrained acetabular component that aimed to decrease the incidence of postoperative dislocation while maintaining the necessary range of motion (ROM); and, through computer-simulated implantations, evaluated the ROM of the THR with and without malpositioning of the acetabular component. Methods A new THR with a constrained acetabular component that had an inward eccentric lining and a 60° cut-out on the dorsal side was designed, and its computer-aided design models were implanted into the pelvic and femoral models reconstructed from the computed tomography data of six healthy Labrador Retriever dogs. The allowable and functional ROM of the implanted THR were determined via computer simulations. The contact patterns between the bone or the prosthetic components at extreme positions of the THR were analyzed. Influence of malpositioning of the acetabular component on the ROM was assessed. Results The means (SD) of the functional ranges for flexion, extension, adduction, abduction, internal rotation and external rotation were 51.8° (6.6°), 163.3° (7.3°), 33.5° (5.7°), 74.0° (3.7°), 41.5° (8.3°) and 65.2° (9.9°), respectively. Malpositioning of the acetabular component by 20° in one direction was found to reduce ROM in other directions (reducing lateral opening: flexion: 12°, adduction: 20°, internal/external rotations: < 20°; increasing lateral opening: extension and abduction: < 16°; reducing retroversion: extension: < 20°, abduction: 15°, external rotation: < 20°; increasing retroversion: flexion: < 20°, abduction, adduction and internal rotation: 20°). Conclusions From the computer

  2. Development of a non-invasive diagnostic technique for acetabular component loosening in total hip replacements.

    PubMed

    Alshuhri, Abdullah A; Holsgrove, Timothy P; Miles, Anthony W; Cunningham, James L

    2015-08-01

    Current techniques for diagnosing early loosening of a total hip replacement (THR) are ineffective, especially for the acetabular component. Accordingly, new, accurate, and quantifiable methods are required. The aim of this study was to investigate the viability of vibrational analysis for accurately detecting acetabular component loosening. A simplified acetabular model was constructed using a Sawbones(®) foam block. By placing a thin silicone layer between the acetabular component and the Sawbones block, 2- and 4-mm soft tissue membranes were simulated representing different loosening scenarios. A constant amplitude sinusoidal excitation with a sweep range of 100-1500 Hz was used. Output vibration from the model was measured using an accelerometer and an ultrasound probe. Loosening was determined from output signal features such as the number and relative strength of observed harmonic frequencies. Both measurement methods were sufficient to measure the output vibration. Vibrational analysis reliably detected loosening corresponding to both 2 and 4 mm tissue membranes at driving frequencies between 100 and 1000 Hz (p < 0.01) using the accelerometer. In contrast, ultrasound detected 2-mm loosening at a frequency range of 850-1050 Hz (p < 0.01) and 4-mm loosening at 500-950 Hz (p < 0.01). PMID:26054805

  3. Measurement of polyethylene wear in acetabular components inserted with and without cement. A randomized trial.

    PubMed

    Devane, P A; Robinson, E J; Bourne, R B; Rorabeck, C H; Nayak, N N; Horne, J G

    1997-05-01

    We measured the three-dimensional wear of polyethylene after total hip arthroplasty with a titanium metal-backed Mallory-Head prosthesis that was inserted with cement in sixty-nine patients (sixty-nine hips) and with a press-fit titanium metal-backed Mallory-Head prosthesis that was inserted without cement in seventy patients (seventy hips). A modular titanium femoral head was used in all of the hips. The patients in the present study were part of a larger double-blind randomized trial comparing the result of total hip arthroplasty performed with cement with that of the same procedure performed without cement in 250 patients. The criterion for inclusion in the study of polyethylene wear was a minimum duration of follow-up of four years, which was met by 148 patients. As adequate radiographs for digitization were not available for nine patients, 139 patients were included in the present study. The age of the patient, the postoperative Harris hip score, the diameter of the femoral head, the thickness of the liner in the polar region of the acetabular component, and the duration of follow-up were similar for the two groups. The mean rate of volumetric wear of the polyethylene was significantly greater in the prostheses that had been inserted without cement than in those that had been inserted with cement (155.1 cubic millimeters per year compared with 98.5 cubic millimeters per year; p = 0.000008). Thirty-four (49 per cent) of the seventy hips in which the prosthesis had been inserted without cement had evidence of osteolysis on radiographs, compared with twelve (17 per cent) of the sixty-nine hips in the other group (p = 0.0002). Osteolysis was associated with an increased rate of polyethylene wear only in the hips in which the prosthesis had been inserted without cement. PMID:9160940

  4. Early catastrophic acetabular failure in Furlong total hip replacements

    PubMed Central

    Hamilton, Steven W.; Wardlaw, Douglas; Gibson, Peter H.

    2009-01-01

    The use of uncemented hip arthroplasty prostheses with ceramic articulations are popular, especially in the young, because of a perceived reduction in wear. We highlight a complication of ceramic on polyethylene articulating couples not previously described in the Furlong replacement. Despite widespread metalosis and particulate debris, osteolysis was not initially seen. The contamination compromised subsequent revision. PMID:19384635

  5. Early catastrophic acetabular failure in Furlong total hip replacements.

    PubMed

    Knox, David; Hamilton, Steven W; Wardlaw, Douglas; Gibson, Peter H

    2009-03-01

    The use of uncemented hip arthroplasty prostheses with ceramic articulations are popular, especially in the young, because of a perceived reduction in wear. We highlight a complication of ceramic on polyethylene articulating couples not previously described in the Furlong replacement. Despite widespread metalosis and particulate debris, osteolysis was not initially seen. The contamination compromised subsequent revision. PMID:19384635

  6. Radiographic evaluation of HDPE cemented and cementless Lord and An.C.A. screwed acetabular models.

    PubMed

    Toni, A; Sudanese, A; Viceconti, M; Montina, P P; Ciaroni, D; Calista, F; Terzi, S; Giunti, A

    1992-01-01

    A total of 187 alumina screwed porous-ceramic coated sockets (An.C.A.), 48 screwed smooth-surfaced Lord sockets, and 251 cemented polyethylene sockets were radiographically evaluated at an average follow-up of 30, 51 and 96 months respectively. After 6 years the Lord prostheses revealed a 38% incidence of loosening, similar to that observed for cemented sockets 10-12 years after surgery. The An.C.A. prostheses revealed radiographic loosening equal to 12% (6 cases) in the first 50 implants, and only 0.7% in the remaining 137 cases: overall, the An.C.A. acetabular prosthesis revealed an index of radiographic loosening equal to 3.3% (7/187). To guarantee "osteointegration" of the porous coating of An.C.A. sockets optimal stability must be obtained when the prosthesis is screwed in. Because the mid-term follow-up for this clinical experience is relatively short (30 months), an opinion on the reliability of the screwed "porous" sockets must await confirmation. PMID:1297574

  7. The effect of the Rim Cutter on cement pressurization and penetration on cemented acetabular fixation in total hip arthroplasty: an in vitro study.

    PubMed

    Smith, B N; Lee, A J C; Timperley, A J; Whitehouse, S L; Crawford, R W

    2010-01-01

    The Rim Cutter (Stryker Orthopedics, Mahwah, New Jersey) is a tool designed to cut a ledge inside the rim of the acetabulum, onto which a precisely trimmed, cemented, flanged cup can be fitted. The aim was to investigate the effect of the Rim Cutter on the intra-acetabular cement mantle pressure and the depth of cement penetration during cup insertion. The study had two parts. In the first part, hemi-pelvis models were fitted with pressure sensors. Pressure in the acetabulum was measured on insertion of a conventional cemented flanged cup with and without the use of a Rim Cutter to prepare the rim of the acetabulum. The second part assessed cement penetration when the same cups were inserted into a foam shell model. The shell was mounted in a jig and had holes drilled in it; the distance that cement penetrated into the holes was measured. A significant increase in cement pressure at the apex (p = 0.04) and the rim (p = 0.004) is seen when the Rim Cutter is used. Cement penetration in the Rim Cutter group was significantly increased at the rim of the acetabulum (p = 0.003). Insertion of a flanged cup after the acetabulum is prepared with the Rim Cutter leads to a significant increase in cement pressure and penetration during cup insertion in vitro when compared with conventional flanged cups. PMID:21053777

  8. Survival of ceramic bearings in total hip replacement after high-energy trauma and periprosthetic acetabular fracture.

    PubMed

    Salih, S; Currall, V A; Ward, A J; Chesser, T J S

    2009-11-01

    Surgeons remain concerned that ceramic hip prostheses may fail catastrophically if either the head or the liner is fractured. We report two patients, each with a ceramic-on-ceramic total hip replacement who sustained high-energy trauma sufficient to cause a displaced periprosthetic acetabular fracture in whom the ceramic bearings survived intact. Simultaneous fixation of the acetabular fracture, revision of the cementless acetabular prosthesis and exchange of the ceramic bearings were performed successfully in both patients. Improved methods of manufacture of new types of alumina ceramic with a smaller grain size, and lower porosity, have produced much stronger bearings. Whether patients should be advised to restrict high-impact activities in order to protect these modern ceramic bearings from fracture remains controversial. PMID:19880903

  9. Total hip replacement through a posterior approach using a 22 mm diameter femoral head : the role of the transverse acetabular ligament and capsular repair in reducing the rate of dislocation.

    PubMed

    Kumar, V; Sharma, S; James, J; Hodgkinson, J P; Hemmady, M V

    2014-09-01

    Despite a lack of long-term follow-up, there is an increasing trend towards using femoral heads of large diameter in total hip replacement (THR), partly because of the perceived advantage of lower rates of dislocation. However, increasing the size of the femoral head is not the only way to reduce the rate of dislocation; optimal alignment of the components and repair of the posterior capsule could achieve a similar effect. In this prospective study of 512 cemented unilateral THRs (Male:Female 230:282) performed between 2004 and 2011, we aimed to determine the rate of dislocation in patients who received a 22 mm head on a 9/10 Morse taper through a posterior approach with capsular repair and using the transverse acetabular ligament (TAL) as a guide for the alignment of the acetabular component. The mean age of the patients at operation was 67 years (35 to 89). The mean follow-up was 2.8 years (0.5 to 6.6). Pre- and post-operative assessment included Oxford hip, Short Form-12 and modified University of California Los Angeles and Merle D'Aubigne scores. The angles of inclination and anteversion of the acetabular components were measured using radiological software. There were four dislocations (0.78%), all of which were anterior. In conclusion, THR with a 22 mm diameter head performed through a posterior approach with capsular repair and using the TAL as a guide for the alignment of the acetabular component was associated with a low rate of dislocation. PMID:25183591

  10. Acetabular revision with impaction bone grafting and a cemented polyethylene acetabular component: comparison of the Kaplan-Meier analysis to the competing risk analysis in 62 revisions with 25 to 30 years follow-up.

    PubMed

    Te Stroet, M A J; Keurentjes, J C; Rijnen, W H C; Gardeniers, J W M; Verdonschot, N; Slooff, T J J H; Schreurs, B W

    2015-10-01

    We present the results of 62 consecutive acetabular revisions using impaction bone grafting and a cemented polyethylene acetabular component in 58 patients (13 men and 45 women) after a mean follow-up of 27 years (25 to 30). All patients were prospectively followed. The mean age at revision was 59.2 years (23 to 82). We performed Kaplan-Meier (KM) analysis and also a Competing Risk (CR) analysis because with long-term follow-up, the presence of a competing event (i.e. death) prevents the occurrence of the endpoint of re-revision. A total of 48 patients (52 hips) had died or had been re-revised at final review in March 2011. None of the deaths were related to the surgery. The mean Harris hip score of the ten surviving hips in ten patients was 76 points (45 to 99). The KM survivorship at 25 years for the endpoint 're-revision for any reason' was 58.0% (95% confidence interval (CI) 38 to 73) and for 're-revision for aseptic loosening' 72.1% (95% CI 51 to 85). With the CR analysis we calculated the KM analysis overestimates the failure rate with respectively 74% and 93% for these endpoints. The current study shows that acetabular impaction bone grafting revisions provide good clinical results at over 25 years. PMID:26430007

  11. Performance of Non-Cemented, Hemispherical, Rim-Fit, Hydroxyapatite Coated Acetabular Component.

    PubMed

    John, Thomas K; Ghosh, Gaurav; Ranawat, Chitranjan S; Ranawat, Amar S; Meftah, Morteza

    2015-12-01

    The purpose of this study was to assess the durability of a non-cemented, hemispherical rim-fit, hydroxyapatite coated cup with a highly cross-linked polyethylene in 223 total hip arthroplasties. At 6-years follow-up (range, 5-9), there were no cup revisions for osteolysis or loosening. Radiologic evidence of osseointegration was based on presence of Stress Induced Reactive Cancellous Bone and radial trabeculae, seen in 47% and 93% of cups, respectively; both were most prevalent in Zone 1. There was no interference demarcation in any zones. Two cups were revised (0.9%): one for dislocation and another for infection. The Kaplan-Meier survivorship for cup revision for any failure (infection, dislocation) was 99% and for mechanical failure (osteolysis, loosening) was 100%. This design has excellent safety, efficacy and durability. PMID:26235521

  12. Porous titanium particles for acetabular reconstruction in total hip replacement show extensive bony armoring after 15 weeks

    PubMed Central

    Walschot, Lucas H B; Aquarius, René; Verdonschot, Nico; Buma, Pieter

    2014-01-01

    Background and purpose — The bone impaction grafting technique restores bone defects in total hip replacement. Porous titanium particles (TiPs) are deformable, like bone particles, and offer better primary stability. We addressed the following questions in this animal study: are impacted TiPs osteoconductive under loaded conditions; do released micro-particles accelerate wear; and are systemic titanium blood levels elevated after implantation of TiPs? Animals and methods — An AAOS type-III defect was created in the right acetabulum of 10 goats weighing 63 (SD 6) kg, and reconstructed with calcium phosphate-coated TiPs and a cemented polyethylene cup. A stem with a cobalt chrome head was cemented in the femur. The goats were killed after 15 weeks. Blood samples were taken pre- and postoperatively. Results — The TiP-graft layer measured 5.6 (SD 0.8) mm with a mean bone ingrowth distance of 2.8 (SD 0.8) mm. Cement penetrated 0.9 (0.3–1.9) mm into the TiPs. 1 reconstruction showed minimal cement penetration (0.3 mm) and failed at the cement-TiP interface. There were no signs of accelerated wear, metallic particle debris, or osteolysis. Median systemic titanium concentrations increased on a log-linear scale from 0.5 (0.3–1.1) parts per billion (ppb) to 0.9 (0.5–2.8) ppb (p = 0.01). Interpretation — Adequate cement pressurization is advocated for impaction grafting with TiPs. After implantation, calcium phosphate-coated TiPs were osteoconductive under loaded conditions and caused an increase in systemic titanium concentrations. However, absolute levels remained low. There were no signs of accelerated wear. A clinical pilot study should be performed to prove that application in humans is safe in the long term. PMID:25238431

  13. Mechanical properties of femoral cortical bone following cemented hip replacement.

    PubMed

    Ni, G X; Lu, W W; Chiu, P K Y; Wang, Y; Li, Z Y; Zhang, Y G; Xu, B; Deng, L F; Luk, K D K

    2007-11-01

    Femoral bone remodeling following total hip replacement is a big concern and has never been examined mechanically. In this study, six goats underwent unilateral cemented hip hemiarthroplasty with polymethyl methacrylate (PMMA) bone cement. Nine months later animals were sacrificed, and the femoral cortical bone slices at different levels were analysed using microhardness testing and microcomputed tomography (micro-CT) scanning. Implanted femurs were compared to contralateral nonimplanted femurs. Extensive bone remodeling was demonstrated at both the proximal and middle levels, but not at the distal level. Compared with the nonimplanted side, significant decreases were found in the implanted femur in cortical bone area, bone mineral density, and cortical bone hardness at the proximal level, as well as in bone mineral density and bone hardness at the middle level. However, no significant difference was observed in either variable for the distal level. In addition, similar proximal-to-distal gradient changes were revealed both in cortical bone microhardness and bone mineral density. From the mechanical point of view, the results of the present study suggested that stress shielding is an important mechanical factor associated with bone adaptation following total hip replacement. PMID:17506504

  14. Complications With Long Cemented Stems in Proximal Femoral Replacement.

    PubMed

    Naik, Amish A; Lietman, Steven A

    2016-05-01

    This study attempted to determine whether patients undergoing cemented long-stem proximal femoral replacement had: (1) an increased short-term mortality rate; (2) greater intraoperative hemodynamic instability; (3) a greater need for resuscitation; and (4) a decreased risk of periprosthetic fracture. The current study reviewed intraoperative and short-term events related to clinical outcomes in 24 consecutive patients who were treated at a single institution over a 5-year period. These patients underwent primary long-stem (≥250 mm, n=13) vs short-stem (<250 mm, n=11) cemented proximal femoral replacement. Other than stem length, the 2 groups were not significantly different in terms of patient age, sex, height, weight, body mass index, diagnosis, or preoperative American Society of Anesthesiologists functional score. Primary outcomes were intraoperative death, blood loss, blood transfusions, fluid resuscitation, hypotension, oxygen desaturation, mortality up to 1 year, and need for revision surgery. At 1 year, a significantly increased mortality rate (77% vs 27%, P=.03) was noted in patients receiving long-stem vs short-stem arthroplasty. Patients who received longer stems also required more intraoperative blood transfusions and fluid resuscitation (P=.04) for greater hypotension (P=.04) and oxygen desaturation (P=.04). Two intraoperative deaths occurred in the long-stem group, and none occurred in the short-stem group. The findings suggest that there is an increased risk of intraoperative hemodynamic instability with long-stem vs short-stem proximal femoral replacement, with a need for greater resuscitative efforts and an increased risk of mortality at 1 year. [Orthopedics. 2016; 39(3):e423-e429.]. PMID:27064780

  15. Clinical and radiographic outcomes of acetabular impaction grafting without cage reinforcement for revision hip replacement: a minimum ten-year follow-up study.

    PubMed

    Gilbody, J; Taylor, C; Bartlett, G E; Whitehouse, S L; Hubble, M J W; Timperley, A J; Howell, J R; Wilson, M J

    2014-02-01

    Impaction bone grafting for the reconstitution of bone stock in revision hip surgery has been used for nearly 30 years. Between 1995 and 2001 we used this technique in acetabular reconstruction, in combination with a cemented component, in 304 hips in 292 patients revised for aseptic loosening. The only additional supports used were stainless steel meshes placed against the medial wall or laterally around the acetabular rim to contain the graft. All Paprosky grades of defect were included. Clinical and radiographic outcomes were collected in surviving patients at a minimum of ten years after the index operation. Mean follow-up was 12.4 years (sd 1.5) (10.0 to 16.0). Kaplan-Meier survival with revision for aseptic loosening as the endpoint was 85.9% (95% CI 81.0 to 90.8) at 13.5 years. Clinical scores for pain relief remained satisfactory, and there was no difference in clinical scores between cups that appeared stable and those that appeared radiologically loose. PMID:24493183

  16. A randomised controlled trial comparing highly cross-linked and contemporary annealed polyethylene after a minimal eight-year follow-up in total hip arthroplasty using cemented acetabular components.

    PubMed

    Langlois, J; Atlan, F; Scemama, C; Courpied, J P; Hamadouche, M

    2015-11-01

    Most published randomised controlled trials which compare the rates of wear of conventional and cross-linked (XL) polyethylene (PE) in total hip arthroplasty (THA) have described their use with a cementless acetabular component. We conducted a prospective randomised study to assess the rates of penetration of two distinct types of PE in otherwise identical cemented all-PE acetabular components. A total of 100 consecutive patients for THA were randomised to receive an acetabular component which had been either highly XL then remelted or moderately XL then annealed. After a minimum of eight years follow-up, 38 hips in the XL group and 30 hips in the annealed group had complete data (mean follow-up of 9.1 years (7.6 to 10.7) and 8.7 years (7.2 to 10.2), respectively). In the XL group, the steady state rate of penetration from one year onwards was -0.0002 mm/year (sd 0.108): in the annealed group it was 0.1382 mm/year (sd 0.129) (Mann-Whitney U test, p < 0.001). No complication specific to either material was recorded. These results show that the yearly linear rate of femoral head penetration can be significantly reduced by using a highly XLPE cemented acetabular component. PMID:26530645

  17. Constrained captive acetabular cup for recurrent dislocation of hemiarthroplasty in elderly: A case series

    PubMed Central

    Rajeev, Aysha; Banaszkiewicz, Paul

    2016-01-01

    Introduction Hemiarthroplasty of the hip is one of the commonest procedures done for intracapsular fractures of the neck of femur in elderly. Dislocation of the hemiarthroplasty is a recognised and significant complication. This is associated with considerable morbidity and mortality. The treatment options include closed manipulation, skin and skeletal traction, conversion to total hip replacement, exploration and open reduction and leaving it out of the acetabulum. Presentation of case A retrospective review of ten patients with recurrent and failed closed manipulative reduction of hemiarthroplasty who underwent revision using a cemented captive acetabular cup and cement to cement revision of femoral component with Exeter CDH stem was carried out. The follow up period was two years and the functional outcomes were assessed using Harris hip scores. Discussion The management of recurrent dislocations of hemiarthroplasty in elderly patient are very challenging. Even though various treatment options are described most of them are associated with increased morbidity and mortality and prevent these patients from early mobilisation. The use of captive acetabular avoid repeated dislocations, prolonged bed rest, wearing of a brace and all the complications associated with sustained immobilization. The drawbacks of using constrained cups are hip pain, limited hip movements and loosening. Conclusion We describe a new method of treatment of this difficult condition with a cemented constrained acetabular captive cup and cement to cement revision using a CDH femoral stem. This method prevents further dislocations and will give good functional outcomes thus reducing the high morbidity and mortality. PMID:27129135

  18. The effect of fly ash and coconut fibre ash as cement replacement materials on cement paste strength

    NASA Astrophysics Data System (ADS)

    Bayuaji, R.; Kurniawan, R. W.; Yasin, A. K.; Fatoni, H. AT; Lutfi, F. M. A.

    2016-04-01

    Concrete is the backbone material in the construction field. The main concept of the concrete material is composed of a binder and filler. Cement, concrete main binder highlighted by environmentalists as one of the industry are not environmentally friendly because of the burning of cement raw materials in the kiln requires energy up to a temperature of 1450° C and the output air waste CO2. On the other hand, the compound content of cement that can be utilized in innovation is Calcium Hydroxide (CaOH), this compound will react with pozzolan material and produces additional strength and durability of concrete, Calcium Silicate Hydrates (CSH). The objective of this research is to explore coconut fibers ash and fly ash. This material was used as cement replacement materials on cement paste. Experimental method was used in this study. SNI-03-1974-1990 is standard used to clarify the compressive strength of cement paste at the age of 7 days. The result of this study that the optimum composition of coconut fiber ash and fly ash to substitute 30% of cement with 25% and 5% for coconut fibers ash and fly ash with similar strength if to be compared normal cement paste.

  19. Characterization and utilization of cement kiln dusts (CKDs) as partial replacements of Portland cement

    NASA Astrophysics Data System (ADS)

    Khanna, Om Shervan

    The characteristics of cement kiln dusts (CKDs) and their effects as partial replacement of Portland Cement (PC) were studied in this research program. The cement industry is currently under pressure to reduce greenhouse gas (GHG) emissions and solid by-products in the form of CKDs. The use of CKDs in concrete has the potential to substantially reduce the environmental impact of their disposal and create significant cost and energy savings to the cement industry. Studies have shown that CKDs can be used as a partial substitute of PC in a range of 5--15%, by mass. Although the use of CKDs is promising, there is very little understanding of their effects in CKD-PC blends. Previous studies provide variable and often conflicting results. The reasons for the inconsistent results are not obvious due to a lack of material characterization data. The characteristics of a CKD must be well-defined in order to understand its potential impact in concrete. The materials used in this study were two different types of PC (normal and moderate sulfate resistant) and seven CKDs. The CKDs used in this study were selected to provide a representation of those available in North America from the three major types of cement manufacturing processes: wet, long-dry, and preheater/precalciner. The CKDs have a wide range of chemical and physical composition based on different raw material sources and technologies. Two fillers (limestone powder and quartz powder) were also used to compare their effects to that of CKDs at an equivalent replacement of PC. The first objective of this study was to conduct a comprehensive composition analysis of CKDs and compare their characteristics to PC. CKDs are unique materials that must be analyzed differently from PC for accurate chemical and physical analysis. The present study identifies the chemical and physical analytical methods that should be used for CKDs. The study also introduced a method to quantify the relative abundance of the different

  20. Effect of strontium-containing hydroxyapatite bone cement on bone remodeling following hip replacement.

    PubMed

    Ni, Guo X; Lin, Jian H; Chiu, Peter K Y; Li, Zhao Y; Lu, William W

    2010-01-01

    It is uncertain whether the use of bioactive bone cement has any beneficial effect on local bone adaptation following hip replacement. In this study, twelve goats underwent cemented hip hemiarthroplasty unilaterally, with either PMMA bone cement or strontium-containing hydroxyapatite (Sr-HA) bioactive bone cement. Nine months later, the femoral cortical bones at different levels were analyzed by microhardness testing and micro-CT scanning. Extensive bone remodeling was found at proximal and mid-levels in both PMMA and Sr-HA groups. However, with regard to the differences of bone mineral density, cortical bone area and bone hardness between implanted and non-implanted femur, less decreases were found in Sr-HA group than PMMA group at proximal and mid-levels, and significant differences were shown for bone area and hardness at proximal level. The results suggested that the use of Sr-HA cement might alleviate femoral bone remodeling after hip replacement. PMID:19728042

  1. Palacos compared to Palamed bone cement in total hip replacement: a randomized controlled trial.

    PubMed

    Meinardi, Joris E; Valstar, Edward R; Van Der Voort, Paul; Kaptein, Bart L; Fiocco, Marta; Nelissen, Rob G H H

    2016-10-01

    Background and purpose - Stability and survival of cemented total hip prostheses is dependent on a multitude of factors, including the type of cement that is used. Bone cements vary in viscosity, from low to medium and high. There have been few clinical RSA studies comparing the performance of low- and high-viscosity bone cements. We compared the migration behavior of the Stanmore hip stem cemented using novel low-viscosity Palamed bone cement with that of the same stem cemented with conventional high-viscosity Palacos bone cement. Patients and methods - We performed a randomized controlled study involving 39 patients (40 hips) undergoing primary total hip replacement for primary or secondary osteoarthritis. 22 patients (22 hips) were randomized to Palacos and 17 patients (18 hips) were randomized to Palamed. Migration was determined by RSA. Results - None of these 40 hips had been revised at the 10-year follow-up mark. To our knowledge, the patients who died before they reached the 10-year endpoint still had the implant in situ. No statistically significant or clinically significant differences were found between the 2 groups for mean translations, rotations, and maximum total-point motion (MTPM). Interpretation - We found similar migration of the Stanmore stem in the high-viscosity Palacos cement group and the low-viscosity Palamed cement group. We therefore expect that the risk of aseptic loosening with the new Palamed cement would be comparable to that with the conventional Palacos cement. The choice of which type of bone cement to use is therefore up to the surgeon's preference. PMID:27329869

  2. Use of waste brick as a partial replacement of cement in mortar

    SciTech Connect

    Naceri, Abdelghani Hamina, Makhloufi Chikouche

    2009-08-15

    The aim of this study is to investigate the use of waste brick as a partial replacement for cement in the production of cement mortar. Clinker was replaced by waste brick in different proportions (0%, 5%, 10%, 15% and 20%) by weight for cement. The physico-chemical properties of cement at anhydrous state and the hydrated state, thus the mechanical strengths (flexural and compressive strengths after 7, 28 and 90 days) for the mortar were studied. The microstructure of the mortar was investigated using scanning electron microscopy (SEM), the mineralogical composition (mineral phases) of the artificial pozzolan was investigated by the X-ray diffraction (XRD) and the particle size distributions was obtained from laser granulometry (LG) of cements powders used in this study. The results obtained show that the addition of artificial pozzolan improves the grinding time and setting times of the cement, thus the mechanical characteristics of mortar. A substitution of cement by 10% of waste brick increased mechanical strengths of mortar. The results of the investigation confirmed the potential use of this waste material to produce pozzolanic cement.

  3. Use of waste brick as a partial replacement of cement in mortar.

    PubMed

    Naceri, Abdelghani; Hamina, Makhloufi Chikouche

    2009-08-01

    The aim of this study is to investigate the use of waste brick as a partial replacement for cement in the production of cement mortar. Clinker was replaced by waste brick in different proportions (0%, 5%, 10%, 15% and 20%) by weight for cement. The physico-chemical properties of cement at anhydrous state and the hydrated state, thus the mechanical strengths (flexural and compressive strengths after 7, 28 and 90 days) for the mortar were studied. The microstructure of the mortar was investigated using scanning electron microscopy (SEM), the mineralogical composition (mineral phases) of the artificial pozzolan was investigated by the X-ray diffraction (XRD) and the particle size distributions was obtained from laser granulometry (LG) of cements powders used in this study. The results obtained show that the addition of artificial pozzolan improves the grinding time and setting times of the cement, thus the mechanical characteristics of mortar. A substitution of cement by 10% of waste brick increased mechanical strengths of mortar. The results of the investigation confirmed the potential use of this waste material to produce pozzolanic cement. PMID:19383569

  4. Polyethylene wear in uncemented acetabular components.

    PubMed

    Hernandez, J R; Keating, E M; Faris, P M; Meding, J B; Ritter, M A

    1994-03-01

    We measured polyethylene wear in 231 porous-coated uncemented acetabular cups. We divided the hips into two groups according to the fixation of the femoral component, by cementing (n = 97) or press-fit (n = 134). Follow-up was from three to five years. The patients in two sub-groups were matched for weight, diagnosis, sex, age and length of follow-up. The linear wear rate of cups articulated with uncemented femoral components (0.22 mm/year) was significantly higher than the wear rate (0.15 mm/year) of cups articulated within cemented femoral components (p < 0.05). These results can be compared with previously reported wear rates of 0.08 mm/year for cemented all-polyethylene cups and 0.11 mm/year for cemented metal-backed cups. The higher wear rates of uncemented arthroplasties could jeopardize the long-term results of this type of hip replacement. PMID:8113288

  5. Optimization of fly ash as sand replacement materials (SRM) in cement composites containing coconut fiber

    NASA Astrophysics Data System (ADS)

    Nadzri, N. I. M.; Jamaludin, S. B.; Mazlee, M. N.; Jamal, Z. A. Z.

    2016-07-01

    The need of utilizing industrial and agricultural wastes is very important to maintain sustainability. These wastes are often incorporated with cement composites to improve performances in term of physical and mechanical properties. This study presents the results of the investigation of the response of cement composites containing coconut fiber as reinforcement and fly ash use as substitution of sand at different hardening days. Hardening periods of time (7, 14 and 28 days) were selected to study the properties of cement composites. Optimization result showed that 20 wt. % of fly ash (FA) is a suitable material for sand replacement (SRM). Meanwhile 14 days of hardening period gave highest compressive strength (70.12 MPa) from the cement composite containing 9 wt. % of coconut fiber and fly ash. This strength was comparable with the cement without coconut fiber (74.19 MPa) after 28 days of curing.

  6. Comparison of cementing techniques of the tibial component in total knee replacement

    PubMed Central

    Li, Ming Guo; Wood, David; Nivbrant, Bo

    2008-01-01

    A few studies have shown that cementing the stem enhances fixation of the tibial baseplate in total knee replacement (TKR). Even the horizontal technique has been shown to provide good fixation. We used radiostereometry to study migration of the tibial component in 30 knees operated with Profix TKR. The knees were randomised for either complete (both under the baseplate and around the stem) or horizontal (only under the baseplate) cementing of the tibial component. At two years the tibial baseplate rotated externally a median of 0.18° in the uncemented stem group and internally a median of 0.23° in the cemented stem group. The tibial baseplate subsided 0.14 mm in the cemented stem group, and no translation was seen in the uncemented stem group. The differences in migration were small and probably without clinical significance. The findings do not favour either of the cementing techniques in TKR. PMID:18704414

  7. Comparison of cementing techniques of the tibial component in total knee replacement.

    PubMed

    Saari, Tuuli; Li, Ming Guo; Wood, David; Nivbrant, Bo

    2009-10-01

    A few studies have shown that cementing the stem enhances fixation of the tibial baseplate in total knee replacement (TKR). Even the horizontal technique has been shown to provide good fixation. We used radiostereometry to study migration of the tibial component in 30 knees operated with Profix TKR. The knees were randomised for either complete (both under the baseplate and around the stem) or horizontal (only under the baseplate) cementing of the tibial component. At two years the tibial baseplate rotated externally a median of 0.18 degrees in the uncemented stem group and internally a median of 0.23 degrees in the cemented stem group. The tibial baseplate subsided 0.14 mm in the cemented stem group, and no translation was seen in the uncemented stem group. The differences in migration were small and probably without clinical significance. The findings do not favour either of the cementing techniques in TKR. PMID:18704414

  8. Options for acetabular fixation surfaces.

    PubMed

    Klika, Alison K; Murray, Trevor G; Darwiche, Hussein; Barsoum, Wael K

    2007-01-01

    Aseptic loosening is the most common cause for revision total hip arthroplasty (THA). Due to poor long-term results with cemented acetabular components, cementless implants that rely on biologic fixation became popular in the United States for both primary and revision procedures in the early 1980s. Cementless acetabular components used in THA have been reported to have superior radiographic performance compared with cemented fixation, although the optimal method of acetabular fixation remains controversial. Cementless acetabular components require initial implant stability to allow for bone ingrowth and remodeling into the acetabular shell, providing long-term durability of the prosthesis. Many improved implant materials are available to facilitate bone growth and remodeling, including the 3 most common surface treatments; fibermesh, sintered beads, and plasma spray coatings. Recently added to these are porous metal surfaces, which have increased porosity and optimal pore sizes when compared with titanium fibermesh. The most studied of these materials is the titanium fibermesh fixation surface, which has demonstrated a mechanical failure rate of 1% at 10 to 15 years. This technology utilizes the diffusion bonding process to attach fiber metal pads to a titanium substrate using heat and pressure. The sintered bead fixation surface offers a porous coating of various sizes of spherical beads, achieved by the sintering process, and has been shown to provide long-term fixation. While there are less long-term published data regarding the titanium plasma spray surface, its early results have provided evidence of its durability, even in the face of significant osteolysis. The most recently added alternative fixation surface is porous tantalum metal, which offers potentially greater bone ingrowth and bone graft incorporation due to its high porosity (80%) and low modulus of elasticity (3 MPa). Porous tantalum implants have shown early favorable clinical results and have

  9. Impaction grafted bone chip size effect on initial stability in an acetabular model: Mechanical evaluation

    PubMed Central

    Holton, Colin; Bobak, Peter; Wilcox, Ruth; Jin, Zhongmin

    2013-01-01

    Introduction Acetabular bone defect reconstruction is an increasing problem for surgeons with patients undergoing complex primary or revision total hip replacement surgery. Impaction bone grafting is one technique that has favourable long-term clinical outcome results for patients who undergo this reconstruction method for acetabular bone defects. Creating initial mechanical stability of the impaction bone graft in this technique is known to be the key factor in achieving a favourable implant survival rate. Different sizes of bone chips were used in this technique to investigate if the size of bone chips used affected initial mechanical stability of a reconstructed acetabulum. Methodology Twenty acetabular models were created in total. Five control models were created with a cemented cup in a normal acetabulum. Then five models in three different groups of bone chip size were constructed. The three groups had an acetabular protrusion defect reconstructed using either; 2–4 mm3, 10 mm3 or 20 mm3 bone chip size for impaction grafting reconstruction. The models underwent compression loading up to 9500 N and displacement within the acetabular model was measured indicating the initial mechanical stability. Results This study reveals that, although not statistically significant, the largest (20 mm3) bone chip size grafted models have an inferior maximum stiffness compared to the medium (10 mm3) bone chip size. Interpretations Our study suggests that 10 mm3 size of bone chips provide better initial mechanical stability compared to smaller or larger bone chips. We dismissed the previously held opinion that the biggest practically possible graft is best for acetabular bone graft impaction. PMID:24396238

  10. Use of waste gypsum to replace natural gypsum as set retarders in portland cement

    SciTech Connect

    Chandara, Chea; Azizli, Khairun Azizi Mohd; Ahmad, Zainal Arifin Sakai, Etsuo

    2009-05-15

    The present study is focused on clarifying the influence of waste gypsum (WG) in replacing natural gypsum (NG) in the production of ordinary Portland cement (OPC). WG taken from slip casting moulds in a ceramic factory was formed from the hydration of plaster of paris. Clinker and 3-5 wt% of WG was ground in a laboratory ball mill to produce cement waste gypsum (CMWG). The same procedure was repeated with NG to substitute WG to prepare cement natural gypsum (CMNG). The properties of NG and WG were investigated via X-ray Diffraction (XRD), X-ray fluorescence (XRF) and differential scanning calorimetry (DSC)/thermogravimetric (TG) to evaluate the properties of CMNG and CMWG. The mechanical properties of cement were tested in terms of setting time, flexural and compressive strength. The XRD result of NG revealed the presence of dihydrate while WG contained dihydrate and hemihydrate. The content of dihydrate and hemihydrates were obtained via DSC/TG, and the results showed that WG and NG contained 12.45% and 1.61% of hemihydrate, respectively. Furthermore, CMWG was found to set faster than CMNG, an average of 15.29% and 13.67% faster for the initial and final setting times, respectively. This was due to the presence of hemihydrate in WG. However, the values obtained for flexural and compressive strength were relatively the same for CMNG and CMWG. Therefore, this result provides evidence that WG can be used as an alternative material to NG in the production of OPC.

  11. Dislodgement of a cemented exeter femoral stem during closed manipulative reduction of a dislocated total hip replacement

    PubMed Central

    Rajeev, Aysha; Mohamed, Abdalla; Shaikh, Mazharuddin; Banaszkiewicz, Paul

    2016-01-01

    Introduction The incidence of cemented femoral stem migration and dislodgement even though has been described is extremely unusual. There is a high chance of polished femoral stem displacement happening while trying to reduce a dislocated total hip replacement by closed measures. Presentation of the case A 73 year old lady who had an Exeter cemented total hip replacement about two weeks back was admitted from Accident and Emergency with a dislocation. During the closed manipulative reduction under general anaesthesia it was noted that the femoral stem has dislodged from the canal. She underwent revision of the total hip replacement with good outcome. Discussion Femoral stem dislodgement occurs in total hip replacement if polished stem or inadequate cementing of the collar is carried out. Conclusion Gentle manipulative reduction under general anaesthesia of dislocated total hip replacement should be carried out if the polished femoral stem is used. PMID:27060643

  12. Recycling municipal incinerator fly- and scrubber-ash into fused slag for the substantial replacement of cement in cement-mortars.

    PubMed

    Lee, Tzen-Chin; Rao, Ming-Kang

    2009-06-01

    Fly- and scrubber-ash (weight ratio of approximately 1:3) from municipal solid waste incinerators (MSWI) are a major land-fill disposal problem due to their leaching of heavy metals. We uniformly mixed both types of ash with optimal amounts of waste glass frit, which was then melted into a glassy slag. The glassy slag was then pulverized to a particle size smaller than 38microm for use as a cement substitute (20-40% of total cement) and blended with sand and cement to produce slag-blended cement-mortar (SCM) specimens. The toxicity characteristics of the leaching procedure tests on the pulverized slag samples revealed that the amount of leached heavy metals was far below regulatory thresholds. The compressive strength of the 28-day cured SCM specimens was comparable to that of ordinary Portland cement mortars, while the compressive strength of specimens cured for 60 or 90 days were 3-11% greater. The observed enhanced strength is achieved by Pozzolanic reaction. Preliminary evaluation shows that the combination of MSWI fly- and scrubber-ash with waste glass yields a cost effective and environmentally friendly cement replacement in cement-mortars. PMID:19216067

  13. Use of waste gypsum to replace natural gypsum as set retarders in portland cement.

    PubMed

    Chandara, Chea; Azizli, Khairun Azizi Mohd; Ahmad, Zainal Arifin; Sakai, Etsuo

    2009-05-01

    The present study is focused on clarifying the influence of waste gypsum (WG) in replacing natural gypsum (NG) in the production of ordinary Portland cement (OPC). WG taken from slip casting moulds in a ceramic factory was formed from the hydration of plaster of paris. Clinker and 3-5wt% of WG was ground in a laboratory ball mill to produce cement waste gypsum (CMWG). The same procedure was repeated with NG to substitute WG to prepare cement natural gypsum (CMNG). The properties of NG and WG were investigated via X-ray Diffraction (XRD), X-ray fluorescence (XRF) and differential scanning calorimetry (DSC)/thermogravimetric (TG) to evaluate the properties of CMNG and CMWG. The mechanical properties of cement were tested in terms of setting time, flexural and compressive strength. The XRD result of NG revealed the presence of dihydrate while WG contained dihydrate and hemihydrate. The content of dihydrate and hemihydrates were obtained via DSC/TG, and the results showed that WG and NG contained 12.45% and 1.61% of hemihydrate, respectively. Furthermore, CMWG was found to set faster than CMNG, an average of 15.29% and 13.67% faster for the initial and final setting times, respectively. This was due to the presence of hemihydrate in WG. However, the values obtained for flexural and compressive strength were relatively the same for CMNG and CMWG. Therefore, this result provides evidence that WG can be used as an alternative material to NG in the production of OPC. PMID:19131236

  14. Canine intersegmental hip joint forces and moments before and after cemented total hip replacement.

    PubMed

    Dogan, S; Manley, P A; Vanderby, R; Kohles, S S; Hartman, L M; McBeath, A A

    1991-01-01

    Intersegmental forces and moments (i.e. resultant free body forces and moments computed at the joint centers) were studied in canine hindlimbs before and after cemented total hip replacement (THR). Five large, adult, mixed-breed dogs were selected. Their gait was recorded (while leash-walked) before surgery using high-speed cinematography and a force plate. Cemented total hip replacement was unilaterally performed on each dog. Gait was again recorded at one and four months after surgery. Segmental properties (mass, center of mass, and mass moment of inertia) of the hindlimbs were experimentally determined, and an inverse dynamics approach was used to compute intersegmental forces and moments in the sagittal plane. Significant reductions in intersegmental joint forces and moments were observed in the operated hindlimb one month after surgery, although kinematic gait parameters were unaltered. Decreases of 77.0% for vertical forces, 61.9% for craniocaudal forces, and 66.2% for extension moments were determined. Four months after surgery, the joint forces and moments had returned to their preoperative values. This experiment demonstrates that the dynamics of normal walking can be restored in a canine model by four months after THR. It also shows that kinetic (rather than kinematic) parameters are more descriptive of antalgic gait in the canine. PMID:1856240

  15. The acetabular component: an elliptical monoblock alternative.

    PubMed

    Sculco, Thomas P

    2002-06-01

    The major failure mode of cemented or noncemented acetabular fixation is osteolysis produced by biologic reaction to polyethylene and metallic debris. A monoblock acetabular noncemented component offers advantages in reducing the failure mechanism of acetabular cups. First, there is no extra-articular back surface polyethylene wear. Second, locking rings that may generate metallic debris are eliminated. Third, screw-holes, which decrease the surface area for ingrowth, are not needed, and pelvic entrance points for wear debris are eliminated. Fourth, an elliptical configuration allows better coaptation of the shell to the dome of the acetabulum. I have implanted >2,400 elliptical monoblock acetabular cups with a short-term follow-up of 6.5 years, with >4 years of follow-up in 840 hips. There have been no mechanical failures requiring revision. Four patients have been revised for recurrent hip instability, and one has been revised for infection. The need to convert to an acetabular component with screw fixation because of poor press-fit is <1%. PMID:12068420

  16. Impacted morsellized bone grafting and cemented primary total hip arthroplasty for acetabular protrusion in patients with rheumatoid arthritis: an 8- to 18-year follow-up study of 36 hips.

    PubMed

    Rosenberg, W W; Schreurs, B W; de Waal Malefijt, M C; Veth, R P; Slooff, T J

    2000-04-01

    Between 1979 and 1989, we performed 36 primary total hip replacements in 31 rheumatoid arthritis patients with protrusio acetabuli. The deficient acetabulum was reconstructed with autologous morsellized bone grafts from the femoral head. 3 patients were lost to follow-up. 12 patients (13 hips) died within 8 years postoperatively, none had a revision. 16 patients (20 hips) were reviewed at an average follow-up of 12 (8-18) years. In 2 hips, a revision was performed for aseptic loosening of the acetabular component, 65 and 8 years after primary surgery, which means a 90% (95% CI: 77%-100%) survival rate at 12 years (Kaplan Meier analysis). This technique is a good option in cases with protrusio acetabuli due to rheumatoid arthritis. PMID:10852319

  17. New methodology for assessing the environmental burden of cement mortars with partial replacement of coal bottom ash and fly ash.

    PubMed

    Menéndez, E; Álvaro, A M; Hernández, M T; Parra, J L

    2014-01-15

    This paper assess the mechanical an environmental behaviour of cement mortars manufactured with addition of fly ash (FA) and bottom ash (BA), as partial cement replacement (10%, 25% and 35%). The environmental behaviour was studied by leaching tests, which were performed under several temperature (23 °C and 60 °C) and pH (5 and 10) conditions, and ages (1, 2, 4 and 7 days). Then, the accumulated amount of the different constituents leached was analysed. In order to obtain an environmental burden (EB) value of each cement mixture, a new methodology was developed. The EB value obtained is related to the amount leached and the hazardous level of each constituent. Finally, the integral study of compressive strength and EB values of cement mixtures allowed their classification. The results showed that mortars manufactured with ordinary Portland cement (OPC) and with coal BA had similar or even better environmental and mechanical behaviour than mortars with FA. Therefore, the partial replacement of cement by BA might be as suitable or even better as the replacement by FA. PMID:24412590

  18. The behavior of the micro-mechanical cement-bone interface affects the cement failure in total hip replacement

    PubMed Central

    Waanders, Daan; Janssen, Dennis; Mann, Kenneth A.; Verdonschot, Nico

    2010-01-01

    In the current study, the effects of different ways to implement the complex micro-mechanical behavior of the cement-bone interface on the fatigue failure of the cement mantle was investigated. In an FEA-model of a cemented hip reconstruction the cement-bone interface was modeled and numerically implemented in four different ways: (I) as infinitely stiff, (II) as infinitely strong with a constant stiffness, (III) a mixed-mode failure response with failure in tension and shear, and (IV) realistic mixed mode behavior obtained from micro FEA-models. Case II, III and IV were analyzed using data from a stiff and a compliant micro-FEA model and their effects on cement failure were analyzed. The data used for Case IV was derived from experimental specimens that were tested previously. Although the total number of cement cracks was low for all cases, the compliant Case II resulted in twice as many cracks as Case I. All cases caused similar stress distributions at the interface. In all cases, the interface did not display interfacial softening; all stayed the elastic zone. Fatigue failure of the cement mantle resulted in a more favorable stress distribution at the cement-bone interface in terms of less tension and lower shear tractions. We conclude that immediate cement-bone interface failure is not likely to occur, but its local compliancy does affect the formation of cement cracks. This means that at a macro-level the cement-bone interface should be modeled as a compliant layer. However, implementation of interfacial post-yield softening does seem to be necessary. PMID:21036358

  19. Bone density and anisotropy affect periprosthetic cement and bone stresses after anatomical glenoid replacement: A micro finite element analysis.

    PubMed

    Chevalier, Yan; Santos, Inês; Müller, Peter E; Pietschmann, Matthias F

    2016-06-14

    Glenoid loosening is still a main complication for shoulder arthroplasty. We hypothesize that cement and bone stresses potentially leading to fixation failure are related not only to glenohumeral conformity, fixation design or eccentric loading, but also to bone volume fraction, cortical thickness and degree of anisotropy in the glenoid. In this study, periprosthetic bone and cement stresses were computed with micro finite element models of the replaced glenoid depicting realistic bone microstructure. These models were used to quantify potential effects of bone microstructural parameters under loading conditions simulating different levels of glenohumeral conformity and eccentric loading simulating glenohumeral instability. Results show that peak cement stresses were achieved near the cement-bone interface in all loading schemes. Higher stresses within trabecular bone tissue and cement mantle were obtained within specimens of lower bone volume fraction and in regions of low anisotropy, increasing with decreasing glenohumeral conformity and reaching their maxima below the keeled design when the load is shifted superiorly. Our analyses confirm the combined influences of eccentric load shifts with reduced bone volume fraction and anisotropy on increasing periprosthetic stresses. They finally suggest that improving fixation of glenoid replacements must reduce internal cement and bone tissue stresses, in particular in glenoids of low bone density and heterogeneity. PMID:27087675

  20. Pelvic and acetabular fractures

    SciTech Connect

    Mears, D.C.; Rubash, H.E.

    1986-01-01

    This treatise focuses primarily on the clinical aspects of diagnosis and treatments of pelvic and acetabular fractures. However, considerable attention is also paid to the radiographic diagnosis of trauma and postoperative effects. The book begins with a succinct review of pelvic and acetabular anatomy and pelvic biomechanics. It continues with a radiographic classification of pelvic injury, which will represent the major source of the book's interest for radiologists. The remainder of the book is concerned with clinical management of pelvic and acetabular trauma, including preoperative planning, surgical approaches, techniques of reduction, internal fixation, eternal fixation, post-operative care, and late problems. Even throughout this later portion of the book there are extensive illustrations, including plain radiographs, computed tomographic (CT) scans, reconstructed three-dimensional CT scans, and schematic diagrams of diverse pelvic and acetabular fractures and the elementary surgical techniques for their repair.

  1. Mechanical effects of stem cement interface characteristics in total hip replacement.

    PubMed

    Verdonschot, N; Huiskes, R

    1996-08-01

    Stem cement debonding is 1 of the most common forms of fixation failure and is thought to be a prelude to gross loosening of a total hip reconstruction. However, the immediate consequences of debonding remains a matter of controversy. The dynamic effects of stem cement debonding in total hip reconstruction were analyzed using 3-dimensional finite element techniques. Stem cement interface conditions were assumed as completely bonded or unbonded, with or without friction. The dynamic effects were accounted for, as presented by the stance and swing phases of the gait cycle. It was found that both cyclic micromotions at the stem cement interface and stresses in the cement mantle were effectively reduced by friction. The friction cases produced failure probabilities of the cement mantle that were relatively close to the one generated by the bonded stem. The probability of mechanical failure of the cement bone interface decreased after debonding and decreased more with reduced stem cement friction. These results show that, although a firm and lasting bond between stem and cement may be desirable for preventing cement failure, the mechanical effects of a debonded stem are less detrimental than were assumed earlier. For straight tapered stem shapes subjected to the loading conditions described, a polished stem may be desirable for the cement bone interface mechanics. PMID:8769468

  2. Size of metallic and polyethylene debris particles in failed cemented total hip replacements

    NASA Technical Reports Server (NTRS)

    Lee, J. M.; Salvati, E. A.; Betts, F.; DiCarlo, E. F.; Doty, S. B.; Bullough, P. G.

    1992-01-01

    Reports of differing failure rates of total hip prostheses made of various metals prompted us to measure the size of metallic and polyethylene particulate debris around failed cemented arthroplasties. We used an isolation method, in which metallic debris was extracted from the tissues, and a non-isolation method of routine preparation for light and electron microscopy. Specimens were taken from 30 cases in which the femoral component was of titanium alloy (10), cobalt-chrome alloy (10), or stainless steel (10). The mean size of metallic particles with the isolation method was 0.8 to 1.0 microns by 1.5 to 1.8 microns. The non-isolation method gave a significantly smaller mean size of 0.3 to 0.4 microns by 0.6 to 0.7 microns. For each technique the particle sizes of the three metals were similar. The mean size of polyethylene particles was 2 to 4 microns by 8 to 13 microns. They were larger in tissue retrieved from failed titanium-alloy implants than from cobalt-chrome and stainless-steel implants. Our results suggest that factors other than the size of the metal particles, such as the constituents of the alloy, and the amount and speed of generation of debris, may be more important in the failure of hip replacements.

  3. A tribological study of UHMWPE acetabular cups and polyurethane compliant layer acetabular cups.

    PubMed

    Smith, S L; Ash, H E; Unsworth, A

    2000-01-01

    , was found with cement fixation (0.30 mm penetration with cement fixation, 0.44 mm with polyethylene holder mounting, and 0.52 mm with metal shell mounting). A 4. 25-million-cycle wear test was then conducted on a further five ABG flared form, polyurethane acetabular cups with cement fixation. Five ABG standard form, UHMWPE acetabular cups were also wear-tested to 5. 0-million cycles. The mean and standard error of the wear rate for the polyurethane cups were 14.1 +/- 4.3 mg/10(6) (12.0 +/- 3.6 mm(3)/10(6)), cycles compared with 44.8 +/- 3.4 mg/10(6) (48.2 +/- 3. 7 mm(3)/10(6)), cycles for the UHMWPE cups. This study showed that the novel polyurethane-compliant layer acetabular cup with cement fixation was tribologically superior to the ABG standard form UHMWPE design currently being used clinically. PMID:11074431

  4. Validation of a computer-assisted method for measurement of radiographic wear in total hip arthroplasty using all polyethylene cemented acetabular components.

    PubMed

    Langlois, Jean; Zaoui, Amine; Scemama, Caroline; Martell, John; Bragdon, Charles; Hamadouche, Moussa

    2015-03-01

    Although cemented all polyethylene (PE) cups have been routinely used in total hip arthroplasty for decades, no computer-assisted method for measurement of radiographic wear has ever been specifically validated for these implants. Using a validated hip phantom model, AP plain hip radiographs were obtained consecutively for eight simulated wear positions. A version of Martell's Hip Analysis Suite software dedicated to all polyethylene sockets was used by three different examiners of varied experience. Bias (mean, standard deviation and 95% confidence interval limit), repeatability (standard deviation and 95% limit) and reproducibility (standard deviation and 95% limit) for two-dimensional wear measurements were assessed, as recommended by the current ASTM guidelines. Using this protocol, the dedicated software showed an overall mean bias of 0.089 ± 0.060 mm (mean ± SD), and 0.118 mm for 95% CI limit. Repeatability (intra examiner) standard deviation and 95% limit were respectively 0.106 mm and 0.292 mm. Reproducibility (inter examiner) standard deviation and 95% limit were respectively 0.112 mm and 0.308 mm. Martell Hip Analysis for all PE cemented cups is a reliable and low-cost instrument in the assessment of wear, despite being less precise than its original version dedicated to cementless components. PMID:25564735

  5. Hemispheric titanium porous coated acetabular component without screw fixation.

    PubMed

    Dorr, L D; Wan, Z; Cohen, J

    1998-06-01

    One hundred fifteen hips in 108 patients with primary total hip arthroplasty using the anatomic porous replacement hemispheric acetabular component implanted without adjunctive screw fixation had a mean postoperative followup time of 6 years (range, 5-7.4 years). Clinical evaluation was performed using the Harris hip score and patient self assessment using a modified Short Form-36 questionnaire. Radiographs were measured for radiolucent lines, polyethylene wear, osteolysis, migration, and fractures. No acetabular metal shell had been revised for loosening or was radiographically loose with or without migration (more than 3 mm) at final followup. Reoperation was done in nine (8%) hips because of polyethylene insert wear or disassembly. No fracture of the acetabular bone occurred at the time of surgery or was observed on radiograph. Fixation of the metal shell was stable, with progressive radiolucent lines observed at final followup in 2% of the hips. Osteolysis was recorded in one patient with two acetabular components. The fixation of noncemented hemispheric porous coated acetabular components is more related to the technique of acetabular bone preparation and press fit implantation than to whether additional screws or peg fixation are used. Fixation of this acetabular component without screws at an average of 6 years after surgery is reproducible and predictable in primary hip arthroplasty. The design of modular polyethylene inserts has been improved and should reduce the wear rate of reoperations of the polyethylene insert. PMID:9646758

  6. Femoral and obturator nerves palsy caused by pelvic cement extrusion after hip arthroplasty.

    PubMed

    Zwolak, Pawel; Eysel, Peer; William-Patrick Michael, Joern

    2011-03-17

    Cement extrusion into the pelvis with subsequent palsy of the obturator and femoral nerves is a rare entity after hip replacement surgery. Cemented fixation of the acetabular cup has been considered as a safe and reliable standard procedure with very good long term results. We present a case of fifty year old female patient after hip arthroplasty procedure which suffered an obturator and femoral nerve palsy caused by extrusion of bone cement into the pelvis. Postoperative X-rays and CT-scan of the pelvis demonstrated a huge mass consisted of bone cement in close proximity of femoral and obturator nerves. The surgery charts reported shallow and weak bony substance in postero-superior aspect of the acetabulum. This weak bony acetabular substance may have caused extrusion of bone cement during press-fitting of the polyethylene cup into the acetabulum, and the following damage of the both nerves produced by polymerization of bone cement. The bone cement fragment has been surgically removed 3 weeks after arthroplasty. The female patient underwent intensive postoperative physical therapy and electro stimulation which resulted in full recovery of the patient to daily routine and almost normal electromyography results. PMID:21808718

  7. Computer-based gait analysis of dogs: evaluation of kinetic and kinematic parameters after cemented and cementless total hip replacement.

    PubMed

    Drüen, S; Böddeker, J; Meyer-Lindenberg, A; Fehr, M; Nolte, I; Wefstaedt, P

    2012-01-01

    To date it is unclear whether cementless total hip replacement (THR) in dogs is of clinical advantage in comparison to cemented THR with regard to lameness improvement. Thus the aim of this study was to compare objectively the development of the gait pattern after cemented and cementless THR in dogs. For this purpose, 18 adult dogs with hip dysplasia underwent computer-based gait analysis on an instrumented treadmill prior to unilateral THR and then again ten days, four weeks and four months after surgery. Analysed kinetic parameters were symmetry indices (SI) of vertical ground reaction forces (GRF), which included peak vertical forces (PFz), mean vertical forces (MFz), vertical impulse (IFz), and vertical ground reaction forces of the arthroplasty limbs only. Analysed kinematic parameters were range-of-motion and the flexion and extension angles of hip, stifle and hock joints. The symmetry indice for PVF, MFz and IFz decreased to a value less than six in both THR groups four months after surgery, which is defined as not lame. Improvement in lameness of the arthroplasty limbs during the examination period of four months was not significantly different between the cemented and cementless groups. The results suggest that within a short-term observation period of four months after surgery, neither cementless nor cemented THR have a greater advantage with regard to lameness improvement. Additional studies with larger pools of subjects and longer time periods for follow-up examinations are necessary to verify these findings. PMID:22828804

  8. Difference in the acetabular cup orientation in standing and supine radiographs.

    PubMed

    Khan, Munir; Beckingsale, Tom; Marsh, Martin; Holland, Jim

    2016-09-01

    Acetabular orientation changes with that of the pelvis during lying and standing. This study was designed to measure these changes. We assessed 17 BHR replacements using EBRA software. The mean acetabular anteversion was more (p = 0.02) on erect than supine radiographs. Linear regression analysis showed that anteversion and inclination increased in some while decreased in others, and Bland and Altman analysis showed wide limits of agreement. The changes in acetabular orientation are thus subject to significant variations between the patients. We suggest studying the factors affecting acetabular orientation in standing to help reduce joint reaction forces and improve outcomes. PMID:27408490

  9. Activity and loading influence the predicted bone remodeling around cemented hip replacements.

    PubMed

    Dickinson, Alexander S

    2014-04-01

    Periprosthetic bone remodeling is frequently observed after total hip replacement. Reduced bone density increases the implant and bone fracture risk, and a gross loss of bone density challenges fixation in subsequent revision surgery. Computational approaches allow bone remodeling to be predicted in agreement with the general clinical observations of proximal resorption and distal hypertrophy. However, these models do not reproduce other clinically observed bone density trends, including faster stabilizing mid-stem density losses, and loss-recovery trends around the distal stem. These may resemble trends in postoperative joint loading and activity, during recovery and rehabilitation, but the established remodeling prediction approach is often used with identical pre- and postoperative load and activity assumptions. Therefore, this study aimed to evaluate the influence of pre- to postoperative changes in activity and loading upon the predicted progression of remodeling. A strain-adaptive finite element model of a femur implanted with a cemented Charnley stem was generated, to predict 60 months of periprosthetic remodeling. A control set of model input data assumed identical pre- and postoperative loading and activity, and was compared to the results obtained from another set of inputs with three varying activity and load profiles. These represented activity changes during rehabilitation for weak, intermediate and strong recoveries, and pre- to postoperative joint force changes due to hip center translation and the use of walking aids. Predicted temporal bone density change trends were analyzed, and absolute bone density changes and the time to homeostasis were inspected, alongside virtual X-rays. The predicted periprosthetic bone density changes obtained using modified loading inputs demonstrated closer agreement with clinical measurements than the control. The modified inputs also predicted the clinically observed temporal density change trends, but still under

  10. Outcome of total knee replacement following explantation and cemented spacer therapy

    PubMed Central

    Ghanem, Mohamed; Zajonz, Dirk; Bollmann, Juliane; Geissler, Vanessa; Prietzel, Torsten; Moche, Michael; Roth, Andreas; Heyde, Christoph-E.; Josten, Christoph

    2016-01-01

    Background: Infection after total knee replacement (TKR) is one of the serious complications which must be pursued with a very effective therapeutic concept. In most cases this means revision arthroplasty, in which one-setting and two-setting procedures are distinguished. Healing of infection is the conditio sine qua non for re-implantation. This retrospective work presents an assessment of the success rate after a two-setting revision arthroplasty of the knee following periprosthetic infection. It further considers drawing conclusions concerning the optimal timing of re-implantation. Patients and methods: A total of 34 patients have been enclosed in this study from September 2005 to December 2013. 35 re-implantations were carried out following explantation of total knee and implantation of cemented spacer. The patient’s group comprised of 53% (18) males and 47% (16) females. The average age at re-implantation time was 72.2 years (ranging from 54 to 85 years). We particularly evaluated the microbial spectrum, the interval between explantation and re-implantation, the number of surgeries that were necessary prior to re-implantation as well as the postoperative course. Results: We reported 31.4% (11) reinfections following re-implantation surgeries. The number of the reinfections declined with increasing time interval between explantation and re-implantation. Patients who developed reinfections were operated on (re-implantation) after an average of 4.47 months. Those patients with uncomplicated course were operated on (re-implantation) after an average of 6.79 months. Nevertheless, we noticed no essential differences in outcome with regard to the number of surgeries carried out prior to re-implantation. Mobile spacers proved better outcome than temporary arthrodesis with intramedullary fixation. Conclusion: No uniform strategy of treatment exists after peri-prosthetic infections. In particular, no optimal timing can be stated concerning re-implantation. Our data

  11. A valuable technique for femoral stem revision in total hip replacement: The in-cement revision - A case series and technical note.

    PubMed

    McDougall, C J; Yu, J; Calligeros, K; Crawford, R; Howie, C R

    2016-12-01

    Revision of a cemented femoral stem can be a challenging procedure. We present a series of cases utilising the "In-cement" revision, whereby the same size stem is introduced into the original cement mantle, without additional cementing. It requires a stable cement mantle in the correct version. We describe the technique and present a review of 23 revision total hip replacements performed over a 5 year period. At average follow-up of 67 months (12-128 months), the overall survivorship was 91.3% with no patient requiring re-revision for stem loosening or mechanical failure. Two patients required re-revision for infection and one of those patients is now deceased. No further operations were required in 21 patients. The "In-cement" revision can be a valuable technique for the revision arthroplasty surgeon. Early results suggest this is a safe and effective technique in the appropriate patient. PMID:27408507

  12. Effect of copolymer latexes on physicomechanical properties of mortar containing high volume fly ash as a replacement material of cement.

    PubMed

    Negim, El-Sayed; Kozhamzharova, Latipa; Gulzhakhan, Yeligbayeva; Khatib, Jamal; Bekbayeva, Lyazzat; Williams, Craig

    2014-01-01

    This paper investigates the physicomechanical properties of mortar containing high volume of fly ash (FA) as partial replacement of cement in presence of copolymer latexes. Portland cement (PC) was partially replaced with 0, 10, 20, 30 50, and 60% FA. Copolymer latexes were used based on 2-hydroxyethyl acrylate (2-HEA) and 2-hydroxymethylacrylate (2-HEMA). Testing included workability, setting time, absorption, chemically combined water content, compressive strength, and scanning electron microscopy (SEM). The addition of FA to mortar as replacement of PC affected the physicomechanical properties of mortar. As the content of FA in the concrete increased, the setting times (initial and final) were elongated. The results obtained at 28 days of curing indicate that the maximum properties of mortar occur at around 30% FA. Beyond 30% FA the properties of mortar reduce and at 60% FA the properties of mortar are lower than those of the reference mortar without FA. However, the addition of polymer latexes into mortar containing FA improved most of the physicomechanical properties of mortar at all curing times. Compressive strength, combined water, and workability of mortar containing FA premixed with latexes are higher than those of mortar containing FA without latexes. PMID:25254256

  13. Effect of Copolymer Latexes on Physicomechanical Properties of Mortar Containing High Volume Fly Ash as a Replacement Material of Cement

    PubMed Central

    Kozhamzharova, Latipa; Gulzhakhan, Yeligbayeva; Bekbayeva, Lyazzat; Williams, Craig

    2014-01-01

    This paper investigates the physicomechanical properties of mortar containing high volume of fly ash (FA) as partial replacement of cement in presence of copolymer latexes. Portland cement (PC) was partially replaced with 0, 10, 20, 30 50, and 60% FA. Copolymer latexes were used based on 2-hydroxyethyl acrylate (2-HEA) and 2-hydroxymethylacrylate (2-HEMA). Testing included workability, setting time, absorption, chemically combined water content, compressive strength, and scanning electron microscopy (SEM). The addition of FA to mortar as replacement of PC affected the physicomechanical properties of mortar. As the content of FA in the concrete increased, the setting times (initial and final) were elongated. The results obtained at 28 days of curing indicate that the maximum properties of mortar occur at around 30% FA. Beyond 30% FA the properties of mortar reduce and at 60% FA the properties of mortar are lower than those of the reference mortar without FA. However, the addition of polymer latexes into mortar containing FA improved most of the physicomechanical properties of mortar at all curing times. Compressive strength, combined water, and workability of mortar containing FA premixed with latexes are higher than those of mortar containing FA without latexes. PMID:25254256

  14. Cemented total hip prosthesis: Radiographic and scintigraphic evaluation

    SciTech Connect

    Aliabadi, P.; Tumeh, S.S.; Weissman, B.N.; McNeil, B.J. )

    1989-10-01

    Conventional radiographs, technetium-99m bone scans, and gallium-67 scans were reviewed in 44 patients who had undergone cemented total hip joint replacement and were imaged because of suspicion of prosthesis loosening or infection. A complete radiolucent line of 2 mm or wider along the bone-cement interface or metal-cement lucency on conventional radiographs was used as the criterion for prosthetic loosening with or without infection and proved to be 54% sensitive and 96% specific. Scintigraphic criteria for prosthetic loosening were increased focal uptake of the radiopharmaceutical for the femoral component and increased focal or diffuse uptake for the acetabular component. For bone scintigraphy, sensitivity was 73% and specificity was 96%. Combining the results of conventional radiographs and bone scans increased sensitivity to 84% and decreased specificity to 92% for the diagnosis of loosening, infection, or both. The study also showed that Ga-67 scintigraphy has a low sensitivity for the detection of infection.

  15. In vitro measurement of strain in the bone cement surrounding the femoral component of total hip replacements during simulated gait and stair-climbing.

    PubMed

    O'Connor, D O; Burke, D W; Jasty, M; Sedlacek, R C; Harris, W H

    1996-09-01

    The strains in the cement mantle surrounding the cemented femoral component of a total hip replacement were measured in vitro, using strain gauges embedded within the cement mantle adjacent to the femoral component in femurs from cadavers under physiologic loads simulating both single-limb stance and stair-climbing. Cement strains in the most proximal portion of the cement mantle were measured with and without full contact of the collar of the femoral stem on the cortex of the medial portion of the femoral neck during both loading conditions. To our knowledge, these are the first studies to contrast by direct measurement the strain profile in the cement mantle of a cemented femoral component under simulated stair-climbing with that occurring under simulated single-limb stance. They extend the findings from finite element analyses and from clinical specimens retrieved at autopsy in identifying those regions of the cement mantle most likely to fail. At two specific foci, the magnitude of the strain in the cement mantle approaches values that could lead to early fatigue failure of the cement. The two regions in which the strains were highest (greater than 1,000 microstrain) were the most proximal portions of the cement mantle and near the tip of the femoral component. Although these two regions are recognized areas of high strain and also common sites of cement debonding and cement mantle failure, the strain-gauge studies showed that the magnitude of cement strains in the proximal portion of the cement mantle were highest during stair-climbing; in contrast, high strains at the tip region occurred in both gait and stair-climbing. Contact between the collar and the medial portion of the femoral neck reduced the strain in the proximal portion of the cement mantle not only in single-limb stance but in stair-climbing as well. The level of strain recorded in these studies for a simulated person weighing 115 pounds (52 kg) could lead to cement fracture during extended in

  16. Bone cement

    PubMed Central

    Vaishya, Raju; Chauhan, Mayank; Vaish, Abhishek

    2013-01-01

    The knowledge about the bone cement is of paramount importance to all Orthopaedic surgeons. Although the bone cement had been the gold standard in the field of joint replacement surgery, its use has somewhat decreased because of the advent of press-fit implants which encourages bone in growth. The shortcomings, side effects and toxicity of the bone cement are being addressed recently. More research is needed and continues in the field of nanoparticle additives, enhanced bone–cement interface etc. PMID:26403875

  17. Calcium looping spent sorbent as a limestone replacement in the manufacture of portland and calcium sulfoaluminate cements.

    PubMed

    Telesca, Antonio; Marroccoli, Milena; Tomasulo, Michele; Valenti, Gian Lorenzo; Dieter, Heiko; Montagnaro, Fabio

    2015-06-01

    The calcium looping (CaL) spent sorbent (i) can be a suitable limestone replacement in the production of both ordinary Portland cement (OPC) and calcium sulfoaluminate (CSA) cement, and (ii) promotes environmental benefits in terms of reduced CO2 emission, increased energy saving and larger utilization of industrial byproducts. A sample of CaL spent sorbent, purged from a 200 kWth pilot facility, was tested as a raw material for the synthesis of two series of OPC and CSA clinkers, obtained from mixes heated in a laboratory electric oven within temperature ranges 1350°-1500 °C and 1200°-1350 °C, respectively. As OPC clinker-generating mixtures, six clay-containing binary blends were investigated, three with limestone (reference mixes) and three with the CaL spent sorbent. All of them showed similar burnability indexes. Moreover, three CSA clinker-generating blends (termed RM, MA and MB) were explored. They included, in the order: (I) limestone, bauxite and gypsum (reference mix); (II) CaL spent sorbent, bauxite and gypsum; (III) CaL spent sorbent plus anodization mud and a mixture of fluidized bed combustion (FBC) fly and bottom ashes. The maximum conversion toward 4CaO·3Al2O3·SO3, the chief CSA clinker component, was the largest for MB and almost the same for RM and MA. PMID:25915150

  18. Osteonecrosis with the use of polymethylmethacrylate cement for hip replacement: thermal-induced damage evidenced in vivo by decreased osteocyte viability.

    PubMed

    Whitehouse, M R; Atwal, N S; Pabbruwe, M; Blom, A W; Bannister, G C

    2014-01-01

    Thermal damage to host bone is a possible source of compromise of fixation in patients undergoing cemented total hip replacement (THR). Data on the subject to date are derived from mathematical modelling powered by animal studies. The aim of this study was to assess the effect of cement thickness on osteocyte viability in a population of patients undergoing cemented THR. An in vivo model was designed and validated by means of a finite element analysis. During standard hip joint replacement in 14 patients, the femoral necks were exposed before final resection to the heat of a curing cement mantle equivalent to 2.5 (Group 1) or 5 mm (Group 2) in vivo in the cemented acetabulum. Matched controls were collected for each patient. Osteocyte counts and viability were assessed by means of haematoxylin and eosin (H&E) stain and lactate dehydrogenase (LDH) assay. Ex vivo experiments were performed to determine the extent of thermal insult. H&E staining proved unreliable for assessing thermal insult in the short term. The LDH assay was reliable and demonstrated a significant reduction in osteocyte viability to a depth of 2.19 mm in group 1 and 9.19 mm in group 2. There was a significant difference between the groups at all depths. The ex vivo experiments revealed thermoclines indicating that host bone in the population undergoing cemented THR is more sensitive to the thermal insult delivered by curing polymethylmethacrylate cement than previously believed. This thermal insult may weaken the fixation between bone and cement and contribute towards aseptic loosening, the commonest cause of failure of THRs. PMID:24464728

  19. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... uncemented acetabular component, prosthesis. 888.3330 Section 888.3330 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  20. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... uncemented acetabular component, prosthesis. 888.3330 Section 888.3330 Food and Drugs FOOD AND DRUG..., prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip joint. The...

  1. Porous surface replacement of the hip with chamfered-cylinder component.

    PubMed

    Amstutz, H; Kilgus, D; Kabo, M; Dorey, F

    1988-01-01

    One hundred porous surface replacements (PSR) were performed in 92 patients (63 men and 29 women) with a mean age of 53 (range 17-76). Follow-up times range from 1 to 4 years, with 48 patients having a follow-up of at least 2 years. Preoperative diagnoses were osteoarthritis (OA) 63, osteonecrosis (ON) 13, dysplasia 9, rheumatoid-ankylosing spondylitis 6, and other 9. Seventeen hips had metal-backed acrylic-fixed THARIES acetabular sockets, nine hips had a porous cobalt chrome hemispheric beaded acetabular component with adjuvant fixation screws and externally protruding screw hubs, and 74 hips had a porous chamfered cylinder-design acetabulum. Pain relief had been immediate and more complete than with acrylic-fixed or biologic-ingrowth stem-type replacement with comparable walking and function improvements. There have been no major systemic complications, sepsis, or loosening. There have been two transient peroneal nerve palsies and three trochanteric fibrous unions. There have been three reoperations, one for subluxation, one for "metalosis" due to mesh pad loosening, and one femoral neck fracture. Examination of one removed femoral surface component which has been histologically sectioned revealed excellent (90%) bone in-growth. Circumferential progressive radiolucencies developed at the bone-cement interface by 1 year in all of the 17 acrylic-fixed acetabular components. Reaming or seating defects were noted in 25% of the ingrowth components on postoperative radiographs. Radiographic analysis of immediate postoperative films of the chamfered cylinder design acetabular components frequently demonstrated bone-component interface radiolucencies which represented component seating defects. These initial interface radiolucencies became progressively more narrow over the first six months postoperatively suggesting "healing" of the reamed bone-component interface with trabecular bone around the chamfered cylinder acetabular components. Partial healing of initial

  2. Partial replacement of fossil fuel in a cement plant: risk assessment for the population living in the neighborhood.

    PubMed

    Rovira, Joaquim; Mari, Montse; Nadal, Martí; Schuhmacher, Marta; Domingo, José L

    2010-10-15

    In cement plants, the substitution of traditional fossil fuels not only allows a reduction of CO(2), but it also means to check-out residual materials, such as sewage sludge or municipal solid wastes (MSW), which should otherwise be disposed somehow/somewhere. In recent months, a cement plant placed in Alcanar (Catalonia, Spain) has been conducting tests to replace fossil fuel by refuse-derived fuel (RDF) from MSW. In July 2009, an operational test was progressively initiated by reaching a maximum of partial substitution of 20% of the required energy. In order to study the influence of the new process, environmental monitoring surveys were performed before and after the RDF implementation. Metals and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) were analyzed in soil, herbage, and air samples collected around the facility. In soils, significant decreases of PCDD/F levels, as well as in some metal concentrations were found, while no significant increases in the concentrations of these pollutants were observed. In turn, PM(10) levels remained constant, with a value of 16μgm(-3). In both surveys, the carcinogenic and non-carcinogenic risks derived from exposure to metals and PCDD/Fs for the population living in the vicinity of the facility were within the ranges considered as acceptable according to national and international standards. This means that RDF may be a successful choice in front of classical fossil fuels, being in accordance with the new EU environmental policies, which entail the reduction of CO(2) emissions and the energetic valorization of MSW. However, further long-term environmental studies are necessary to corroborate the harmlessness of RDF, in terms of human health risks. PMID:20709362

  3. Cross table lateral radiography for measurement of acetabular cup version

    PubMed Central

    Gunderson, Ragnhild Beate

    2016-01-01

    Background Appropriate orientation of the acetabular cup is an important factor for long-term results of total hip arthroplasty. For measurement of cup version cross-table lateral radiography is frequently used, but the reliability has been questioned. We compared cross table lateral radiography with computed tomography in patients that had undergone primary total hip arthroplasty. Methods The study was prospectively done in 117 patients (117 hips). At 3 months after total hip replacement the acetabular version was measured by cross table lateral radiography and compared to measurements by computed tomography. Results By cross table lateral radiography acetabular anteversion was on mean 13.9° with a standard deviation of 10.1° as compared to 17.8°±12.6° by computed tomography. Mean difference was −3.8 with a distribution of measurements of ±13 degrees for 95% of the cases. Conclusions Our study shows that cross table radiography provides acceptable information for clinical use, but has limited use for precise analysis of acetabular cup version. PMID:27275482

  4. Acute polyethylene fracture in an uncemented acetabular cup

    PubMed Central

    Gross, Allan E.; Dust, William N.

    1997-01-01

    The smaller acetabular components used in total hip replacement may have a polyethylene liner that is too thin, resulting in higher polyethylene stress and an increased potential for wear. The authors present a case that highlights the problem of acute polyethylene fracture. To compensate for the thinness of the polyethylene, the authors recommend the use of a smaller head size to allow polyethylene thickness of at least 8 mm. PMID:9267302

  5. A technique to remove a well-fixed titanium-coated rm acetabular cup in revision hip arthroplasty

    PubMed Central

    2011-01-01

    A major concern during revision hip arthroplasty is acetabular bone loss and bleeding during the extraction of well-fixed cementless acetabular cup, because no interface exists between the host bone and the cup. Forceful removal of such component using curved gouges and osteotomes often leads to extended bone loss and compromises reimplantation of a new socket. In the following case report, we removed a well-fixed polyethylene titanium-coated RM acetabular cup with 20 years of follow-up, by significant wear of the polyethylene layer. The isoelastic femoral stem was also removed by mechanical failure. We report a technique for removal of the cementless acetabular cup using powered acetabular reamers. The RM cup was sequentially reamed and when the polyethylene layer was thin enough, the remaining cup was removed easily by hand tools. The acetabular bone stock is preserved and the risks of bone fractures and bleeding are minimized. To our knowledge, these principles were applied only in cemented cups. We have used this technique in 10 cases with excellent results and no complications were noted. This is a simple, reproducible, non-costly, non-timing consuming, safe and successful technique to remove well-fixed titanium-coated RM acetabular cups. PMID:21689456

  6. Dislocation of a dual mobility total hip replacement following fracture of the polyethylene liner.

    PubMed

    Vedrine, Bertrand; Guillaumot, Pierre; Chancrin, Jean-Luc

    2016-05-18

    An eight-year-old male English Setter was referred for management of a dislocation of a cemented dual mobility canine total hip prosthesis that occurred four months after the initial surgery. Revision surgery showed that the dislocation was associated with fracture of the ultra-high molecular weight polyethylene liner. The dislocation was successfully reduced after replacing the liner. A dual mobility acetabular component is composed of a mobile polyethylene liner inside a metallic cemented cup. Chronic wear of the components of a canine dual mobility total hip replacement has not been described previously. The use of this type of implant is fairly recent and limited long term follow-up of the implanted cases may be the explanation. Acute rupture of a polyethylene liner has never been described in humans, the only case of rupture of a polyethylene liner occurred 10 years after implantation. The case presented here of rupture of the polyethylene liner of a dual mobility total hip replacement is a hitherto unreported failure mode in this model of acetabular cup in the dog. PMID:26991949

  7. Acetabular Reconstruction in Total Hip Arthroplasty

    PubMed Central

    Santhanam, Siva Swaminathan; Choi, Jung Woo

    2016-01-01

    The difficulties encountered in dealing with the bone deficient acetabulum are amongst the greatest challenges in hip surgery. Acetabular reconstruction in revision total hip arthroplasty can successfully be achieved with hemispherical components featuring a porous or roughened ingrowth surface and options for placement of multiple screws for minor acetabular defect. Acetabular component selection is mostly based on the amount of bone loss present. In the presence of combined cavitary and segmental defects without superior acetabular coverage, reconstructions with a structural acetabular allograft protected by a cage or a custom-made triflange cage have been one of preferred surgical options. The use of a cage or ring over structural allograft bone for massive uncontained defects in acetabular revision can restore host bone stock and facilitate subsequent rerevision surgery to a certain extent. But high complication rates have been reported including aseptic loosening, infection, dislocation and metal failure. On the other hand, recent literature is reporting satisfactory outcomes with the use of modular augments combined with a hemispherical shell for major acetabular defect. Highly porous metals have been introduced for clinical use in arthroplasty surgery over the last decade. Their higher porosity and surface friction are ideal for acetabular revision, optimizing biological fixation. The use of trabecular metal cups in acetabular revision has yielded excellent clinical results. This article summarizes author's experience regarding revision acetabular reconstruction options following failed hip surgery including arthroplasty. PMID:27536638

  8. Acetabular Reconstruction in Total Hip Arthroplasty.

    PubMed

    Shon, Won Yong; Santhanam, Siva Swaminathan; Choi, Jung Woo

    2016-03-01

    The difficulties encountered in dealing with the bone deficient acetabulum are amongst the greatest challenges in hip surgery. Acetabular reconstruction in revision total hip arthroplasty can successfully be achieved with hemispherical components featuring a porous or roughened ingrowth surface and options for placement of multiple screws for minor acetabular defect. Acetabular component selection is mostly based on the amount of bone loss present. In the presence of combined cavitary and segmental defects without superior acetabular coverage, reconstructions with a structural acetabular allograft protected by a cage or a custom-made triflange cage have been one of preferred surgical options. The use of a cage or ring over structural allograft bone for massive uncontained defects in acetabular revision can restore host bone stock and facilitate subsequent rerevision surgery to a certain extent. But high complication rates have been reported including aseptic loosening, infection, dislocation and metal failure. On the other hand, recent literature is reporting satisfactory outcomes with the use of modular augments combined with a hemispherical shell for major acetabular defect. Highly porous metals have been introduced for clinical use in arthroplasty surgery over the last decade. Their higher porosity and surface friction are ideal for acetabular revision, optimizing biological fixation. The use of trabecular metal cups in acetabular revision has yielded excellent clinical results. This article summarizes author's experience regarding revision acetabular reconstruction options following failed hip surgery including arthroplasty. PMID:27536638

  9. Porous-coated acetabular components with screw fixation. Five to ten-year results.

    PubMed

    Latimer, H A; Lachiewicz, P F

    1996-07-01

    The results of 136 consecutive primary total hip arthroplasties performed by one surgeon with the Harris-Galante-I porous-coated acetabular component were reviewed at a mean of seven years (range, five to ten years). In all hips, the outer diameter of the acetabular component was the same as the diameter of the final reamer used in the preparation of the acetabulum. However, this reamer was used only briefly at the rim of the acetabulum, and therefore the components had so-called press-fit stability. A mean of four screws (range, three to six screws) were used for additional fixation of the component. The clinical evaluation was performed with use of the Harris hip score. Standardized anteroposterior radiographs of the pelvis were assessed for migration of the component, radiolucent and radiodense lines, linear wear of the polyethylene, and osteolysis. No acetabular component had been revised for loosening and none were radiographically loose at the time of the most recent follow-up evaluation. There were no complications related to the use of the screws, and no screw had bent or broken. A non-progressive radiolucent line was seen in one acetabular zone in thirty-four hips (25 per cent) and in two acetabular zones in six hips (4 per cent). No hip had a radiolucent line in all three acetabular zones. The mean rate of linear wear of the polyethylene was 0.1 millimeter per year. There was no dissociation of the acetabular liner from the metal shell. Two hips (1 per cent) had asymptomatic osteolysis in the ischium and adjacent to the rim of the acetabular component; this was treated with grafting at the site of the lesion and exchange of the femoral head and the worn polyethylene liner. Five femoral components inserted without cement and one inserted with cement were revised because of loosening. The data suggest that, at a mean of seven years, fixation of this porous-coated component was uniformly excellent. The low prevalence of radiolucent lines and the absence of

  10. Biological and mechanical properties of an experimental glass-ionomer cement modified by partial replacement of CaO with MgO or ZnO.

    PubMed

    Kim, Dong-Ae; Abo-Mosallam, Hany; Lee, Hye-Young; Lee, Jung-Hwan; Kim, Hae-Won; Lee, Hae-Hyoung

    2015-01-01

    Some weaknesses of conventional glass ionomer cement (GIC) as dental materials, for instance the lack of bioactive potential and poor mechanical properties, remain unsolved.Objective The purpose of this study was to investigate the effects of the partial replacement of CaO with MgO or ZnO on the mechanical and biological properties of the experimental glass ionomer cements.Material and Methods Calcium fluoro-alumino-silicate glass was prepared for an experimental glass ionomer cement by melt quenching technique. The glass composition was modified by partial replacement (10 mol%) of CaO with MgO or ZnO. Net setting time, compressive and flexural properties, and in vitrorat dental pulp stem cells (rDPSCs) viability were examined for the prepared GICs and compared to a commercial GIC.Results The experimental GICs set more slowly than the commercial product, but their extended setting times are still within the maximum limit (8 min) specified in ISO 9917-1. Compressive strength of the experimental GIC was not increased by the partial substitution of CaO with either MgO or ZnO, but was comparable to the commercial control. For flexural properties, although there was no significance between the base and the modified glass, all prepared GICs marked a statistically higher flexural strength (p<0.05) and comparable modulus to control. The modified cements showed increased cell viability for rDPSCs.Conclusions The experimental GICs modified with MgO or ZnO can be considered bioactive dental materials. PMID:26398508

  11. Biological and mechanical properties of an experimental glass-ionomer cement modified by partial replacement of CaO with MgO or ZnO

    PubMed Central

    Dong-Ae, KIM; Hany, ABO-MOSALLAM; Hye-Young, LEE; Jung-Hwan, LEE; Hae-Won, KIM; Hae-Hyoung, LEE

    2015-01-01

    Some weaknesses of conventional glass ionomer cement (GIC) as dental materials, for instance the lack of bioactive potential and poor mechanical properties, remain unsolved. Objective The purpose of this study was to investigate the effects of the partial replacement of CaO with MgO or ZnO on the mechanical and biological properties of the experimental glass ionomer cements. Material and Methods Calcium fluoro-alumino-silicate glass was prepared for an experimental glass ionomer cement by melt quenching technique. The glass composition was modified by partial replacement (10 mol%) of CaO with MgO or ZnO. Net setting time, compressive and flexural properties, and in vitro rat dental pulp stem cells (rDPSCs) viability were examined for the prepared GICs and compared to a commercial GIC. Results The experimental GICs set more slowly than the commercial product, but their extended setting times are still within the maximum limit (8 min) specified in ISO 9917-1. Compressive strength of the experimental GIC was not increased by the partial substitution of CaO with either MgO or ZnO, but was comparable to the commercial control. For flexural properties, although there was no significance between the base and the modified glass, all prepared GICs marked a statistically higher flexural strength (p<0.05) and comparable modulus to control. The modified cements showed increased cell viability for rDPSCs. Conclusions The experimental GICs modified with MgO or ZnO can be considered bioactive dental materials. PMID:26398508

  12. [Aseptic, simultaneous and bilateral mobilisation due to an acetabular shell fracture in a 43 year-old patient].

    PubMed

    Ceretti, M; Fanelli, M; Pappalardo, S

    2014-01-01

    The acetabular shell mobilization is the main long-term complication in total hip replacement. Metal-back fracture has also to be considered among the possible causes of shell mobilization. A case is presented of bilateral acetabular shell mobilization due to the trabecular covering de-soldering from the metal-back in a 43 year-old patient, 13-14 years after the first surgery. PMID:24360788

  13. Placement of the acetabular component.

    PubMed

    Beverland, D E; O'Neill, C K J; Rutherford, M; Molloy, D; Hill, J C

    2016-01-01

    Ideal placement of the acetabular component remains elusive both in terms of defining and achieving a target. Our aim is to help restore original anatomy by using the transverse acetabular ligament (TAL) to control the height, depth and version of the component. In the normal hip the TAL and labrum extend beyond the equator of the femoral head and therefore, if the definitive acetabular component is positioned such that it is cradled by and just deep to the plane of the TAL and labrum and is no more than 4mm larger than the original femoral head, the centre of the hip should be restored. If the face of the component is positioned parallel to the TAL and psoas groove the patient specific version should be restored. We still use the TAL for controlling version in the dysplastic hip because we believe that the TAL and labrum compensate for any underlying bony abnormality. The TAL should not be used as an aid to inclination. Worldwide, > 75% of surgeons operate with the patient in the lateral decubitus position and we have shown that errors in post-operative radiographic inclination (RI) of > 50° are generally caused by errors in patient positioning. Consequently, great care needs to be taken when positioning the patient. We also recommend 35° of apparent operative inclination (AOI) during surgery, as opposed to the traditional 45°. PMID:26733639

  14. Ten-year follow-up of the non-porous Allofit cementless acetabular component.

    PubMed

    Zenz, P; Stiehl, J B; Knechtel, H; Titzer-Hochmaier, G; Schwagerl, W

    2009-11-01

    Cementless acetabular fixation has demonstrated superior long-term durability in total hip replacement, but most series have studied implants with porous metal surfaces. We retrospectively evaluated the results of 100 consecutive patients undergoing total hip replacement where a non-porous Allofit component was used for primary press-fit fixation. This implant is titanium alloy, grit-blasted, with a macrostructure of forged teeth and has a biradial shape. A total of 81 patients (82 hips) were evaluated at final follow-up at a mean of 10.1 years (8.9 to 11.9). The Harris Hip Score improved from a mean 53 points (23 to 73) pre-operatively to a mean of 96 points (78 to 100) at final review. The osseointegration of all acetabular components was radiologically evaluated with no evidence of loosening. The survival rate with revision of the component as the endpoint was 97.5% (95% confidence interval 94 to 100) after 11.9 years. Radiolucency was found in one DeLee-Charnley zone in four acetabular components. None of the implants required revision for aseptic loosening. Two patients were treated for infection, one requiring a two-stage revision of the implant. One femoral stem was revised for osteolysis due to the production of metal wear debris, but the acetabular shell did not require revision. This study demonstrates that a non-porous titanium acetabular component with adjunct surface fixation offers an alternative to standard porous-coated implants. PMID:19880887

  15. Revision stapes surgery for lysis of the long process of the incus: comparing hydroxyapatite bone cement versus malleovestibulopexy and total ossicular replacement prosthesis.

    PubMed

    Pitiot, Vincent; Hermann, Ruben; Tringali, Stéphane; Dubreuil, Christian; Truy, Eric

    2016-09-01

    The objective of the study was to report audiological results in revision stapes surgery, comparing hydroxyapatite (HAP) bone cement, malleovestibular (MV) prosthesis, and total ossicular replacement prosthesis (TORP). The study is a retrospective case review conducted in a tertiary referral center. Patients treated for revision stapes surgery from 2010 to 2014, where a lysis of the long process of the incus (LPI) was observed with the use of HAP bone cement, MV prosthesis, or a TORP were included in the study. The main outcomes measured were pre- and postoperative bone conduction (BC) and air conduction (AC) pure-tone averages (PTA) (0.5, 1, 2, 3 kHz), including high frequencies BC (HFBC) (1, 2, 3, 4 kHz) and air-bone gap (ABG). 107 revision stapes surgery were performed in 96 ears. Main cause of failure was LPI lysis in 38 cases (39.6 %). 31 patients were analyzed: HAP bone cement was used in 11 patients (Group I), MV prosthesis in ten patients (Group II), and TORP in ten patients (Group III). The mean post-operative ABG was 10.7 dB (±7.4) (p = 0.003), 10.7 dB (±8.8) (p = 0.001), and 16.9 dB (±9.8) (p = 0.001), respectively. There were no significant differences between groups. In Group I, the mean change in HFBC revealed an improvement of 5.6 dB (±7.9) (p = 0.03), while in Group III there was a significant deterioration of the thresholds of 5.8 dB (±7.6) (p = 0.04). There were no cases of post-operative anacusis. In revision stapes surgery when LPI is eroded, we recommend to perform a cement ossiculoplasty for stabilizing a standard Teflon piston when LPI is still usable, the LPI lengthening with cement being not recommended. When LPI is too eroded, we prefer performing a malleovestibulopexy, and reserve TORP for cases with a bad anatomical presentation. PMID:26690574

  16. Increased risk of revision of acetabular cups coated with hydroxyapatite

    PubMed Central

    Lazarinis, Stergios; Kärrholm, Johan

    2010-01-01

    Background Hydroxyapatite (HA) is the main inorganic component of bone, and HA coating is widely used on acetabular cups in hip arthroplasty. It has been suggested that this surface finish improves cup survival. Methods All patients registered in the Swedish Hip Arthroplasty Register between 1992 and 2007 with an uncemented acetabular implant that was available either with or without HA coating were identified. 8,043 total hip arthroplasties (THAs) with the most common cup types (Harris-Galante, Romanus, and Trilogy) were investigated. A Cox regression model including type of coating, age, sex, primary diagnosis, cup type, and type of stem fixation was used to calculate adjusted risk ratios (RRs) for the risk of revision. Results HA coating was a risk factor for cup revision due to aseptic loosening (adjusted RR 1.7; 95% CI: 1.3–2). Age at primary arthroplasty of < 50 years, a diagnosis of pediatric hip disease, the use of a cemented stem, and the Romanus and Harris-Galante cup types were also associated with statistically significantly increased risk of cup revision due to aseptic loosening. Interpretation Our findings question the routine use of HA-coated cups in primary total hip arthroplasty. With some designs, this practice may even increase the risk of loosening—resulting in revision surgery. PMID:19968603

  17. Fly and bottom ashes from biomass combustion as cement replacing components in mortars production: rheological behaviour of the pastes and materials compression strength.

    PubMed

    Maschio, Stefano; Tonello, Gabriele; Piani, Luciano; Furlani, Erika

    2011-10-01

    In the present research mortar pastes obtained by replacing a commercial cement with the equivalent mass of 5, 10, 20 and 30 wt.% of fly ash or bottom ash from fir chips combustion, were prepared and rheologically characterized. It was observed that the presence of ash modifies their rheological behaviour with respect to the reference blend due to the presence, in the ashes, of KCl and K2SO4 which cause precipitation of gypsum and portlandite during the first hydration stages of the pastes. Hydrated materials containing 5 wt.% of ash display compression strength and absorption at 28 d of same magnitude as the reference composition; conversely, progressive increase of ash cause a continuous decline of materials performances. Conversely, samples tested after 180 d display a marked decline of compression strength, as a consequence of potassium elution and consequent alkali-silica reaction against materials under curing. PMID:21762950

  18. Quantification of clearance and creep in acetabular wear measurements

    PubMed Central

    Gregory, Thomas; Vandenbussche, Eric

    2016-01-01

    Background This study aimed to measure femoral head penetration before occurrence of real wear, and to quantify the portions attributable respectively to clearance and plastic deformations in various acetabular designs. Methods We analyzed CT scans from 15 patients at ‘day five’ after total hip arthroplasty (THA). All patients received Exafit® femoral stems and 28 mm heads: 5 patients had cemented Durasul® all-PE cups, 5 patients had un-cemented Allofit® metal-backed cups, and 5 patients had un-cemented Stafit® dual-mobility cups. We also analyzed CT scans of samples of the three head-cup combinations to compare in vivo and in vitro measurements. Results The mean femoral head penetration measured on ‘day five’ was lower for all-PE cups (0.196 mm) than for metal-backed cups (0.551 mm) and dual-mobility cups (0.634 mm). Conclusions The present study indicates that isolated measurements of femoral head penetration include 0.15–0.46 mm of radial clearance and 0.05–0.27 mm of creep, and confirms that the majority of so-called bedding-in observed in the first post-operative months is not entirely due to wear. PMID:27162781

  19. Importance of maintaining the basic stress pathway above the acetabular dome during acetabular reconstruction.

    PubMed

    Nie, Yong; Pei, Fuxing; Shen, Bin; Kang, Pengde; Li, Zongming

    2016-07-01

    The basic stress pathway above the acetabular dome is important for the maintenance of implant stability in press-fit acetabular reconstruction of total hip arthroplasty. However, information on the basic stress pathway and its impact factors remains unclear. The objective of this study was to investigate the effects of the orientations and positions of the acetabular component on the basic stress pathway. The basic stress pathway above the acetabular dome was defined as two parts: 3D basic trabecular bone stress distribution and quantified basic cortical bone stress level, using two subject-specific finite element normal hip models. The effects were then analysed by generating 32 reconstructed acetabular cases with different cup abduction and anteversion angles within a range of 35-50° and 10-25°, respectively, and 12 cases with different hip centre heights within a range of 0-15 mm above the acetabular dome. The 3D trabecular stress distribution decreased remarkably in all cases, while the 80% of the basic cortical bone stress level was maintained in cases when the acetabular component was positioned at 10° or 15° anteversion and 40° or 45° abduction angles. The basic stress pathway above the acetabular dome was disturbed when the superior displacement of the hip centre exceeded 5 mm above the anatomical hip centre. Positioning the acetabular component correctly contributes to maintain the stress balance between the acetabular cup and the bone during acetabular reconstruction, thus helping restore the normal hip biomechanics and preserve the stability of the implants. PMID:26469561

  20. [Cemented total knee replacement: comparative study between the use or not of tourniquet on the inmediate results].

    PubMed

    Gutiérrez-García, J A; Sierra-Pérez, M; García-Velazco, R A; Salas-Mora, C A; Cisneros-González, V M

    2016-01-01

    Comparison of immediate postoperative results of patients undergoing cemented total knee arthroplasty with and without ischemia. Observational, cross-sectional, retrospective, analytical, single-center study that included 180 patients who underwent total knee arthroplasty from 2011 to 2014: 120 without ischemia, 60 with ischemia. Mean age was 70 years with SD ± 7. Criteria to assess the immediate postoperative results include intraoperative bleeding, hemoglobin differential and pain. Exclusion criteria comprised patients being treated at a pain clinic, those on anticoagulants, with a history of bleeding disorders, psychiatric conditions, kidney failure or those intolerant to NSAIDs. In total knee arthroplasty without ischemia there is better pain control (p = 0.026). The hemoglobin differential and intraoperative bleeding were less with ischemia (p = 0.008). 32.8% of patients required blood transfusion, but no statistically significant relationship was established with the use or non-use of ischemia (p = 0.301). The most commonly reported pain was within a VAS of 0-3; 62.2% of cases reported mild pain. Mean hemoglobin differential was 3.7 with SD ± 1.3 with a range from 0 to 7.4. Patients in whom no ischemia was used during the surgical procedure experienced less pain. There was less bleeding and hemoglobin differential with the use of ischemia. However, this did not result in a statistically significant difference in the need for blood transfusion. The use of ischemia with caution and according to the surgeons preference is recommended. PMID:27627771

  1. Long-term Radiographic Assessment of Cemented Polyethylene Acetabular Cups

    PubMed Central

    Isaac, Graham; Porter, Neil; Fisher, John; Older, John

    2008-01-01

    In vitro studies demonstrating excessive wear in polyethylene cups sterilized using gamma irradiation and stored in air led to the abandonment of this sterilization technique. We evaluated the clinical wear performance of a metal femoral component on a polyethylene cup in a hip prosthesis from a selected subset of implants in a group of patients followed for at least 20 years and assessed the time dependency of variation in penetration rates. We measured penetration in 33 polyethylene cups in 25 patients who had a Charnley low-friction arthroplasty between 1982 and 1984. All patients had Charnley Ogee® cups implanted for more than 20 years and sterilized using the gamma irradiation in air technique. If degradation occurred over time in vivo, it was not reflected by an increased penetration rate with increasing time in vivo; even after 20 years of implantation, the degree of wear remained low. This suggests gamma irradiation affects wear on ultra-high-molecular-weight polyethylene by reducing wear secondary to the crosslinking, by increasing wear as shown through in vitro studies of heavily oxidized samples, or by oxidation resulting from prolonged shelf life. The effect of progressive oxidation in vivo does not appear to affect wear in vivo. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18196419

  2. Reducing cement's CO2 footprint

    USGS Publications Warehouse

    van Oss, Hendrik G.

    2011-01-01

    The manufacturing process for Portland cement causes high levels of greenhouse gas emissions. However, environmental impacts can be reduced by using more energy-efficient kilns and replacing fossil energy with alternative fuels. Although carbon capture and new cements with less CO2 emission are still in the experimental phase, all these innovations can help develop a cleaner cement industry.

  3. Osteopathic diagnosis of an acetabular injury.

    PubMed

    Morthland, Tim; Cote, Nicholas S; Humphrey, Jon; Fulk, Doug

    2010-05-01

    Physical findings demarking pathologic somatovisceral reflex activity and fascial strain patterns may lead the osteopathic physician to diagnoses that are masked within the initial presentation of a patient. The authors present a case report that demonstrates the use of osteopathic principles in the diagnosis of a chronic acetabular fracture and acetabular labral tear in a 19-year-old man. The injuries resulted from a posterior hip dislocation sustained during a basketball game more than 1 year before presentation. Osteopathic manipulative treatment and diagnostic techniques also relieved the patient's persistent thoracic pain, nausea, and vomiting. Subsequent orthopedic repair had the potential to avert or delay degenerative hip disease in the patient. PMID:20538751

  4. Coralline hydroxyapatite in complex acetabular reconstruction.

    PubMed

    Wasielewski, Ray C; Sheridan, Kate C; Lubbers, Melissa A

    2008-04-01

    This retrospective study examined whether a coralline hydroxyapatite bone graft substitute adequately repaired bone defects during complex acetabular reconstructions. Seventeen patients who underwent acetabular revision using Pro Osteon 500 were assessed to determine whether any cups required re-revision, whether bone had incorporated into the coralline hydroxyapatite grafts, and whether the coralline hydroxyapatite grafts resorbed with time. At latest follow-up, no cups required re-revision, but 1 had failed. Radiographic evidence of bone incorporation was observed in every coralline hydroxyapatite graft. Graft resorption was not observed. PMID:19292282

  5. Surgical dislocation of the hip for the fixation of acetabular fractures.

    PubMed

    Tannast, M; Krüger, A; Mack, P W; Powell, J N; Hosalkar, H S; Siebenrock, K A

    2010-06-01

    Surgical dislocation of the hip in the treatment of acetabular fractures allows the femoral head to be safely displaced from the acetabulum. This permits full intra-articular acetabular and femoral inspection for the evaluation and potential treatment of cartilage lesions of the labrum and femoral head, reduction of the fracture under direct vision and avoidance of intra-articular penetration with hardware. We report 60 patients with selected types of acetabular fracture who were treated using this approach. Six were lost to follow-up and the remaining 54 were available for clinical and radiological review at a mean follow-up of 4.4 years (2 to 9). Substantial damage to the intra-articular cartilage was found in the anteromedial portion of the femoral head and the posterosuperior aspect of the acetabulum. Labral lesions were predominantly seen in the posterior acetabular area. Anatomical reduction was achieved in 50 hips (93%) which was considerably higher than that seen in previous reports. There were no cases of avascular necrosis. Four patients subsequently required total hip replacement. Good or excellent results were achieved in 44 hips (81.5%). The cumulative eight-year survivorship was 89.0% (95% confidence interval 84.5 to 94.1). Significant predictors of poor outcome were involvement of the acetabular dome and lesions of the femoral cartilage greater than grade 2. The functional mid-term results were better than those of previous reports. Surgical dislocation of the hip allows accurate reduction and a predictable mid-term outcome in the management of these difficult injuries without the risk of the development of avascular necrosis. PMID:20513883

  6. Survival rates and causes of revision in cemented primary total knee replacement: a report from the Norwegian Arthroplasty Register 1994-2009.

    PubMed

    Gøthesen, O; Espehaug, B; Havelin, L; Petursson, G; Lygre, S; Ellison, P; Hallan, G; Furnes, O

    2013-05-01

    We evaluated the rates of survival and cause of revision of seven different brands of cemented primary total knee replacement (TKR) in the Norwegian Arthroplasty Register during the years 1994 to 2009. Revision for any cause, including resurfacing of the patella, was the primary endpoint. Specific causes of revision were secondary outcomes. Three posterior cruciate-retaining (PCR) fixed modular-bearing TKRs, two fixed non-modular bearing PCR TKRs and two mobile-bearing posterior cruciate-sacrificing TKRs were investigated in a total of 17 782 primary TKRs. The median follow-up for the implants ranged from 1.8 to 6.9 years. Kaplan-Meier 10-year survival ranged from 89.5% to 95.3%. Cox's relative risk (RR) was calculated relative to the fixed modular-bearing Profix knee (the most frequently used TKR in Norway), and ranged from 1.1 to 2.6. The risk of revision for aseptic tibial loosening was higher in the mobile-bearing LCS Classic (RR 6.8 (95% confidence interval (CI) 3.8 to 12.1)), the LCS Complete (RR 7.7 (95% CI 4.1 to 14.4)), the fixed modular-bearing Duracon (RR 4.5 (95% CI 1.8 to 11.1)) and the fixed non-modular bearing AGC Universal TKR (RR 2.5 (95% CI 1.3 to 5.1)), compared with the Profix. These implants (except AGC Universal) also had an increased risk of revision for femoral loosening (RR 2.3 (95% CI 1.1 to 4.8), RR 3.7 (95% CI 1.6 to 8.9), and RR 3.4 (95% CI 1.1 to 11.0), respectively). These results suggest that aseptic loosening is related to design in TKR. PMID:23632673

  7. The relationship between operative and radiographic acetabular component orientation: which factors influence resultant cup orientation?

    PubMed

    Grammatopoulos, G; Pandit, H G; da Assunção, R; McLardy-Smith, P; De Smet, K A; Gill, H S; Murray, D W

    2014-10-01

    There is great variability in acetabular component orientation following hip replacement. The aims of this study were to compare the component orientation at impaction with the orientation measured on post-operative radiographs and identify factors that influence the difference between the two. A total of 67 hip replacements (52 total hip replacements and 15 hip resurfacings) were prospectively studied. Intra-operatively, the orientation of the acetabular component after impaction relative to the operating table was measured using a validated stereo-photogrammetry protocol. Post-operatively, the radiographic orientation was measured; the mean inclination/anteversion was 43° (sd 6°)/ 19° (sd 7°). A simulated radiographic orientation was calculated based on how the orientation would have appeared had an on-table radiograph been taken intra-operatively. The mean difference between radiographic and intra-operative inclination/anteversion was 5° (sd 5°)/ -8° (sd 8°). The mean difference between simulated radiographic and intra-operative inclination/anteversion, which quantifies the effect of the different way acetabular orientation is measured, was 3°/-6° (sd 2°). The mean difference between radiographic and simulated radiographic orientation inclination/anteversion, which is a manifestation of the change in pelvic position between component impaction and radiograph, was 1°/-2° (sd 7°). This study demonstrated that in order to achieve a specific radiographic orientation target, surgeons should implant the acetabular component 5° less inclined and 8° more anteverted than their target. Great variability (2 sd about ± 15°) in the post-operative radiographic cup orientation was seen. The two equally contributing causes for this are variability in the orientation at which the cup is implanted, and the change in pelvic position between impaction and post-operative radiograph. PMID:25274911

  8. The use of fibre-based demineralised bone matrix in major acetabular reconstruction: surgical technique and preliminary results

    PubMed Central

    Karoubi, Mathieu; Dumaine, Valérie; Courpied, Jean Pierre

    2010-01-01

    Acetabular osteolysis associated with socket loosening is one of the main long-term complications of total hip arthroplasty. In case of major bone loss, where <50% host bone coverage can be obtained with a porous-coated cementless cup, it is generally agreed that a metal ring or cage in association with a cemented component and allograft bone should be used. In order to promote allograft bone consolidation and incorporation, we have associated demineralised bone matrix (DBM, Grafton® A Flex) to the construct ion. Here we describe the technical details of major acetabular reconstruction using the Kerboull acetabular reinforcement device with allograft bone and DBM. This device has a hook that must be placed under the teardrop of the acetabulum and a plate for iliac fixation. The main advantages of this device are help in restoring the normal centre of hip rotation, guiding the reconstruction and partially unloading the graft. The Kerboull acetabular reinforcement device has provided a 92% survival rate free of loosening at 13-year follow-up in a consecutive series of 60 type III and IV deficiencies. Our preliminary results using DBM indicate faster allograft consolidation and remodelling. PMID:21057788

  9. Cementless hemispheric acetabular component in total hip replacement.

    PubMed

    Weber, D; Schaper, L A; Pomeroy, D L; Badenhausen, W E; Curry, J I; Smith, M W; Suthers, K E

    2000-01-01

    A series of 198 total hip arthroplasties was performed using a porous-coated, hemispheric press-fit cup. One hundred and twenty-seven cups were available for clinical and radiological examination at mean follow-up of 10.6 years. The mean age at the index procedure was 61.2 years. The mean Harris hip score at final follow-up was 89.8. Three cups were revised for aseptic loosening and two liners were changed for eccentric wear and pelvic osteolysis. Nine additional patients showed mild or suspected osteolysis. Two cups were rated "fibrous" stable. There was no correlation between additional screw fixation of the press-fit cup and osteolysis or revision. PMID:10990381

  10. Basic Science Considerations in Primary Total Hip Replacement Arthroplasty

    PubMed Central

    Mirza, Saqeb B; Dunlop, Douglas G; Panesar, Sukhmeet S; Naqvi, Syed G; Gangoo, Shafat; Salih, Saif

    2010-01-01

    Total Hip Replacement is one of the most common operations performed in the developed world today. An increasingly ageing population means that the numbers of people undergoing this operation is set to rise. There are a numerous number of prosthesis on the market and it is often difficult to choose between them. It is therefore necessary to have a good understanding of the basic scientific principles in Total Hip Replacement and the evidence base underpinning them. This paper reviews the relevant anatomical and biomechanical principles in THA. It goes on to elaborate on the structural properties of materials used in modern implants and looks at the evidence base for different types of fixation including cemented and uncemented components. Modern bearing surfaces are discussed in addition to the scientific basis of various surface engineering modifications in THA prostheses. The basic science considerations in component alignment and abductor tension are also discussed. A brief discussion on modular and custom designs of THR is also included. This article reviews basic science concepts and the rationale underpinning the use of the femoral and acetabular component in total hip replacement. PMID:20582240

  11. Fixation method does not affect restoration of rotation center in hip replacements: A single-site retrospective study

    PubMed Central

    2012-01-01

    Background Aseptic loosening is one of the greatest problems in hip replacement surgery. The rotation center of the hip is believed to influence the longevity of fixation. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique. Methods We retrospectively compared pre- and post-operative positions of the hip rotation center in 25 and 68 patients who underwent artificial hip replacements in our department in 2007 using cemented or cementless cup fixation, respectively, with digital radiographic image analysis. Results The mean horizontal and vertical distances between the rotation center and the acetabular teardrop were compared in radiographic images taken pre- and post-operatively. The mean horizontal difference was −2.63 mm (range: -11.00 mm to 10.46 mm, standard deviation 4.23 mm) for patients who underwent cementless fixation, and −2.84 mm (range: -10.87 to 5.30 mm, standard deviation 4.59 mm) for patients who underwent cemented fixation. The mean vertical difference was 0.60 mm (range: -20.15 mm to 10.00 mm, standard deviation 3.93 mm) and 0.41 mm (range: -9.26 mm to 6.54 mm, standard deviation 3.58 mm) for the cementless and cemented fixation groups, respectively. The two fixation techniques had no significant difference on the position of the hip rotation center in the 93 patients in this study. Conclusions The hip rotation center was similarly restored using either the cemented or cementless fixation techniques in this patient cohort, indicating that the fixation technique itself does not interfere with the position of the center of rotation. To completely answer this question further studies with more patients are needed. PMID:22686355

  12. Meralgia Paresthetica and Femoral Acetabular Impingement: A Possible Association

    PubMed Central

    Ahmed, Aiesha

    2010-01-01

    Meralgia paresthetica consists of pain and dysesthesia in the anterolateral thigh. Etiology is divided into spontaneous and iatrogenic causes. To my knowledge this has never been attributed to femoral acetabular impingement. This case highlights the presence of lateral femoral cutaneous neuropathy in the setting of femoral acetabular impingement syndrome thus raising the possibility of an association. Keywords Femoral acetabular impingement; Lateral femoral cutaneous nerve; Dysesthesia; Nerve conduction studies PMID:22043261

  13. [What's new in total hip replacement?].

    PubMed

    Kowalczewski, Jacek B; Milecki, Marcin; Marczak, Dariusz

    2005-01-01

    The authors present special types of stems and acetabulum components. Analyzing the available the authors try to assess which parameters of the prosthesis influence long-term outcomes. "Wear and tear" of the implants was also analysed. Cemented and cementless acetabular components where also analysed. Capoplasties neck-sparing procedures and MIS techniques were also taken into consideration with special attention given to the dangers related to these new techniques. PMID:16875180

  14. Finite element analysis of the impingement on the acetabular liner rim due to wear of the acetabular liner surface

    NASA Astrophysics Data System (ADS)

    Saputra, Eko; Anwar, Iwan Budiwan; Ismail, Rifky; Jamari, J.; van der Heide, Emile

    2016-04-01

    This workstudies the impingement on the rim of acetabular liner due to wear on the surface of acetabular liner using finite element simulation. A three dimensional contact model between a femoral head and an acetabular liner was developed. There are three steps in this simulation, i.e. creating the virtualwear on the surface of acetabular liner, applying the load at the femoral head, and rotating the femoral head from neutral position till the impingement occurrence. The virtualwear is created based on the data of wear depth which was obtained from literature. Results showed that the wear on the acetabular liner surface wouldaffected the impingement occurrence, in which the impingement angle becomes narrow. In addition, the failure possibility of the acetabular liner rimwould become higher.

  15. Failure analysis of retrieved PE-UHMW acetabular liners.

    PubMed

    Laska, Anna; Archodoulaki, Vasiliki-Maria; Duscher, Bernadette

    2016-08-01

    Ultra-high molecular weight polyethylene (PE-UHMW) acetabular liners have a limited lifespan in a patient's body. There are many factors affecting the performance of the implant and furthermore the properties of the polymeric material are changing after implantation. In this work material changes according to structure and morphology and their implication on mechanical properties are in focus. The physical and mechanical properties of ten crosslinked (xL) PE-UHMW and nine conventional (conv) gamma-sterilized PE-UHMW hip components, used as sliding surface in total hip joint replacement, with different in-vivo times are compared. The evaluation of the retrieved acetabular liners is performed in view of crosslinking and conventional gamma-sterilization but also in terms of the influence of gender concerning alteration in properties. The oxidative degradation in the PE-UHMW is investigated by means of Fourier Transformed Infrared Spectroscopy (FTIR). The characterization of the morphology is carried out via differential scanning calorimetry (DSC). A depth profile of the micro-hardness and elastic modulus is taken over the cross-section of the components in order to find the influence of chemical constitution and morphology on the micro-mechanical properties. It could be shown that crosslinking and oxidative degradation influence the degree of crystallinity of the polymer. Oxidation occurs for both types of the material due to in-vivo time. Higher degree of crystallinity can be correlated to higher hardness and indentation modulus. No unequivocal superiority of crosslinked over conventional liners can be observed. The influence of sex concerning alteration of the evaluated properties matters but need to be further investigated. PMID:26849029

  16. Hydroxyapatite coating of an acetabular prosthesis. Effect on stability.

    PubMed

    Moilanen, T; Stocks, G W; Freeman, M A; Scott, G; Goodier, W D; Evans, S J

    1996-03-01

    We report the radiological and clinical outcome of a press-fit (SLF) acetabular component at two to three years in two groups of patients having primary total hip replacement. In 69 the implant was coated with hydroxyapatite (HA) and in 40 it was uncoated. The stability of the cup was assessed by measurement of proximal migration and change in the angle of inclination. The clinical results in the two groups did not differ significantly, and the mean proximal linear wear was similar in both. Fewer radiolucent lines (RLLs) were seen on the radiographs of cups coated with HA. The mean proximal migration was studied by calculating regression lines for each patient using migration measurements: for the SLF+HA group the mean slope was 0.06 mm/year and for the SLF-HA group 0.20 mm/year (p = 0.22). The change in the angle of inclination during follow-up was also consistently smaller in HA-coated cups. Using regression methods the SLF+HA group had a mean slope of 0.08 degrees/year and the SLF-HA group 0.44 degrees/year and the SLF-HA group 0.44 degrees/year (p = 0.023). Partial HA coating appeared to have no effect on the clinical outcome or on the rate of wear of polyethylene, but there was a trend towards a reduced rate of proximal migration, and a significant reduction in rotational migration and the number of radiolucent lines. This suggests that HA coating enhances the stability of this acetabular component. PMID:8666624

  17. Optimal acetabular orientation for hip resurfacing.

    PubMed

    Grammatopoulos, G; Pandit, H; Glyn-Jones, S; McLardy-Smith, P; Gundle, R; Whitwell, D; Gill, H S; Murray, D W

    2010-08-01

    Pseudotumours are a rare complication of hip resurfacing. They are thought to be a response to metal debris which may be caused by edge loading due to poor orientation of the acetabular component. Our aim was to determine the optimal acetabular orientation to minimise the risk of pseudotumour formation. We matched 31 hip resurfacings revised for pseudotumour formation with 58 controls who had a satisfactory outcome from this procedure. The radiographic inclination and anteversion angles of the acetabular component were measured on anteroposterior radiographs of the pelvis using Einzel-Bild-Roentgen-Analyse software. The mean inclination angle (47 degrees, 10 degrees to 81 degrees) and anteversion angle (14 degrees, 4 degrees to 34 degrees) of the pseudotumour cases were the same (p = 0.8, p = 0.2) as the controls, 46 degrees (29 degrees to 60 degrees) and 16 degrees (4 degrees to 30 degrees) respectively, but the variation was greater. Assuming an accuracy of implantation of +/- 10 degrees about a target position, the optimal radiographic position was found to be approximately 45 degrees of inclination and 20 degrees of anteversion. The incidence of pseudotumours inside the zone was four times lower (p = 0.007) than outside the zone. In order to minimise the risk of pseudotumour formation we recommend that surgeons implant the acetabular component at an inclination of 45 degrees (+/- 10) and anteversion of 20 degrees (+/- 10) on post-operative radiographs. Because of differences between the radiographic and the operative angles, this may be best achieved by aiming for an inclination of 40 degrees and an anteversion of 25 degrees. PMID:20675749

  18. Micro-observations of different types of nano-Al₂O₃on the hydration of cement paste with sludge ash replacement.

    PubMed

    Luo, Huan-Lin; Lin, Deng-Fong; Shieh, Show-Ing; You, Yan-Fei

    2015-01-01

    In recent years, sewer systems and wastewater treatment plants have become important in developing countries. Consequently, the amount of sewage sludge produced by these countries has been gradually increasing, and determining how to properly recycle this sludge is becoming an important topic for researchers. In this study, to expand the recyclability of sewage sludge ash (SSA) in engineering applications, two types of nano-aluminium oxides (Al₂O₃), MC2A and MC2R, were added to SSA/cement paste and mortar specimens. The MC2R type (γ phase) had a smaller particle size and larger specific surface area than the MC2A type (α phase). The results indicate that the addition of nano-Al₂O₃to SSA/cement paste can effectively improve the hydration products of the paste. Moreover, the amount of hydration products increased as the amount of nano-Al₂O₃added to the SSA/cement paste increased. The test results indicate that MC2A nano-Al₂O₃can more uniformly distribute in the paste body and improve the hydration of cement than MC2R nano-Al₂O₃. Thus, more calcium-silicate-hydrate (C-S-H) gel and calcium aluminate hydrate (C-A-H) salts were produced, and the strength of the specimens was improved. This study suggests that MC2A nano-Al₂O₃is preferable to MC2R nano- Al₂O₃for SSA/cement specimen applications. PMID:26510613

  19. Action Of Cement Hardening On Artificial Hip Joint Components

    NASA Astrophysics Data System (ADS)

    Roder, U.; Niess, N.; Plitz, W.

    1981-05-01

    Artificial acetabular cups loose their original shape and undergo deformations during implantation, caused by the polymerization shrinkage of the bone cement. In laboratory experiments, two acetabula of different material - both common in clinical use - were studied by holographic real-time interferometry during cement hardening. This method picks up characteristic features in the transient behaviour of the form changes. It is shown, that temperature, porosity and shrinkage of the cement has a large influence on the form of a polyethylene acetabulum, whereas there is only little effect on an acetabulum, made of alumina ceramic.

  20. Navigated Acetabular Cup Fixation for Acetabular Deformity or Revision Total Hip Arthroplasty

    PubMed Central

    Yoon, Jung-Ro; Yu, Jung Jin; Seo, Hyo-Sung

    2014-01-01

    Purpose To evaluate the usefulness of navigated acetabular cup fixation for total hip arthroplasty in patients with acetabular deformity or revision total hip arthroplasty. Materials and Methods This study enrolled 28 patients with at least 12 months' follow-up. The safe zone of the acetabular cup was defined as 40°±10°in inclination and 15°±10°in anteversion. The authors used the navigation and radiographic data to determine whether the acetabular cup was located within the safe zone or not. To evaluate the clinical outcomes, preoperative and last follow-up Harris hip scores were checked, and the occurrence of complications was evaluated. Results According to the navigation data, the mean inclination and anteversion were 38.5°±4.7°(range, 32°-50°) and 16.6°±4.0°(range, 8°-23°), respectively. According to the radiographic data the mean inclination and anteversion were 40.5°±4.6°(range, 32°-50°) and 19.4°±4.2°(range, 8°-25°), respectively. In both cases, all values were within the safe zone. Harris hip score was improved in all patients from preoperative 52.3±14.4 points (range, 29-87 points) to 88.0±9.0 points (range, 65-99 points) at the last follow-up. There was no dislocation or loosening of both cases. Conclusion Navigated acetabular cup fixation is a useful technique for total hip arthroplasty in patients with acetabular deformity or revision total hip arthroplasty because it prevents the malposition and related complications.

  1. Bilateral Femoral Nutrient Foraminal Cement Penetration during Total Hip Arthroplasty

    PubMed Central

    Coomber, Ross; Bhumbra, Rej S; Marston, Robert

    2012-01-01

    Introduction: Cement pressurisation is important for the insertion of both the acetabular and femoral components during Total Hip Arthroplasty (THA). Secondary to pressurization the rare phenomenon of unilateral cement incursion into the nutrient foramen has previously been reported. No bilateral case has been reported to date. This has implications both for misdiagnosis of periprosthetic fractures and for medico-legal consequences due to a presumed adverse intra-operative event. Case Report: We present a case report of a 59 year old, caucasian female who underwent staged bilateral cemented Stanmore THA. The post-operative radiographs demonstrate evidence of bilateral nutrient foramen penetration intra-operatively by standard viscosity cement. The patient suffered no adverse consequences. Conclusions: In summary, cement extravasation into the nutrient foramen is an important differential to be considered in presence of posterior-medial cement in the diaphysis of femur following THA. This requires no further intervention and has no effect on the outcome.

  2. Hip replacement: landmark surgery in modern medical history.

    PubMed

    Mellon, Stephen J; Liddle, Alexander D; Pandit, Hemant

    2013-07-01

    Total hip replacement (THR) is most often performed to treat end-stage symptomatic osteoarthritis. Patients typically present with increasing pain, restricted mobility and stiffness. In this procedure, the femoral head and part of the femoral neck are excised. The acetabulum is enlarged and an acetabular cup is inserted. The femoral head is replaced by a femoral component, the stem of which is inserted into the medullary canal of the femur. The components can be either cemented in place or press-fit (cementless). The THR concept was popularised by Sir John Charnley in the 1960s and although, over half a century of development has resulted in incremental improvements, the procedure is not dramatically different from the one he described. However, over the last two decades there have been significant changes in the types of bearing surfaces used. Metal on polyethylene continues to be the workhorse for the majority of cases. In the young and active, bearing surfaces with low wear rate are increasingly used. Since the early 1960s, THR has played an important role in alleviating pain and restoring mobility to millions of people. The cost-effectiveness of THR in treating advanced osteoarthritis makes it one of the most successful of all surgical interventions. PMID:23693138

  3. The Morscher Press Fit acetabular component: a nine- to 13-year review.

    PubMed

    Gwynne-Jones, D P; Garneti, N; Wainwright, C; Matheson, J A; King, R

    2009-07-01

    We reviewed the results at nine to 13 years of 125 total hip replacements in 113 patients using the monoblock uncemented Morscher press-fit acetabular component. The mean age at the time of operation was 56.9 years (36 to 74). The mean clinical follow-up was 11 years (9.7 to 13.5) and the mean radiological follow-up was 9.4 years (7.7 to 13.1). Three hips were revised, one immediately for instability, one for excessive wear and one for deep infection. No revisions were required for aseptic loosening. A total of eight hips (7.0%) had osteolytic lesions greater than 1 cm, in four around the acetabular component (3.5%). One required bone grafting behind a well-fixed implant. The mean wear rate was 0.11 mm/year (0.06 to 0.78) and was significantly higher in components with a steeper abduction angle. Kaplan-Meier survival curves at 13 years showed survival of 96.8% (95% confidence interval 90.2 to 99.0) for revision for any cause and of 95.7% (95% confidence interval 88.6 to 98.4) for any acetabular re-operation. PMID:19567847

  4. Unusual Cause of Hip Pain: Intrusion of the Acetabular Labrum

    PubMed Central

    Jang, Se-Ang; Byun, Young-Soo; Jeong, Dae-Geun; Han, In-Ho; Kim, Min-Guek

    2015-01-01

    Femoroacetabular impingement and dysplatic hip joint is well known cause of osteoarthritis. In these diseases, labral tear and subsequent cartilage damage is thought to be main pathophysiology of development of osteoarthritis. If there are no known bony abnormalities, we called it as idiopathic osteoarthritis. Normal appearance of acetabular labrum is a continuous, usually triangular structure that attaches to the bony rim of the acetabulum and is completed at the inferior portion by the transverse acetabular ligament over the acetabular notch. A few authors reported intra-articular labrum and its relation to the development of osteoarthritis. But they didn't comment the primary bony abnormality especially acetabulum. We'd like to report x-ray, computed tomogram, magnetic resonance arthrogram and arthroscopic findings of a case had double contour sign of acetabular dome combined with intrusion of acetabular labrum.

  5. The jumbo acetabular component for acetabular revision: Curtain Calls and Caveats.

    PubMed

    Lachiewicz, P F; Watters, T S

    2016-01-01

    The 'jumbo' acetabular component is now commonly used in acetabular revision surgery where there is extensive bone loss. It offers high surface contact, permits weight bearing over a large area of the pelvis, the need for bone grafting is reduced and it is usually possible to restore centre of rotation of the hip. Disadvantages of its use include a technique in which bone structure may not be restored, a risk of excessive posterior bone loss during reaming, an obligation to employ screw fixation, limited bone ingrowth with late failure and high hip centre, leading to increased risk of dislocation. Contraindications include unaddressed pelvic dissociation, inability to implant the component with a rim fit, and an inability to achieve screw fixation. Use in acetabulae with < 50% bone stock has also been questioned. Published results have been encouraging in the first decade, with late failures predominantly because of polyethylene wear and aseptic loosening. Dislocation is the most common complication of jumbo acetabular revisions, with an incidence of approximately 10%, and often mandates revision. Based on published results, a hemispherical component with an enhanced porous coating, highly cross-linked polyethylene, and a large femoral head appears to represent the optimum tribology for jumbo acetabular revisions. PMID:26733644

  6. Bipolar hip arthroplasty as salvage treatment for loosening of the acetabular cup with significant bone defects

    PubMed Central

    Ghanem, Mohamed; Glase, Almuth; Zajonz, Dirk; Roth, Andreas; Heyde, Christoph-E.; Josten, Christoph; von Salis-Soglio, Georg

    2016-01-01

    Introduction: Revision arthroplasty of the hip is becoming increasingly important in recent years. Early primary arthroplasty and longer life expectancy of the patients increases the number of revision surgery. Revision surgery of hip arthroplasty is major surgery for the patients, especially the elderly, with significant risks concerning the general condition of the patient. The aim of this work is to evaluate the outcome of bipolar hip arthroplasty as a salvage procedure for treatment of loosening of the acetabular cup with significant acetabular bone defects after total hip replacement (THR) in multi-morbid patients. Patients and methods: During the period from January 1st 2007 to December 31st 2011 19 revision hip surgeries were performed in 19 patients, in which the loosened acetabular cup was replaced by a bipolar head. The examined patient group consisted exclusively of female patients with an average of 75 years. The predominant diagnosis was “aseptic loosening” (84.2%). All patients in our study were multi-morbid. We decided to resort to bipolar hip arthroplasty due to the compromised general condition of patients and the major acetabular bone defects, which were confirmed intraoperatively. The postoperative follow-up ranged from 0.5 to 67 months (average 19.1 months). Results: Evaluation of the modified Harris Hip Score showed an overall improvement of the function of the hip joint after surgery of approximately 45%. Surgery was less time consuming and thus adequate for patients with significantly poor general health condition. We noticed different complications in a significant amount of patients (68.4%). The most common complication encountered was the proximal migration of the bipolar head. The rate of revision following the use of bipolar hip arthroplasty in revision surgery of the hip in our patients was high (21%). Despite the high number of complications reported in our study, we have noticed significant improvement of hip joint function as

  7. The National Register of Joint Replacements of the Czech Republic.

    PubMed

    Vavřík, P; Landor, I; Popelka, S; Fialka, R; Hach, J

    2014-01-01

    The National Register of Joint Replacements of the Czech Republic was established as part of the National Health Information System in 2002. The register's administrator is the Institute of Health Information and Statistics of the Czech Republic, the Czech Society for Orthopaedics and Traumatology acts as its guarantor of scientific quality. The register is financed from governmental sources. It was launched into full operation in 2003 and it currently focuses on hip joint replacements. Register of knee and shoulder joint replacements is in the process of preparation. The register provides aggregate epidemiological data and other statistics, including the Revision Rate (RR) and curves of cumulative survival probability (Kaplan-Meier) for the main monitored groups of patients and implants used. In years 2003-2012 there were 101,734 primary implantations and 13,459 revision surgeries registered. In terms of gender distribution there is a predominance of females amounting to 59.4% in primary implantations and to 63.49% in revision surgeries. The age structure covers the entire range of adult population; however, more than 50% of the replacements are being implanted between 60-74 years of age. Most frequent indications for primary implantation are primary coxarthrosis (69.85%), post-fracture conditions (13.41%) and post-dysplasia arthritis (8.73%). The most frequent indications for revision surgery are aseptic loosening of acetabular component (38.15%), aseptic loosening of femoral component (22.01%) and recurrent dislocation (6.5%). 45,450 (44.68%) of primary implantations were cemented, 36,477 (35.86%) uncemented, 16,559 (16.28%) hybrid with cemented femur and 656 (0.64%) hybrid with cemented acetabulum. There were also records of 2,592 cervicocapital prostheses (2.55%). Most commonly used is the classic anterolateral approach 75.86% in primary implantations and 50.06% in revision surgeries. Mini-invasive approaches in primary implantations did not exceed 3.2% of all

  8. [Analysis of the Basic Stress Pathway Above Acetabular Dome].

    PubMed

    Nie, Yong; Ma, Jun; Haung, Qiang; Hu, Qinsheng; Shi, Xiaojun; Pei, Fuxing

    2015-08-01

    The basic stress pathway above the acetabular dome is important for the maintenance of implant stability in acetabular reconstruction of total hip arthroplasty (THA). The purpose of this study was to describe the basic stress pathway to provide evidence for clinical acetabular reconstruction guidance of THA. A subject-specific finite element (FE) model was developed from CT data to generate 3 normal hip models and a convergence study was conducted to determine the number of pelvic trabecular bone material properties using 5 material assignment plans. In addition, in the range of 0 to 20 mm above the acetabular dome, the models were sectioned and the stress pathway was defined as two parts, i.e., 3D, trabecular bone stress distribution and quantified cortical bone stress level. The results showed that using 100 materials to define the material property of pelvic trabecular bone could assure both the accuracy and efficiency of the FE model. Under the same body weight condition, the 3D trabecular bone stress distributions above the acetabular dome were consistent, and especially the quantified cortical bone stress levels were all above 20 MPa and showed no statistically significant difference (P>0.05). Therefore, defining the basic stress pathway above the acetabular dome under certain body weight condition contributes to design accurate preoperative plan for acetabular reconstruction, thus helping restore the normal hip biomechanics and preserve the stability of the implants. PMID:26710451

  9. Revision hip replacement for recurrent Hydatid disease of the pelvis: a case report and review of the literature.

    PubMed

    Neelapala, Venkata S S; Chandrasekar, Coonoor R; Grimer, Robert J

    2010-01-01

    A case of a large recurrent hydatid cyst involving the right ilium and right hip treated with excision of the cyst, Total hip replacement and revision of the acetabular component with a Tripolar articulation for cyst recurrence and acetabular component loosening is presented along with a review of the relevant literature. To our knowledge there is no reported case of Total Hip replacement and revision for hydatid disease involving the bony pelvis. PMID:20222941

  10. Bridging Suture Repair for Acetabular Chondral Carpet Delamination

    PubMed Central

    Kaya, Mitsunori; Hirose, Toshiaki; Yamashita, Toshihiko

    2015-01-01

    Acetabular chondral carpet delamination is a frequent finding at hip arthroscopy. The cartilage is macroscopically normal but deboned from the subchondral bone, without a disruption at the chondrolabral junction. Arthroscopic anatomic repair of delaminated cartilage is challenging. We propose that a combination of microfracture and use of stitches to press the delaminated cartilage against the subchondral bone using a suture limb offers an effective method to provide an environment for cartilage repair. This article describes the technique of bridging suture repair for carpet delamination in detail; the technique enables the surgeon to stabilize the delaminated acetabular cartilage. Intra-articular soft anchors and an acetabular rim knotless anchor footprint provide a stable repair for delaminated cartilage. This technique is especially helpful in cases with acetabular cartilage carpet delamination. PMID:26759774

  11. Total hip arthroplasty after rotational acetabular osteotomy.

    PubMed

    Ito, Hideya; Takatori, Yoshio; Moro, Toru; Oshima, Hirofumi; Oka, Hiroyuki; Tanaka, Sakae

    2015-03-01

    In this study, we aimed to determine whether the outcomes of total hip arthroplasty (THA) after rotational acetabular osteotomy (RAO) are equal to those of primary THA, and to elucidate the characteristics of THA after RAO. The clinical and radiographic findings of THA after RAO (44 hips), with minimum 24 months of follow-up, were compared with a matched control group of 58 hips without prior RAO. We found that the outcomes in terms of functional scores and complication rates did not differ between THA after RAO and THA without previous pelvic osteotomy, indicating that the results of THA after RAO are equivalent to those of primary THA. Although THA after RAO requires technical considerations, similar clinical outcomes to primary THA can be expected. PMID:25456635

  12. Modern cementing techniques. An experimental study of vacuum insertion of bone cement.

    PubMed

    Draenert, K

    1989-01-01

    The results of these experiments show that an increase in the intramedullary pressure (IMP) can lead to embolization of bone marrow contents via the venous drainage system along the linea aspera. A vacuum applied distally to the medullary canal is very effective for filling the diaphyseal tube with cement. The cancellous bone honeycombs of the proximal metaphysis, however, can only be filled if the bone sponge is tunneled at the level of the femoral calcar; a proximal vacuum then yields filling of the cancellous bone framework with bone cement. In order to fill the weight-bearing spongious framework of the pelvic bone with cement, the acetabular cavity should be sealed with a rubber ring and vacuum applied proximo-laterally to the ilium, thereby giving an extremely high suction pressure. PMID:2690560

  13. Wear of highly crosslinked polyethylene acetabular components

    PubMed Central

    Callary, Stuart A; Solomon, Lucian B; Holubowycz, Oksana T; Campbell, David G; Munn, Zachary; Howie, Donald W

    2015-01-01

    Background and purpose Wear rates of highly crosslinked polyethylene (XLPE) acetabular components have varied considerably between different published studies. This variation is in part due to the different techniques used to measure wear and to the errors inherent in measuring the relatively low amounts of wear in XLPE bearings. We undertook a scoping review of studies that have examined the in vivo wear of XLPE acetabular components using the most sensitive method available, radiostereometric analysis (RSA). Methods A systematic search of the PubMed, Scopus, and Cochrane databases was performed to identify published studies in which RSA was used to measure wear of XLPE components in primary total hip arthroplasty (THA). Results 18 publications examined 12 primary THA cohorts, comprising only 260 THAs at 2–10 years of follow-up. The mean or median proximal wear rate reported ranged from 0.00 to 0.06 mm/year. However, differences in the manner in which wear was determined made it difficult to compare some studies. Furthermore, differences in RSA methodology between studies, such as the use of supine or standing radiographs and the use of beaded or unbeaded reference segments, may limit future meta-analyses examining the effect of patient and implant variables on wear rates. Interpretation This scoping review confirmed the low wear rates of XLPE in THA, as measured by RSA. We make recommendations to enhance the standardization of reporting of RSA wear results, which will facilitate early identification of poorly performing implants and enable a better understanding of the effects of surgical and patient factors on wear. PMID:25301435

  14. Preliminary Biomechanical Study of Different Acetabular Reinforcement Devices for Acetabular Reconstruction

    PubMed Central

    Tai, Ching-Lung; Lee, Po-Yi; Hsieh, Pang-Hsing

    2015-01-01

    Background Acetabular reinforcement devices (ARDs) are frequently used as load-sharing devices to allow allograft incorporation in revision hip arthroplasty with massive acetabular bone loss. The key to a successful reconstruction is robust fixation of the device to the host acetabulum. Interlocking fixation is expected to improve the initial stability of the postoperative construct. However, all commercially available ARDs are designed with non-locking fixation. This study investigates the efficacy of standard ARDs modified with locking screw mechanisms for improving stability in acetabular reconstruction. Methods Three types of ARDs were examined to evaluate the postoperative compression and angular stability: i) standard commercial ARDs, ii) standard ARDs modified with monoaxial and iii) standard ARDs modified with polyaxial locking screw mechanisms. All ARDs were implanted into osteomized synthetic pelvis with pelvic discontinuity. Axial compression and torsion tests were then performed using a servohydraulic material testing machine that measured load (angle) versus displacement (torque). Initial stability was compared among the groups. Results Equipping ARDs with interlocking mechanisms effectively improved the initial stability at the device/bone interface compared to standard non-locked ARDs. In both compression and torsion experiments, the monoaxial interlocking construct demonstrated the highest construct stiffness (672.6 ± 84.1 N/mm in compression and 13.3 ± 1.0 N·m/degree in torsion), whereas the non-locked construct had the lowest construct stiffness (381.4 ± 117.2 N/mm in compression and 6.9 ± 2.1 N·m/degree in torsion) (P < 0.05). Conclusions Our study demonstrates the potential benefit of adding a locking mechanism to an ARD. Polyaxial ARDs provide the surgeon with more flexibility in placing the screws at the cost of reduced mechanical performance. This in vitro study provides a preliminary evaluation of biomechanical performance for ARDs

  15. Arthroscopic Reduction and Transportal Screw Fixation of Acetabular Posterior Wall Fracture: Technical Note.

    PubMed

    Park, Jin Young; Chung, Woo Chull; Kim, Che Keun; Huh, Soon Ho; Kim, Se Jin; Jung, Bo Hyun

    2016-06-01

    Acetabular fractures can be treated with variable method. In this study, acetabular posterior wall fracture was treated with arthroscopic reduction and fixation using cannulated screw. The patient recovered immediately and had a satisfactory outcome. In some case of acetabular fracture could be good indication with additional advantages of joint debridement and loose body removal. So, we report our case with technical note. PMID:27536654

  16. Arthroscopic Reduction and Transportal Screw Fixation of Acetabular Posterior Wall Fracture: Technical Note

    PubMed Central

    Park, Jin young; Kim, Che Keun; Huh, Soon Ho; Kim, Se Jin; Jung, Bo Hyun

    2016-01-01

    Acetabular fractures can be treated with variable method. In this study, acetabular posterior wall fracture was treated with arthroscopic reduction and fixation using cannulated screw. The patient recovered immediately and had a satisfactory outcome. In some case of acetabular fracture could be good indication with additional advantages of joint debridement and loose body removal. So, we report our case with technical note. PMID:27536654

  17. Total Hip Arthroplasty Using Modular Trabecular Metal Acetabular Components for Failed Treatment of Acetabular Fractures: A Mid-term Follow-up Study

    PubMed Central

    Huang, De-Yong; Zhang, Liang; Zhou, Yi-Xin; Zhang, Chun-Yu; Xu, Hui; Huang, Yong

    2016-01-01

    Background: Porous-coated cups have been widely used in acetabular reconstruction after failed treatment of acetabular fractures, and good results have been reported with the use of these cups; however, the durability and functionality of modular trabecular metal (TM) acetabular components in acetabular reconstruction after failed treatment of acetabular fractures remain unclear. This study aimed to examine the radiographic and clinical outcomes associated with the use of modular TM acetabular components for failed treatment of acetabular fractures to assess the durability and functionality of these components in acetabular reconstruction after failed treatment of acetabular fractures. Methods: A total of 41 patients (41 hips) underwent total hip arthroplasty (THA) using modular TM acetabular components for failed treatment of acetabular fractures at our hospital between January 2007 and December 2012. Among these patients, two were lost to follow-up. Therefore, 39 patients (39 hips) were finally included in this study. The Harris hip score before and after the surgery, satisfaction level of the patients, and radiographic results were assessed. Results: The mean Harris hip score increased from 34 (range, 8–52) before surgery to 91 (range, 22–100) at the latest follow-up examination (P < 0.001). The results were excellent for 28 hips, good for six, fair for three, and poor for two. Among the 39 patients, 25 (64%) and 10 (26%) were very satisfied and somewhat satisfied, respectively. All cups were found to be fully incorporated, and no evidence of cup migration or periacetabular osteolysis was noted. Conclusions: Despite the technically demanding nature of the procedure, THA using modular TM acetabular components showed good durability and functionality and may be an effective reconstruction option for failed treatment of acetabular fractures. PMID:27064033

  18. Open-configuration MRI study of femoro-acetabular impingement.

    PubMed

    Yamamura, Mitsuyoshi; Miki, Hidenobu; Nakamura, Nobuo; Murai, Masakazu; Yoshikawa, Hideki; Sugano, Nobuhiko

    2007-12-01

    Femoro-acetabular impingement has been proposed as a causative factor of primary hip osteoarthritis. However, primary osteoarthritis of the hip is infrequent in Japan and other Asian countries, even though the hips of Asians frequently sustain impingement, since the Asian lifestyle commonly requires a larger range of hip motion than the Western lifestyle. Therefore, using open-configuration MRI, we investigated whether impingement actually occurs during some traditional Japanese hip positions. The hips of 5 healthy Japanese females were examined in 5 sitting postures: 1) sitting straight; 2) bowing while sitting straight; 3) sitting cross-legged; 4) W-sitting; and 5) squatting. The impingement point was detected by multiple plane reconstructed (MPR) views along with the acetabular rim depicted circumferentially. Impingement was considered to have occurred when, on MRI, the anterior femoral head-neck junction approached the acetabular rim and the femoral head was seen to float from the bottom of the acetabulum with the acetabular rim acting as a fulcrum. Impingement was observed in all volunteers in the W-sitting position, and in 2 of 5 volunteers during squatting. These findings show that impingement occurs frequently during daily Japanese activities. Thus, depending on race, femoro-acetabular impingement might not always cause primary osteoarthritis of the hip. (c) 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:1582-1588, 2007. PMID:17600811

  19. Accuracy of the modified Hardinge approach in acetabular positioning

    PubMed Central

    Goyal, Prateek; Lau, Adrian; McCalden, Richard; Teeter, Matthew G.; Howard, James L.; Lanting, Brent A.

    2016-01-01

    Background The surgical approach chosen for total hip arthroplasty (THA) may affect the positioning of the acetabular component. The purpose of this study was to examine the accuracy in orienting the acetabular component using the modified Hardinge approach. Methods We used our institutional arthroplasty database to identify patients with primary, press-fit, hemispherical acetabular components of a metal-on-polyethylene THA performed between 2003 and 2011. Patients with radiographs obtained 1–3 years after the index procedure were included for measurement of anteversion and inclination angles. Acceptable values of anteversion and abduction angles were defined as 15° ± 10° and 40° ± 10°, respectively. Results We identified 1241 patients from the database, and the modified Hardinge approach was used in 1010 of the patients included in our analysis. The acetabular component was anteverted in the acceptable zone in 54.1% of patients. The abduction angle was within the defined range in 79.2% of patients. Combined anteversion and abduction angles within the defined zone were present in 43.6% of patients. Conclusion Consistent with studies examining accuracy from other approaches, our study reveals that the modified Hardinge approach was only moderately accurate in positioning the acetabular component in the acceptable zone. PMID:27240130

  20. Cement disease.

    PubMed

    Jones, L C; Hungerford, D S

    1987-12-01

    Does "cement disease" exist? The bony environment surrounding a loosened cemented prosthesis is an abnormal pathologic condition which, if left unattended, will progress to a total failure of the joint including an inhibition of function and immobilizing pain. That biomaterial properties of the cement used for fixation also contribute to the pathologic state separates this disease from other modes of loosening. This leads inevitably to the conclusion that "cement disease" does exist. Methyl methacrylate has revolutionized the treatment of severe joint dysfunction. There can be no doubt that improving surgical technique, cement handling, and the cement itself will continue to improve the results and reduce the incidence of failure due to loosening. Cement is undoubtedly satisfactory for elderly patients with low activity levels and relatively short life expectancies. However, because of the inherent biologic and biomechanical properties of methyl methacrylate, it is unlikely that it can be rendered satisfactory in the long run for the young, the active, or the overweight patient, for whom alternatives are currently being sought. In such cases, the elimination of "cement disease" can only occur with the elimination of cement. Alternatives include the search for other grouting materials and the development of prostheses with satisfactory surfaces for either press-fit or biologic ingrowth. PMID:3315375

  1. Early polyethylene wear and osteolysis with ABG acetabular cups (7- to 12-year follow-up)

    PubMed Central

    Livesley, Peter

    2005-01-01

    We reviewed 81 consecutive ABG I primary total hip replacements implanted in 72 patients between January 1993 and December 1998. The mean follow-up was 8.2 (range 7–12) years. There was significant polyethylene wear and osteolysis associated with the acetabular cup .The cumulative survival of the cup with revision being the end point at 8.2 years was 95.1% (95% CI: 92–97.6%). However, the cumulative survival of the cup with revision and aseptic loosening together was 72% (95% CI: 61–78%) and survival of the acetabular liner for wear was 62% (95% CI: 48–74%). Stem survival with revision being the end point was 100%. In spite of significant radiological failures of the cups, most patients remained asymptomatic. Though results of the ABG stems in this series were good, we advocate a regular follow-up of all these hips in view of the poor outcome of the cups. PMID:16283307

  2. Computer-Assisted Rotational Acetabular Osteotomy for Patients with Acetabular Dysplasia

    PubMed Central

    Kobayashi, Naomi; Ike, Hiroyuki; Kubota, So; Saito, Tomoyuki

    2016-01-01

    Rotational acetabular osteotomy (RAO) is a well-established surgical procedure for patients with acetabular dysplasia, and excellent long-term results have been reported. However, RAO is technically demanding and precise execution of this procedure requires experience with this surgery. The usefulness of computer navigation in RAO includes its ability to perform three-dimensional (3D) preoperative planning, enable safe osteotomy even with a poor visual field, reduce exposure to radiation from intraoperative fluoroscopy, and display the tip position of the chisel in real time, which is educationally useful as it allows staff other than the operator to follow the progress of the surgery. In our results comparing 23 hips that underwent RAO with navigation and 23 hips operated on without navigation, no significant difference in radiological assessment was observed. However, no perioperative complications were observed in the navigation group whereas one case of transient femoral nerve palsy was observed in non-navigation group. A more accurate and safer RAO can be performed using 3D preoperative planning and intraoperative assistance with a computed tomography-based navigation system. PMID:26929806

  3. The submuscular sliding plate technique for acetabular posterior wall fractures extending to the acetabular roof.

    PubMed

    Kim, J J; Kim, J W; Oh, H K

    2014-12-01

    There is extension of the Kocher-Langenbeck approach using trochanteric osteotomy for posterior wall fracture extending to acetabular roof, but it exposes to complications such as nonunion, breakage, and heterotopic ossification. The current study introduces a submuscular sliding plate technique. We retrospectively analyzed 13 patients treated with this technique. It is based on conventional method for posterior wall fracture. After reduction of roof fragment with direct visualization, a pre-contoured plate was passed through a submuscular tunnel under the gluteus medius and minimus. A small split incision was performed on the muscles, and screws were inserted with a triple trocar complex safely under fluoroscopic imaging. All patients had fracture union without complications. X-rays results showed anatomical reduction in 10 cases and imperfect reduction in 3 cases. Our results were satisfactory, particularly without heterotopic ossifications despite no prophylactic regimen of NSAID was applied and no neurological complications, so we believe that this technique is a good option for posterior wall fractures extending to the acetabular roof. PMID:25453921

  4. The role of the cemented all-polyethylene tibial component in total knee replacement: a 30-year patient follow-up and review of the literature.

    PubMed

    Blumenfeld, Thomas J; Scott, Richard D

    2010-12-01

    Use of an all-polyethylene tibial component in primary total knee arthroplasty remains an attractive option considering the reported durability of the construct, the lowered cost compared to modular metal-backed tibia, and the elimination of backside wear. The two major intra-operative disadvantages include the inability to alter the tibial component thickness after permanent implant placement and the inability to use varus-valgus constrained designs. The long-term disadvantage is the inability to perform a modular insert exchange should this be required. We report the 30-year outcome of a single patient using the duopatellar total knee replacement system. Based on a critical review of the literature we would recommend use in patients 80 years of age or older, consideration in patients 75 to 79 years, and possibly in younger yet less active patients. These three groups would be the least likely to require a modular tibial liner exchange in their lifetime. PMID:20060725

  5. Revision of hemiarthroplasty to total hip arthroplasty using the cement-in-cement technique.

    PubMed

    Mounsey, E J; Williams, D H; Howell, J R; Hubble, M J

    2015-12-01

    Revision of a cemented hemiarthroplasty of the hip may be a hazardous procedure with high rates of intra-operative complications. Removing well-fixed cement is time consuming and risks damaging already weak bone or perforating the femoral shaft. The cement-in-cement method avoids removal of intact cement and has shown good results when used for revision total hip arthroplasty (THA). The use of this technique for the revision of a hemiarthroplasty to THA has not been previously reported. A total of 28 consecutive hemiarthroplasties (in 28 patients) were revised to a THA using an Exeter stem and the cement-in-cement technique. There were four men and 24 women; their mean age was 80 years (35 to 93). Clinical and radiographic data, as well as operative notes, were collected prospectively and no patient was lost to follow-up. Four patients died within two years of surgery. The mean follow up of the remainder was 70 months (25 to 124). Intra-operatively there was one proximal perforation, one crack of the femoral calcar and one acetabular fracture. No femoral components have required subsequent revision for aseptic loosening or are radiologically loose. Four patients with late complications (14%) have since undergone surgery (two for a peri-prosthetic fracture, and one each for deep infection and recurrent dislocation) resulting in an overall major rate of complication of 35.7%. The cement-in-cement technique provides reliable femoral fixation in this elderly population and may reduce operating time and rates of complication. PMID:26637675

  6. Observations on the initial stability of acetabular components in total hip arthroplasty. An experimental study.

    PubMed

    Pitto, R P; Sterzl, M; Hohmann, D

    1996-01-01

    It was the purpose of the study to investigate the initial stability, with or without screws, of 3 acetabular components with press-fit anchoring, by measuring bone-prosthesis micromovements during the application of physiological loading on the hip simulated in the laboratory. The prostheses, already used clinically, were characterized by different shapes and coatings. For the purposes of the study a total of 30 acetabula were used in 10 human pelves in polyurethane and 5 human pelves preserved at -20 degrees. The pelves were assembled on a hydraulic bench test with a steel jig that could be oriented, and they were cemented with polymethylmethacrylate. Three electromagnetic transducers with sensitivity of up to 1 micron (+ 500 microns) were used to measure the micromovements between the prosthesis and the acetabular rim in its three anatomical quadrants. Bone-prosthesis micromovements were recorded during 5 consecutive load tests, from 0 to 2.39 kN (244 kg). Experimental studies have shown that bone-prosthesis micromovement that exceeds 150 microns obstructs bone integration. The most significant micromovement was observed for all of the prostheses, without accessory screws, in the iliac quadrant, but only the hemispherical one with a semi-smooth surface in zirconium oxide surpassed the threshold of 150 microns. Prostheses with a porous surface demonstrated good stability (102 +/- 33 microns and 94 +/- 36 microns, respectively). None of the prostheses demonstrated micromovement exceeding 90 microns in the area corresponding to the pubis and the ischium. The use of 2 accessory screws sensitively increased the stability of all of the prostheses on the ilium, reducing the average micromovement by 40 microns. Reduction of micromovement was less on the pubis and on the ischium. PMID:8968114

  7. Acetabular Labral Tears in Patients with Sports Injury

    PubMed Central

    Kang, Chan; Cha, Soo-Min

    2009-01-01

    Background We wanted to investigate acetabular labral tears and their correlation with femoroacetabular impingement in patients with sports injury. Methods Among 111 patients who were diagnosed with the acetabular labral tears after arthroscopic treatment from January 2004 to December 2007, we selected 41 patients with sports injury. There were 12 cases of Taekwondo injury, 5 of golf injury, 4 of soccer injury, 3 of gymnastics injury, 2 of Hapkido injury, 2 of aerobics injury, 2 of rock-climbing injury, 2 of fitness training injury and 9 of other sports injuries. We checked the subtypes of acetabular labral tears and the accompanying femoroacetabular impingement. For the cases with accompanying femoroacetabular impingement, we investigated the subtypes according to the types of sports, gender and age. At last follow-up, we checked the Harris Hip Score (HHS), the Hip Outcome Score (HOS) sports scale and the percentage of patients who returned to their sports activity. Results The average age of symptomatic onset was 26 years (range, 12 to 65 years). The ratio of males to females was 29 : 12. An average duration of the hip pain was 17 months (range, 1 to 60 months). The degenerative type of acetabular labral tears was the most prevalent with 32 cases (78%), and there were 9 cases (22%) of the partial tear type. Thirty cases (73%) were accompanied by femoroacetabular impingement. The average age of the 23 cases (56%) of the cam-type was 23 years (range, 12 to 48 years), and it was more likely to occur in men (87%) and for people practicing martial arts such as Taekwondo or Hapkido. An average age of the 5 cases (12%) of the pincer-type was 26 (range, 16 to 43 years), it usually occurred in women (60%) and for non-martial arts such as golf and gymnastics. There were 2 cases of the mixed type (cam + pincer-type). At 27 months follow-up, the HHS was 61 to 92 points, the HOS sports scale increased 43 to 75%, and the rate of returning to sports was 71%. Conclusions In

  8. Effect of acetabular reinforcement ring with hook for acetabular dysplasia clarified by three-dimensional finite element analysis.

    PubMed

    Zhao, Xin; Chosa, Etsuo; Yamako, Go; Watanabe, Shinji; Deng, Gang; Totoribe, Koji

    2013-12-01

    The objective of this study was to biomechanically determine the effect of the severity of acetabular dysplasia, number and positions of screws and type of bone graft material used on the initial fixation strength of the acetabular reinforcement ring with hook (Ganz ring) using the finite element method. Relative micromotion increased as the severity of acetabular dysplasia increased and tended to decrease as the number of screws increased, but varied according to screw placement position. Increased strength of the bone graft material led to decreased relative micromotion. Biomechanically, the Ganz ring can be placed securely using 3 screws in patients with Crowe 1 dysplasia. However, in patients with Crowe 2 or higher dysplasia, it is necessary to spread at least 4 screws across an area of good host bone. PMID:23993349

  9. Natural cement as the precursor of Portland cement: Methodology for its identification

    SciTech Connect

    Varas, M.J. . E-mail: mjvaras@geo.ucm.es; Alvarez de Buergo, M.; Fort, R.

    2005-11-15

    When cements appeared in the 19th century, they took the place of traditional binding materials (lime, gypsum, and hydraulic lime) which had been used until that time. Early cements can be divided into two groups, natural and artificial (Portland) cements. Natural cements were introduced first, but their widespread usage was short-lived as they were quickly replaced by artificial cements (Portland), still the most important and predominant today. The main differences between natural and artificial cements arise during the manufacturing process. The final properties of the cements are greatly influenced by differences in the raw materials and burning temperatures employed. The aim of this paper is to assess the efficiency of traditional analytical techniques (petrographic microscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), and Fourier transform infrared spectroscopy (FTIR)) used to differentiate natural and artificial cements.

  10. European experience with cementless total hip replacements.

    PubMed

    Morscher, E W

    1983-01-01

    The differences between prostheses fixed with and without cement consist mainly of the design and the nature of the surface of the implant. The shapes of the sockets to be implanted without cement show a wide variety--cylinder, square, conus, ellipsoid with and without threads. The hemispherical shape, which was chosen for the acetabular component of the isoelastic hip joint, does not disturb the natural form and function of the hip joint since the outer surface is closely adapted to the original subchondral bone layer. Undesired stress concentrations therefore are eliminated. The fixation of the noncemented cup is secured by threads, pegs, screws, etc. and by ingrowth of bony tissue in the grooves of the surfaces. Except for some special forms, most of the stems are based on the self-locking principle. All prosthesis models show preparations that increase the surface area (ribs, wings, corrugations, or rims). PMID:6368478

  11. Ten-year results of a press-fit, porous-coated acetabular component.

    PubMed

    Grobler, G P; Learmonth, I D; Bernstein, B P; Dower, B J

    2005-06-01

    We retrospectively reviewed, ten years after surgery, 100 consecutive total hip replacements in which the Duraloc 300 cup had been used. Post-operative radiographs were analysed for placement of the cup and interface gaps and follow-up radiographs for lucent lines, osteolysis, wear and migration. All the components were found to be stable with no evidence of loosening. The mean rate of wear was 0.12 mm/year. Three hips developed acetabular osteolysis at the level of the apex hole. Two have successfully undergone bone grafting without removal of the implants and one patient is awaiting surgery. The Duraloc 300 cup has a survival of 100% at ten years with no aseptic loosening and a low incidence of pelvic osteolysis. PMID:15911659

  12. Traumatic Periprosthetic Acetabular Fracture Treated with One-Stage Exchange and Bone Reconstruction Using a Synthetic Bone Graft Substitute

    PubMed Central

    2016-01-01

    A case of a traumatic periprosthetic acetabular fracture in an elderly patient, which was treated by one-stage hip exchange with implantation of an antiprotrusio cage and reconstruction of the acetabular bone loss with an injectable calcium sulphate/hydroxyapatite bone graft substitute, is reported. The paste-like bone graft substitute was injected through the holes of the antiprotrusio cage. After a setting time of 15 minutes, a low-profile cup was cemented onto the cage using polymethylmethacrylate and a new stem was inserted. The patient was encouraged to ambulate three days postoperatively weight-bearing as tolerated. At the one-year follow-up visit the patient was ambulatory and full weight-bearing without any walking aids. The follow-up radiographs demonstrated stable position and articulation of the revision hip arthroplasty with no signs of loosening of the antiprotrusio cage. However, the most interesting finding was that the bone graft substitute had remodelled to a great extent into bone. This calcium sulphate/hydroxyapatite composite shows high osteoconductive potential and can be used to regenerate bone stock in revision arthroplasty. PMID:27446621

  13. Traumatic Periprosthetic Acetabular Fracture Treated with One-Stage Exchange and Bone Reconstruction Using a Synthetic Bone Graft Substitute.

    PubMed

    Svacina, Jan

    2016-01-01

    A case of a traumatic periprosthetic acetabular fracture in an elderly patient, which was treated by one-stage hip exchange with implantation of an antiprotrusio cage and reconstruction of the acetabular bone loss with an injectable calcium sulphate/hydroxyapatite bone graft substitute, is reported. The paste-like bone graft substitute was injected through the holes of the antiprotrusio cage. After a setting time of 15 minutes, a low-profile cup was cemented onto the cage using polymethylmethacrylate and a new stem was inserted. The patient was encouraged to ambulate three days postoperatively weight-bearing as tolerated. At the one-year follow-up visit the patient was ambulatory and full weight-bearing without any walking aids. The follow-up radiographs demonstrated stable position and articulation of the revision hip arthroplasty with no signs of loosening of the antiprotrusio cage. However, the most interesting finding was that the bone graft substitute had remodelled to a great extent into bone. This calcium sulphate/hydroxyapatite composite shows high osteoconductive potential and can be used to regenerate bone stock in revision arthroplasty. PMID:27446621

  14. Dissociation of a polyethylene liner from an acetabular cup.

    PubMed

    Cameron, H U

    1993-10-01

    A polyethylene linear dissociated from a metal acetabular shell that could not be removed at the time of hip revision because the hexagonal hole in its screw head had become rounded off. A high-speed metal cutting burr was used to remove the screw and allow cup revision. PMID:8265224

  15. Tritanium acetabular wedge augments: short-term results

    PubMed Central

    Restrepo, Camilo; Heller, Snir

    2016-01-01

    Background Reconstruction of acetabular defects in total hip arthroplasty (THA) presents a great challenge to orthopaedic surgeons. Previous studies have reported on the use and outcomes of trabecular metal acetabular augments for the reconstruction of acetabular defects. However, no study has been conducted evaluating the short-term results of tritanium acetabular wedge augments for the reconstruction of acetabular defects in THA. Methods A retrospective study was conducted using a prospective database at a single institution including primary and revision THA patients from January 2013 to December 2014. Patients were included if they received a tritanium acetabular wedge augment system and had a minimum of 2-year follow-up (average 2.2 years ±0.3, range, 2–2.6 years). Demographic data and outcomes data [Harris Hip Score—HHS and Short Form (SF)-36] was collected. Radiographic data was also collected on THA revision cases (Paprosky classification), developmental dysplasia of the hip (DDH) cases (Crowe classification), and radiographic follow-up using DeLee and Charnley’s classification system. Results There were 4 revision THA patients, 3 DDH patients, and 1 patient with posttraumatic arthritis. At the latest radiographic follow-up, there were no lucent lines in DeLee and Charnley Zones I, II or III. During the follow-up period, there was no open revision surgery. The SF-36 physical score significantly improved from preoperative measurement (29.6±2.2) to postoperative measurement (52.2±8.7, P=0.003), and the SF-36 mental score also significantly improved from preoperative assessment (34.5±4.5) to postoperative assessment (52.2±7.5, P=0.003). Total HHS scores also significantly improved postoperatively (P=0.02), with significant improvements in both the pain score (P=0.01) and function score (P=0.02). Conclusions Tritanium acetabular wedge augments in this short follow-up case series exhibit high clinical outcome scores, no radiographic lucency, and no

  16. An occult acetabular fracture preceding a femoral neck fracture.

    PubMed

    Lasanianos, Nikolaos; Kanakaris, Nikolaos; Giannoudis, Peter V

    2009-08-01

    This article describes the case of a 69-year-old patient with an occult acetabular fracture complicated by an ipsilateral femoral neck fracture occurring within 2 months. The acetabular fracture remained undiagnosed at examination due to insufficient clinical and radiographic data interpretation. The patient was assured of early mobilization that led to a fall and subsequent hip fracture. We focus on the potential reasons for the nondiagnosis of the acetabular fracture. Acetabular fractures in the elderly may occur after low-energy injuries. The lack of history of violent injury may lead to an incorrect diagnosis. Plain anteroposterior (AP) pelvis radiographs alone may prove an insufficient tool, especially in the hands of inexperienced personnel. As is characteristic, a retrospective review of the AP pelvis radiograph obtained after the first fall in our case revealed the undisplaced fracture of the anterior column that was missed initially. Combined fractures of the hip and the acetabulum are rarely described in the literature and are usually addressed by total hip arthroplasty (THA) alone. Similar fracture patterns that develop in 2 stages (2 injuries), as the 1 presented herein, are even more rare. The uniqueness of this combined fracture required a unique surgical treatment. The senior surgeon (P.V.G.) addressed the acetabular fracture separately to graft the anterior column fracture and facilitate union, as it was already 8 weeks old and the second fall had generated a further gap between the fragments. Stable fixation was felt appropriate prior to the THA. Thus, a double surgical approach was used. Six weeks postoperatively, the patient was able to perform full weight-bearing mobilization without an antalgic gait pattern. At 6-month follow-up, radiographs showed the metalwork to be in place with no displacement, and the fracture had progressed to union. PMID:19708620

  17. Protrusio After Medial Acetabular Wall Breach in Total Hip Arthroplasty

    PubMed Central

    Martin, Christopher T.; Heiner, Anneliese D.; Baer, Thomas E.; Pugely, Andrew J.; Noiseux, Nicolas O.

    2015-01-01

    Background Medial protrusio is a recognized complication of total hip arthroplasty, but it is not known if a medial wall breach during cup implantation increases the risk. We thus investigated the effect of up to a 2 cm defect in the medial acetabular wall in a cadaveric model. Separately, we investigated the ability of acetabular screws to rescue the construct. Methods Nine human fresh-frozen hemipelves were reamed medially to create the defect, implanted with acetabular cups, and then loaded to failure. The nine contralateral hemipelves were reamed in a standard fashion and served as controls. Separately, nine hemipelves with a medial defect were augmented with two acetabular screws each, then loaded to failure, with the contralateral side as a control. Load-to-failure, stiffness, and energy were recorded. Findings The presence of a medial wall defect decreased the load-to-failure by a mean of 26% (5710 v. 4221 N, p=0.024). The addition of two acetabular screws did not rescue the construct (mean 27% decrease, 4082 v. 2985 N, p=0.024). The majority of specimens failed in a supra-physiologic range of force. Bone density correlated with failure loads (R2 range of 0.54-0.78), and osteoporotic specimens were more likely to fail at a physiologic range, consistent with forces experienced during minor stumbles or falls. Interpretation Osteoporotic patients with a medial wall defect after hip arthroplasty may be susceptible to fracture during activities of daily living. Protected weight bearing with an assistive device may be reasonable in order to minimize fall risk until cup ingrowth is achieved. PMID:26361450

  18. Porous Tantalum Buttress Augments for Severe Acetabular Posterior Column Deficiency.

    PubMed

    Meneghini, R Michael; Hull, Jason R; Russo, Glenn S; Lieberman, Jay R; Jiranek, William A

    2015-11-01

    In revision total hip arthroplasty (THA), consensus is lacking regarding the optimal method for reconstruction of the most severe acetabular defects. Porous tantalum (TM) buttress augments were designed for the most severe postero-superior defects. The purpose of this study was to report the results of a consecutive series of acetabular reconstructions utilizing TM buttress augments. Eight complex acetabular reconstructions utilizing a TM buttress augment were performed at two centers. All were Paprosky 3A or Paprosky 3B bone loss classification, with severe superior and posterior column deficiency where wedge augments were insufficient for mechanical support. The acetabular cup sizes ranged from 64-78, and a buttress shim was used in 7 of 8 cases. Clinical and radiographic follow-up averaged 16.5 months (range, 10-28) and no cases were lost to follow-up. There were no cases of clinical or radiographic loosening, and no case had required reoperation or revision. All patients except one were ambulating with either no assist device or a single cane at final follow-up. There was one complication of an iliac wing fracture noted incidentally on postoperative x-rays in the lone patient in whom a buttress shim was not used. At short-term follow-up, TM acetabular buttress augments appear to effectively substitute for the use of structural allografts or cages, which would otherwise be used in this challenging setting. The potential for biologic fixation is promising for the durability of these reconstructions; however, longer-term follow-up is required for full evaluation. PMID:26680404

  19. Validation of neck axis distance as a radiographic measure for acetabular anteversion

    PubMed Central

    Nitschke, Ashley; Petersen, Brian; Lambert, Jeffery R.; Glueck, Deborah H.; Jesse, Mary Kristen; Strickland, Colin; Mei-Dan, Omer

    2016-01-01

    Excessive acetabular anteversion is an important treatment consideration in hip preservation surgery. There is currently no reliable quantitative method for determining acetabular anteversion utilizing radiographs alone. The three main purposes of this study were to: (i) define and validate the neck axis distance (NAD) as a new visual and reproducible semi-quantitative radiographic parameter used to measure acetabular anteversion; (ii) determine the degree of correlation between NAD and computed tomography (CT)-measured acetabular anteversion; (iii) establish a sensitive and specific threshold value for NAD to identify excessive acetabular anteversion. This retrospective cohort study included all patients presenting to a single institution over a 14-month period who had undergone a dedicated musculoskeletal CT pelvis along with a standardized anteroposterior (AP) pelvis radiograph. Trained observers measured the NAD on the AP pelvis radiograph and equatorial acetabular anteversion on CT for all hips. Mixed model analysis was used to find prediction equations, and ROC analysis was used to evaluate the diagnostic accuracy of NAD. NAD is a valid semi-quantitative predictor of acetabular anteversion and strongly correlates with CT-measured equatorial acetabular anteversion (P  <  0.0001). A NAD measurement of greater than 14 mm predicts excessive acetabular anteversion with 76% sensitivity and 78% specificity. NAD is an accurate radiographic predictor of acetabular anteversion, which may be readily used as an effective screening tool during the evaluation of patients with hip pain. PMID:27026824

  20. Lateral acetabular labral length is inversely related to acetabular coverage as measured by lateral center edge angle of Wiberg.

    PubMed

    Petersen, Brian D; Wolf, Bryan; Lambert, Jeffrey R; Clayton, Carolyn W; Glueck, Deborah H; Jesse, Mary Kristen; Mei-Dan, Omer

    2016-08-01

    Patients with developmental dysplasia of the hip often have compensatory labral hypertrophy, which presumably lends stability to an unstable joint. Conversely, patients with acetabular overcoverage may have small or ossified labra. The purpose of this study is to explore the interaction of labral length with the degree of acetabular hip coverage. A retrospective cohort of patients with hip pain presenting to a hip preservation center, who had undergone hip magnetic resonance imaging and AP pelvis radiographs were studied. General linear multivariate models were used to assess the association between three measures of labral length (lateral, anterior and anterior inferior locations along the acetabular rim) and the X-ray derived lateral center edge angle (LCEA) of Wiberg. Of the three acetabular labral locations measured, only the lateral labrum was associated with LCEA Wiberg (P = 0.0008). Lateral labral length increases as LCEA of Wiberg decreases. The anterior and anterior inferior labral locations did not show a predictable increase in labral length as LCEA Wiberg decreased. PMID:27583157

  1. Lateral acetabular labral length is inversely related to acetabular coverage as measured by lateral center edge angle of Wiberg

    PubMed Central

    Petersen, Brian D.; Wolf, Bryan; Lambert, Jeffrey R.; Clayton, Carolyn W.; Glueck, Deborah H.; Jesse, Mary Kristen; Mei-Dan, Omer

    2016-01-01

    Patients with developmental dysplasia of the hip often have compensatory labral hypertrophy, which presumably lends stability to an unstable joint. Conversely, patients with acetabular overcoverage may have small or ossified labra. The purpose of this study is to explore the interaction of labral length with the degree of acetabular hip coverage. A retrospective cohort of patients with hip pain presenting to a hip preservation center, who had undergone hip magnetic resonance imaging and AP pelvis radiographs were studied. General linear multivariate models were used to assess the association between three measures of labral length (lateral, anterior and anterior inferior locations along the acetabular rim) and the X-ray derived lateral center edge angle (LCEA) of Wiberg. Of the three acetabular labral locations measured, only the lateral labrum was associated with LCEA Wiberg (P = 0.0008). Lateral labral length increases as LCEA of Wiberg decreases. The anterior and anterior inferior labral locations did not show a predictable increase in labral length as LCEA Wiberg decreased. PMID:27583157

  2. Initial Results of an Acetabular Center Axis Registration Technique in Navigated Hip Arthroplasty with Deformed Acetabular Rims

    PubMed Central

    Wada, Hiroshi; Mishima, Hajime; Yoshizawa, Tomohiro; Sugaya, Hisashi; Nishino, Tomofumi; Yamazaki, Masashi

    2016-01-01

    Background In cementless total hip arthroplasty, imageless computer-assisted navigation is usually used to register the anterior pelvic plane (APP). The accuracy of this method is influenced by the subcutaneous tissues overlying the registration landmarks. On the other hand, the acetabular center axis (ACA) is determined from the acetabular rim. Precise registration of the ACA is possible because of direct palpation using a pointer. Imageless navigation using the ACA usually targets patients with normal acetabular morphology. The aim of this study was to investigate the accuracy of imageless navigation using the ACA instead of the APP in patients with normal or deformed acetabular rims. Methods The intraoperative cup position was compared with that obtained from the postoperative computed tomography (CT) images in 18 cases. Results The inclination angle derived from the navigation system was 3.4 ± 5.3 degrees smaller and the anteversion angle was 1.4 ± 3.1 degrees larger than those derived from the CT images. Conclusion The inclination cup angle of the navigation system was significantly inferior to the true value, particularly in cases with large anterior osteophytes. PMID:27073586

  3. Implication of acetabular width on the anteroposterior pelvic radiograph of patients with developmental dysplasia of the hip.

    PubMed

    Nie, Yong; Pei, Fuxing; Shen, Bin; Kang, Pengde; Li, Zongming

    2015-03-01

    Radiographic parameters that can help acetabular reconstruction during total hip arthroplasty (THA) for patients with developmental dysplasia of the hip (DDH) are few. The radiographs of 138 dysplastic hips that had undergone cementless THA were evaluated regarding the acetabular width above the acetabular component and the coverage of the component by native bone. The acetabular reconstruction process was simulated using 3D models from CT data, and the acetabular component coverage was calculated in 3D space based on the measurement and algorithm we proposed. Significant positive correlation between the acetabular width and the acetabular component coverage was found. Our study introduced a useful parameter, which can mark the superior reference position of the acetabular component for acetabular reconstruction in DDH patients. PMID:25311162

  4. Properties of Cement Mortar Produced from Mixed Waste Materials with Pozzolanic Characteristics

    PubMed Central

    Yen, Chi-Liang; Tseng, Dyi-Hwa; Wu, Yue-Ze

    2012-01-01

    Abstract Waste materials with pozzolanic characteristics, such as sewage sludge ash (SSA), coal combustion fly ash (FA), and granulated blast furnace slag (GBS), were reused as partial cement replacements for making cement mortar in this study. Experimental results revealed that with dual replacement of cement by SSA and GBS and triple replacement by SSA, FA, and GBS at 50% of total cement replacement, the compressive strength (Sc) of the blended cement mortars at 56 days was 93.7% and 92.9% of the control cement mortar, respectively. GBS had the highest strength activity index value and could produce large amounts of CaO to enhance the pozzolanic activity of SSA/FA and form calcium silicate hydrate gels to fill the capillary pores of the cement mortar. Consequently, the Sc development of cement mortar with GBS replacement was better than that without GBS, and the total pore volume of blended cement mortars with GBS/SSA replacement was less than that with FA/SSA replacement. In the cement mortar with modified SSA and GBS at 70% of total cement replacement, the Sc at 56 days was 92.4% of the control mortar. Modifying the content of calcium in SSA also increased its pozzolanic reaction. CaCl2 accelerated the pozzolanic activity of SSA better than lime did. Moreover, blending cement mortars with GBS/SSA replacement could generate more monosulfoaluminate to fill capillary pores. PMID:22783062

  5. Properties of Cement Mortar Produced from Mixed Waste Materials with Pozzolanic Characteristics.

    PubMed

    Yen, Chi-Liang; Tseng, Dyi-Hwa; Wu, Yue-Ze

    2012-07-01

    Waste materials with pozzolanic characteristics, such as sewage sludge ash (SSA), coal combustion fly ash (FA), and granulated blast furnace slag (GBS), were reused as partial cement replacements for making cement mortar in this study. Experimental results revealed that with dual replacement of cement by SSA and GBS and triple replacement by SSA, FA, and GBS at 50% of total cement replacement, the compressive strength (Sc) of the blended cement mortars at 56 days was 93.7% and 92.9% of the control cement mortar, respectively. GBS had the highest strength activity index value and could produce large amounts of CaO to enhance the pozzolanic activity of SSA/FA and form calcium silicate hydrate gels to fill the capillary pores of the cement mortar. Consequently, the Sc development of cement mortar with GBS replacement was better than that without GBS, and the total pore volume of blended cement mortars with GBS/SSA replacement was less than that with FA/SSA replacement. In the cement mortar with modified SSA and GBS at 70% of total cement replacement, the Sc at 56 days was 92.4% of the control mortar. Modifying the content of calcium in SSA also increased its pozzolanic reaction. CaCl(2) accelerated the pozzolanic activity of SSA better than lime did. Moreover, blending cement mortars with GBS/SSA replacement could generate more monosulfoaluminate to fill capillary pores. PMID:22783062

  6. Debonding of porous coating of a threaded acetabular component: retrieval analysis.

    PubMed

    Łapaj, Łukasz; Markuszewski, Jacek; Rybak, Tomasz; Wierusz-Kozłowska, Małgorzata

    2013-01-01

    This report presents a case of debonding of plasma sprayed porous titanium coating from a threaded acetabular component which caused aseptic loosening of the implant. Weight bearing after delamination caused abrasive damage of the acetabular shell, and particles of the coating embedded in the acetabular liner. Microscopic examination of periprosthetic tissues showed presence of metal particles and macrophage infiltration. Despite microscopic examination of the retrieved component the cause of debonding remains unclear. PMID:23127634

  7. Acetabular component deformation with press-fit fixation.

    PubMed

    Squire, Matthew; Griffin, William L; Mason, J Bohannon; Peindl, Richard D; Odum, Susan

    2006-09-01

    Acetabular component deformation secondary to forces encountered during insertion is a potential consequence of the press-fit technique. This study characterized the stiffness of Pinnacle 100 cups (DePuy, Warsaw, Ind) via mechanical testing and used this information with intraoperative measurements of cup deformation to calculate the in vivo forces acting on cups inserted during hip arthroplasty in 21 patients. We found that 90.5% of cups had measurable compression deformity, averaging 0.16 +/- 0.16 mm. The corresponding forces acting on these cups averaged 414 +/- 421 N. For hard-on-hard bearing surfaces, such in vivo deformation of acetabular shells may result in negative clinical consequences such as equatorial loading with increased wear and potential seizing of components, chipping of ceramic inserts, or locking mechanism damage. PMID:16950065

  8. Arthroscopic repair of acetabular chondral delamination with fibrin adhesive.

    PubMed

    Tzaveas, Alexandros P; Villar, Richard N

    2010-01-01

    Acetabular chondral delamination is a frequent finding at hip arthroscopy. The cartilage is macroscopically normal but disrupted from the subchondral bone. Excision of chondral flaps is the usual procedure for this type of lesion. However, we report 19 consecutive patients in whom the delaminated chondral flap was re-attached to the underlying subchondral bone with fibrin adhesive. We used the modified Harris hip score for assessment of pain and function. Improvement in pain and function was found to be statistically significant six months and one year after surgery. No local or general complications were noted. Three patients underwent further surgery for unrelated reasons. In each, the area of fibrin repair appeared intact and secure. Our results suggest that fibrin is a safe agent to use for acetabular chondral delamination. PMID:20235074

  9. Profile Measurement of Worn Acetabular Cup by Holographic Contouring

    NASA Astrophysics Data System (ADS)

    Kakunai, Satoshi; Sakamoto, Tohoru; Sakurai, Daisuke; Aota, Yuuki; Shelton, Julia

    Wear in a polyethylene acetabular cup is dependent on the history of the cup, namely on the sterilization treatment, initial mounting situation, the patient's lifestyle and length of time in vivo. Understanding wear patterns is essential in order to prevent inflammation and prosthesis failure. This study describes the profile measurement of a worn acetabular cup by holographic contouring, which can provide non-contact measurement over the entire visual field. Experiments were performed to verify the method, and measurements of cups worn in vivo were carried out. Cup profile was investigated using holograms obtained in three directions and changes in cup profile were evaluated using fringe patterns in which the interval range was adjusted from tens of microns to several millimeters.

  10. Nonunion of acetabular fractures: evaluation with interactive multiplanar CT

    SciTech Connect

    Kuhlman, J.E.; Fishman, E.K.; Ney, D.R.; Brooker, A.F. Jr.; Magid, D.

    1989-01-01

    Nonunions involving fractures of the acetabulum are reportedly rare, with few citings and little discussion in the literature. It is possible that acetabular nonunions go undetected because imaging of the acetabulum is difficult by conventional radiography. We report two cases of fracture nonunion involving the weight-bearing surface of the acetabulum diagnosed with the aid of computed tomography (CT) and a newly developed interactive 2D/3D orthotool that uniquely processes and reformats routine CT data. The interactive 2D/3D orthotool is a sophisticated computer program that allows dynamic viewing of standard multiplanar reconstructions in the axial, coronal, and sagittal planes as well as multiple oblique projections. The 2D/3D orthotool provides on screen correlation of two-dimensional multiplanar images with three-dimensional reconstructions of the pelvis. The authors found this capability ideally suited for studying fractures with off-axis orientation such as those through the acetabular dome, greatly facilitating the diagnosis of nonunion.

  11. Stress fracture in acetabular roof due to motocross: case report.

    PubMed

    de Paiva Luciano, Alexandre; Filho, Nelson Franco

    2016-01-01

    One of the first steps to be taken in order to reduce sports injuries such as stress fractures is to have in-depth knowledge of the nature and extent of these pathological conditions. We present a case report of a stress fracture of the acetabular roof caused through motocross. This type of case is considered rare in the literature. The description of the clinical case is as follows. The patient was a 27-year-old male who started to have medical follow-up because of uncharacteristic pain in his left hip, which was concentrated mainly in the inguinal region of the left hip during motocross practice. After clinical investigation and complementary tests, he was diagnosed with a stress fracture of the acetabular roof. PMID:27274494

  12. Acetabular Paralabral Cyst: An Unusual Cause of Femoral Vein Compression

    PubMed Central

    Kullar, Raj S.; Kapron, Ashley L.; Ihnat, Daniel; Aoki, Stephen K.; Maak, Travis G.

    2015-01-01

    Acetabular labral tears are a known cause of hip pain in the young, active patient. Labral tears can be due to trauma, femoroacetabular impingement, capsular laxity, dysplasia, and degenerative pathology. Paralabral cysts are relatively common in association with labral tears of the hip, with cysts seen on magnetic resonance imaging studies in as many as 50% to 70% of patients with labral tears. In some cases the cysts can become sizeable and cause neurovascular compression. Nonoperative interventions for the management of paralabral cysts in the shoulder and knee have shown high recurrence rates. In the shoulder and knee, arthroscopic debridement of paralabral cysts has shown good results with lower recurrence rates and resolution of neurovascular function. In the hip there is limited literature regarding surgical management of paralabral cysts. We present a surgical technique for arthroscopic decompression of acetabular paralabral cysts combined with labral repair. PMID:25973371

  13. An extended posterior approach to the hip and pelvis for complex acetabular reconstruction that preserves the gluteal muscles and their neurovascular supply.

    PubMed

    Solomon, L B; Hofstaetter, J G; Bolt, M J; Howie, D W

    2014-01-01

    We investigated the detailed anatomy of the gluteus maximus, gluteus medius and gluteus minimus and their neurovascular supply in 22 hips in 11 embalmed adult Caucasian human cadavers. This led to the development of a surgical technique for an extended posterior approach to the hip and pelvis that exposes the supra-acetabular ilium and preserves the glutei during revision hip surgery. Proximal to distal mobilisation of the gluteus medius from the posterior gluteal line permits exposure and mobilisation of the superior gluteal neurovascular bundle between the sciatic notch and the entrance to the gluteus medius, enabling a wider exposure of the supra-acetabular ilium. This technique was subsequently used in nine patients undergoing revision total hip replacement involving the reconstruction of nine Paprosky 3B acetabular defects, five of which had pelvic discontinuity. Intra-operative electromyography showed that the innervation of the gluteal muscles was not affected by surgery. Clinical follow-up demonstrated good hip abduction function in all patients. These results were compared with those of a matched cohort treated through a Kocher-Langenbeck approach. Our modified approach maximises the exposure of the ilium above the sciatic notch while protecting the gluteal muscles and their neurovascular bundle. PMID:24395310

  14. The influence of cement mantle thickness and stem geometry on fatigue damage in two different cemented hip femoral prostheses.

    PubMed

    Ramos, A; Simões, J A

    2009-11-13

    Experimental models can be used for pre-clinical testing of cemented and other type of hip replacements. Total hip replacement (THR) failure scenarios include, among others, cement damage accumulation and the assessment of accurate stress and strain magnitudes at the cement mantle interfaces (stem-cement and cement-bone) can be used to predict mechanical failure. The aseptic loosening scenario in cemented hip replacements is currently not fully understood, and methods of evaluating medical devices must be developed to improve clinical performance. Different results and conclusions concerning the cement micro-cracking mechanism have been reported. The aim of this study was to verify the in vitro behavior of two cemented femoral stems with respect to fatigue crack formation. Fatigue crack damage was assessed at the medial, lateral, anterior and posterior sides of the Lubinus SPII and Charnley stems. All stems were loaded and tested in stair climbing fatigue loading during one million cycles at 2 Hz. After the experiments each implanted synthetic femur was sectioned and analyzed. We observed more damage (cracks per area) for the Lubinus SPII stem, mainly on the proximal part of the cement mantle. The micro-cracking formation initiated in the stem-cement interface and grew towards the direction of cortical bone of the femur. Overall, the cement-bone interface seems to be crucial for the success of the hip replacement. The Charnley stem provoked more damage on the cement-bone interface. A failure index (maximum length of crack/maximum thickness of cement) considered was higher for the cement-stem interface of the Lubinus SPII stem. For a cement mantle thickness higher than 5 mm, cracking initiated at the cement-bone interface and depended on the opening canal process (reaming procedure and instrumentation). The analysis also showed that fatigue-induced damage on the cement mantle, increasing proximally, and depended on the axial position of the stem. The cement

  15. Successful Long-Term Fixation and Progression of Osteolysis Associated with First-Generation Cementless Acetabular Components Retrieved Post Mortem

    PubMed Central

    Urban, Robert M.; Hall, Deborah J.; Della Valle, Craig; Wimmer, Markus A.; Jacobs, Joshua J.; Galante, Jorge O.

    2012-01-01

    Background: Primary cementless acetabular reconstruction has shown durable long-term fixation. Late failures secondary to aseptic loosening are rare but may occur in patients with previously well-fixed components. In the present study, the histopathological characteristics of postmortem specimens were correlated with wear damage and radiographic data in an attempt to better understand the long-term events in the periacetabular tissue around well-functioning devices. Methods: Seventeen primary cementless Harris-Galante I acetabular components with adjacent tissues were harvested after a mean of eleven years (range, four to twenty-five years) from patients whose implants were well functioning at the time of death. Undecalcified and paraffin sections were used to quantify the extent of bone and soft tissues within the porous coating and at the interface between the coating and the surrounding bone. Wear particles were identified with use of polarized light microscopy and energy-dispersive x-ray analysis. Bearing-surface volumetric wear and backside wear damage of the polyethylene liner were assessed. Results: All of the components were fixed by bone ingrowth (mean extent, 33% ± 21%). Particle-induced granulomas were present in the porous coating and along the interface and progressed through screw holes, ballooning into the retroacetabular bone in the longer-term specimens. Particles of femoral and acetabular origin were identified in the granulomas. Bearing-surface volumetric wear (mean, 41.6 mm3/year) increased with duration and correlated with increasing extent of granuloma in the porous coating and the increasing size of pelvic granulomas. Radiolucencies on radiographs correlated with the extent of bone and fibrous tissue ingrowth. Of the six pelvic granulomas that were identified histologically, only one was apparent on routine radiographs. Conclusions: Acetabular fixation by bone ingrowth can be successful into the third decade after implantation. Osteolysis

  16. Press-fit versus threaded acetabular cups in total hip arthroplasty: Functional and radiological results after five years.

    PubMed

    Ellenrieder, Martin; Bader, Rainer; Bergschmidt, Philipp; Mittelmeier, Wolfram

    2016-03-01

    Prospectively the outcome after total hip replacement with a new threaded acetabular cup design was compared to an established press-fit cup. After 1, 2 and 5 years, the 36-item Short Form Health Survey, Western Ontario and McMaster University Osteoarthritis Index and Harris Hip Score revealed no significant differences between the two groups (each group: n=42 patients), except for a higher Harris Hip Score in the threaded cup group after five years (p=0.02). After five years, one threaded cup had a mild radiolucent line without further signs of loosening. All other cups of both groups (98.6%) showed a full osseous integration. The cup inclination angle ranged from 41-58° (threaded cups) to 39-77° (press-fit cups). The new threaded cup provides equivalent clinical outcomes and osseous integration but more precise implant positioning compared to the press-fit design. No complications typically ascribed to threaded cups (acetabular fractures, bone resorption, nerve impairment) occurred. PMID:26984655

  17. The effect of dynamic hip motion on the micromotion of press-fit acetabular cups in six degrees of freedom.

    PubMed

    Crosnier, Emilie A; Keogh, Patrick S; Miles, Anthony W

    2016-08-01

    The hip joint is subjected to cyclic loading and motion during activities of daily living and this can induce micromotions at the bone-implant interface of cementless total hip replacements. Initial stability has been identified as a crucial factor to achieve osseointegration and long-term survival. Whilst fixation of femoral stems achieves good clinical results, the fixation of acetabular components remains a challenge. In vitro methods assessing cup stability keep the hip joint in a fixed position, overlooking the effect of hip motion. The effect of hip motion on cup micromotion using a hip motion simulator replicating hip flexion-extension and a six degrees of freedom measurement system was investigated. The results show an increase in cup micromotion under dynamic hip motion compared to Static Flexion. This highlights the need to incorporate hip motion and measure all degrees of freedom when assessing cup micromotion. In addition, comparison of two press-fit acetabular cups with different surface coatings suggested similar stability between the two cups. This new method provides a basis for a more representative protocol for future pre-clinical evaluation of different cup designs. PMID:27210567

  18. Lunar cement

    NASA Technical Reports Server (NTRS)

    Agosto, William N.

    1992-01-01

    With the exception of water, the major oxide constituents of terrestrial cements are present at all nine lunar sites from which samples have been returned. However, with the exception of relatively rare cristobalite, the lunar oxides are not present as individual phases but are combined in silicates and in mixed oxides. Lime (CaO) is most abundant on the Moon in the plagioclase (CaAl2Si2O8) of highland anorthosites. It may be possible to enrich the lime content of anorthite to levels like those of Portland cement by pyrolyzing it with lunar-derived phosphate. The phosphate consumed in such a reaction can be regenerated by reacting the phosphorus product with lunar augite pyroxenes at elevated temperatures. Other possible sources of lunar phosphate and other oxides are discussed.

  19. Intermediate clinical follow-up of a dual-radius acetabular component.

    PubMed

    Van Flandern, G J; Bierbaum, B E; Newberg, A H; Gomes, S L; Mattingly, D A; Karpos, P A

    1998-10-01

    In this study, 92 primary total hip arthroplasties were performed in 83 patients using a porous-coated, dual-radius, cementless, acetabular component. All hips underwent line-to-line dome reaming with press-fit implantation that was judged to have complete bone contact. This acetabular shell provides a 1-mm oversized peripheral rim, which adds excellent initial stability while allowing complete bone contact in all hips. No fractures occurred. In 83% of hips, adjunctive screw fixation was not necessary. At a minimum of 4 years, follow-up, there were no revisions, no acetabular migration, one case of acetabular erosion consistent with osteolysis, and the average Harris Hip Score was 95. The design features of this new acetabular component have provided excellent fixation with complete initial bone contact, resulting in satisfactory intermediate clinical and radiographic results. The design provides excellent peripheral stability and complete bone contact. PMID:9802669

  20. Improving acetabular cup orientation in total hip arthroplasty by using smartphone technology.

    PubMed

    Peters, Frank M; Greeff, Richard; Goldstein, Neal; Frey, Chris T

    2012-08-01

    Acetabular cup placement in total hip arthroplasty is often difficult to assess, especially in the lateral position and using the posterior approach. Conventional techniques and computer-assisted surgery are the 2 most popular methods for proper placement of the acetabular cup in Lewinnek's safe zone of orientation (anteversion 15° ± 10° and lateral inclination 40° ± 10°). We developed a system that uses the accelerometer and camera function of the iPhone. A level indicator application and protractor application were downloaded to the iPhone and used to improve acetabular cup placement. This system has proven to be accurate and quick. Our series of 50 prospective cases showed good results with all our acetabular cups being placed within a narrow range in the safe zone and with less than 5% difference between the preoperative, intraoperative, and postoperative acetabular inclinations. PMID:22245126

  1. Arthroscopic Technique for Chondrolabral Capsular Preservation During Labral Repair and Acetabular Osteoplasty

    PubMed Central

    Nwachukwu, Benedict U.; McCormick, Frank; Martin, Scott D.

    2013-01-01

    Traditional techniques for acetabular osteoplasty in femoral acetabular impingement have required surgical detachment of the labrum at the chondrolabral junction. Such approaches compromise labral blood flow and contribute to a limited ability for healing at the chondrolabral junction. In this technical note and accompanying video, we present a technique for preservation of the chondrolabral junction during labral repair and acetabular osteoplasty. We elevate the chondrolabral complex subperiosteally off the acetabular rim, and the acetabular shelf is then contoured under fluoroscopic guidance. The labrum is then repaired and reconstituted to a new anatomic footprint. We find this technique to be advantageous because it preserves the blood flow to the labrum, thereby maximizing healing potential. Outcome studies are warranted to further elucidate the functional and outcome benefits of this surgical technique. PMID:24265986

  2. Sacroiliac joint dysfunction as a reason for the development of acetabular retroversion: a new theory.

    PubMed

    Cibulka, Michael T

    2014-05-01

    Acetabular retroversion has been recently implicated as an important factor in the development of femoral acetabular impingement and hip osteoarthritis. The proper function of the hip joint requires that the anatomic features of the acetabulum and femoral head complement one another. In acetabular retroversion, the alignment of the acetabulum is altered where it opens in a posterolaterally instead of anterior direction. Changes in acetabular orientation can occur with alterations in pelvic tilt (anterior/posterior), and pelvic rotation (left/right). An overlooked problem that alters pelvic tilt and rotation, often seen by physical therapists, is sacroiliac joint dysfunction. A unique feature that develops in patients with sacroiliac joint dysfunction (SIJD) is asymmetry between the left and right innominate bones that can alter pelvic tilt and rotation. This article puts forth a theory suggesting that acetabular retroversion may be produced by sacroiliac joint dysfunction. PMID:24350878

  3. Ankle replacement

    MedlinePlus

    Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... Ankle replacement surgery is most often done while you are under general anesthesia. This means you will ...

  4. Ankle replacement

    MedlinePlus

    ... to the cut bony surfaces. A special glue/bone cement may be used to hold them in place. A piece of plastic is then inserted between the two metal parts. Screws maybe placed to stabilize your ankle. The surgeon ...

  5. Sculpting with Cement.

    ERIC Educational Resources Information Center

    Olson, Lynn

    1983-01-01

    Cement offers many creative possibilities for school art programs. Instructions are given for sculpting with fiber-cement and sand-cement, as well as for finishing processes and the addition of color. Safety is stressed. (IS)

  6. The importance of a thick cement mantle depends on stem geometry and stem-cement interfacial bonding.

    PubMed

    Caruana, J; Janssen, D; Verdonschot, N; Blunn, G W

    2009-04-01

    The thickness of the cement mantle around the femoral component of total hip replacements is a contributing factor to aseptic loosening and revision. Nevertheless, various designs of stems and surgical tooling lead to cement mantles of different thicknesses. Opinion is divided on whether a thick mantle enhances implant longevity. This study investigates the effect of cement mantle thickness on accumulated damage in the cement, and how this is influenced by the presence or absence of a proximal collar and on whether the stem-cement interface remains bonded. Three-dimensional finite element simulations incorporating creep and non-linear damage accumulation were performed to investigate cracking in the cement mantles around Stanmore Hips under physiologically informed stair-climbing and gait loads. Cement mantle thickness, stem-cement interfacial bonding, and collar design were varied to assess the interactive effects of these parameters. In all cases, damage levels were three to six times higher when the stem-cement interface remained bonded. Cement mantle thickness had little effect on cement damage accumulation around debonded collared stems but was critical in both bonded and collarless cases, where a thicker mantle reduced cement cracking. Damage around a smooth debonded stem with a collar is thus much less sensitive to cement thickness than around bonded or collarless stems. PMID:19405437

  7. Is labral hypotrophy correlated with increased acetabular depth?

    PubMed

    Toft, Felix; Anliker, Elmar; Beck, Martin

    2015-07-01

    Labral hypertrophy is a distinct feature in hip dysplasia. Occasionally, very small, hypotrophic labra are observed. However, there is no literature concerning this pathology. We investigated if the size of the labrum correlated with any radiologic parameters reflecting the amount of acetabular coverage. It was hypothezised that there is a negative correlation between labrum size and acetabular coverage. Labra were categorized into three groups depending on the relation between length of the articular sided surface and height of bony attachment. Labra with a height:length ratio of 2 were classified as hypotrophic, with a height:length ratio of 1 as normal and with a ratio of 0.5 as hypertrophic. Labral cross-sectional areas (CSA) were measured on radial magnetic resonance imaging-arthrography slices using the measuring tool of the PACS system of 20 hips with hypotrophic labra (group 1), 20 hips with normal labral appearance (group 2) and 10 hips with hypertrophic labra (group 3). These values were then analyzed against following parameters: neck-shaft-angle (NSA), lateral center-edge angle (LCE), acetabular index (AI), femoral extrusion index (FEI) and acetabular retroversion index (ARI). Analyses of variance were used to determine differences in mean values between the three groups. Mean labral CSA differed significantly between all groups (group 1: 12.1 ± 2.9 mm(2); group 2: 25.2 ± 6.2 mm(2); group 3: 41.1 ± 12.3 mm(2); P < 0.001). NSA, LCE, AI and FEI all showed a significant difference between group 3 and 1 or 2. The ARI showed no difference between groups. Stepwise linear regression analyses showed a significant correlation between LCE angle and labral CSA with a corrected R (2)-value of 0.301. Labral CSA correlates with the LCE. No statistically significant difference between groups 1 and 2 concerning the LCE, AI or FEI could be identified. Nevertheless, group 1 had the highest mean coverage of all groups, hips with hypertrophic

  8. Is labral hypotrophy correlated with increased acetabular depth?

    PubMed Central

    Toft, Felix; Anliker, Elmar; Beck, Martin

    2015-01-01

    Labral hypertrophy is a distinct feature in hip dysplasia. Occasionally, very small, hypotrophic labra are observed. However, there is no literature concerning this pathology. We investigated if the size of the labrum correlated with any radiologic parameters reflecting the amount of acetabular coverage. It was hypothezised that there is a negative correlation between labrum size and acetabular coverage. Labra were categorized into three groups depending on the relation between length of the articular sided surface and height of bony attachment. Labra with a height:length ratio of 2 were classified as hypotrophic, with a height:length ratio of 1 as normal and with a ratio of 0.5 as hypertrophic. Labral cross-sectional areas (CSA) were measured on radial magnetic resonance imaging-arthrography slices using the measuring tool of the PACS system of 20 hips with hypotrophic labra (group 1), 20 hips with normal labral appearance (group 2) and 10 hips with hypertrophic labra (group 3). These values were then analyzed against following parameters: neck-shaft-angle (NSA), lateral center-edge angle (LCE), acetabular index (AI), femoral extrusion index (FEI) and acetabular retroversion index (ARI). Analyses of variance were used to determine differences in mean values between the three groups. Mean labral CSA differed significantly between all groups (group 1: 12.1 ± 2.9 mm2; group 2: 25.2 ± 6.2 mm2; group 3: 41.1 ± 12.3 mm2; P < 0.001). NSA, LCE, AI and FEI all showed a significant difference between group 3 and 1 or 2. The ARI showed no difference between groups. Stepwise linear regression analyses showed a significant correlation between LCE angle and labral CSA with a corrected R2-value of 0.301. Labral CSA correlates with the LCE. No statistically significant difference between groups 1 and 2 concerning the LCE, AI or FEI could be identified. Nevertheless, group 1 had the highest mean coverage of all groups, hips with hypertrophic labra

  9. Acetabular fractures: what radiologists should know and how 3D CT can aid classification.

    PubMed

    Scheinfeld, Meir H; Dym, Akiva A; Spektor, Michael; Avery, Laura L; Dym, R Joshua; Amanatullah, Derek F

    2015-01-01

    Correct recognition, description, and classification of acetabular fractures is essential for efficient patient triage and treatment. Acetabular fractures may result from high-energy trauma or low-energy trauma in the elderly. The most widely used acetabular fracture classification system among radiologists and orthopedic surgeons is the system of Judet and Letournel, which includes five elementary (or elemental) and five associated fractures. The elementary fractures are anterior wall, posterior wall, anterior column, posterior column, and transverse. The associated fractures are all combinations or partial combinations of the elementary fractures and include transverse with posterior wall, T-shaped, associated both column, anterior column or wall with posterior hemitransverse, and posterior column with posterior wall. The most unique fracture is the associated both column fracture, which completely dissociates the acetabular articular surface from the sciatic buttress. Accurate categorization of acetabular fractures is challenging because of the complex three-dimensional (3D) anatomy of the pelvis, the rarity of certain acetabular fracture variants, and confusing nomenclature. Comparing a 3D image of the fractured acetabulum with a standard diagram containing the 10 Judet and Letournel categories of acetabular fracture and using a flowchart algorithm are effective ways of arriving at the correct fracture classification. Online supplemental material is available for this article. PMID:25763739

  10. Decreased Lumbar Lordosis and Deficient Acetabular Coverage Are Risk Factors for Subchondral Insufficiency Fracture.

    PubMed

    Jo, Woo Lam; Lee, Woo Suk; Chae, Dong Sik; Yang, Ick Hwan; Lee, Kyoung Min; Koo, Kyung Hoi

    2016-10-01

    Subchondral insufficiency fracture (SIF) of the femoral head occurs in the elderly and recipients of organ transplantation. Osteoporosis and deficient lateral coverage of the acetabulum are known risk factors for SIF. There has been no study about relation between spinopelvic alignment and anterior acetabular coverage with SIF. We therefore asked whether a decrease of lumbar lordosis and a deficiency in the anterior acetabular coverage are risk factors. We investigated 37 patients with SIF. There were 33 women and 4 men, and their mean age was 71.5 years (59-85 years). These 37 patients were matched with 37 controls for gender, age, height, weight, body mass index and bone mineral density. We compared the lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope, acetabular index, acetabular roof angle, acetabular head index, anterior center-edge angle and lateral center-edge angle. Lumbar lordosis, pelvic tilt, sacral slope, lateral center edge angle, anterior center edge angle, acetabular index and acetabular head index were significantly different between SIF group and control group. Lumbar lordosis (OR = 1.11), lateral center edge angle (OR = 1.30) and anterior center edge angle (OR = 1.27) had significant associations in multivariate analysis. Decreased lumbar lordosis and deficient anterior coverage of the acetabulum are risk factors for SIF as well as decreased lateral coverage of the acetabulum. PMID:27550496

  11. Role of the Acetabular Labrum in Load Support Across the Hip Joint

    PubMed Central

    Henak, Corinne R.; Ellis, Benjamin J.; Harris, Michael D.; Anderson, Andrew E.; Peters, Christopher L.; Weiss, Jeffrey A.

    2011-01-01

    The relatively high incidence of labral tears among patients presenting with hip pain suggests that the acetabular labrum is often subjected to injurious loading in vivo. However, it is unclear whether the labrum participates in load transfer across the joint during activities of daily living. This study examined the role of the acetabular labrum in load transfer for hips with normal acetabular geometry and acetabular dysplasia using subject-specific finite element analysis. Models were generated from volumetric CT data and analyzed with and without the labrum during activities of daily living. The labrum in the dysplastic model supported 4-11% of the total load transferred across the joint, while the labrum in the normal model supported only 1-2% of the total load. Despite the increased load transferred to the acetabular cartilage in simulations without the labrum, there were minimal differences in cartilage contact stresses. This was because the load supported by the cartilage correlated to the cartilage contact area. A higher percentage of load was transferred to the labrum in the dysplastic model because the femoral head achieved equilibrium near the lateral edge of the acetabulum. The results of this study suggest that the labrum plays a larger role in load transfer and joint stability in hips with acetabular dysplasia than in hips with normal acetabular geometry. PMID:21757198

  12. Massive acetabular bone loss: Limits of trabecular metal cages

    PubMed Central

    Villanueva-Martínez, Manuel; Ríos-Luna, Antonio; Diaz-Mauriño, Juán

    2011-01-01

    Massive acetabular bone loss (more than 50% of the acetabular area) can result in insufficient native bone for stable fixation and long-term bone ingrowth of conventional porous cups. The development of trabecular metal cages with osteoconductive properties may allow a more biological and versatile approach that will help restore bone loss, thus reducing the frequency of implant failure in the short-to-medium term. We report a case of massive bone loss affecting the dome of the acetabulum and the ilium, which was treated with a trabecular metal cage and particulate allograft. Although the trabecular metal components had no intrinsic stability, they did enhance osseointegration and incorporation of a non-impacted particulate graft, thus preventing failure of the reconstruction. The minimum 50% contact area between the native bone and the cup required for osseointegration with the use of porous cups may not hold for new trabecular metal cups, thus reducing the need for antiprotrusio cages. The osteoconductive properties of trabecular metal enhanced allograft incorportation and iliac bone rebuilding without the need to fill the defect with multiple wedges nor protect the reconstruction with an antiprotrusio cage. PMID:21221229

  13. Transosseous Acetabular Labral Repair as an Alternative to Anchors

    PubMed Central

    Pérez-Carro, Luis; Cabello, Andres Gonzalez; Rakha, Mohamed Ibrahim; Patnaik, Sarthak; Centeno, Elias; Miranda, Victor; Fernández, Ana Alfonso

    2015-01-01

    Labral tears are the most common pathology in patients undergoing hip arthroscopy and the most common cause of mechanical hip symptoms. Labral repair techniques have been described in the literature using suture anchors placed as close as possible to the acetabular rim without penetrating the articular surface. Optimal surgical technique for labral repair is very important, and an inappropriate entry point and guide angulation may lead to intra-articular penetration of the anchor, chondral damage, anchor loosening, or inadequate fixation. A shallow dysplastic hip, the drilling trajectory, the narrow width of the acetabular rim, or some specific anatomic variations may generate difficulty during anchor placement. Suture anchors themselves have been associated with several significant complications, including rim fracture, osteolysis, enlargement of drill holes, and infection. The treatment of labral lesions with transosseous suture is an alternative to anchor use, eliminating the need for anchors and avoiding anchor-associated complications. This technique offers versatility to surgeons and is more cost-effective for patients and health services. We aim to describe the indications and technique for transosseous labral repair without anchors. PMID:26697295

  14. Subchondral Insufficiency Fracture of the Femoral Head Caused by Excessive Lateralization of the Acetabular Rim

    PubMed Central

    Kimura, Tetsuya; Goto, Tomohiro; Hamada, Daisuke; Tsutsui, Takahiko; Wada, Keizo; Fukuta, Shoji; Nagamachi, Akihiro; Sairyo, Koichi

    2016-01-01

    We present a case of a 53-year-old woman with subchondral insufficiency fracture (SIF) of the femoral head without history of severe osteoporosis or overexertion. Plain radiographs showed acetabular overcoverage with excessive lateralization of the acetabular rim. A diagnosis of SIF was made by typical MRI findings of SIF. The lesion occurred at the antipodes of the extended rim. Increased mechanical stress over the femoral head due to impingement against the excess bone was suspected as a cause of SIF. The distinct femoral head deformity is consistent with this hypothesis. This is the first report of SIF associated with acetabular overcoverage. PMID:27293935

  15. Explicit finite element modelling of the impaction of metal press-fit acetabular components.

    PubMed

    Hothi, H S; Busfield, J J C; Shelton, J C

    2011-03-01

    Metal press-fit cups and shells are widely used in hip resurfacing and total hip replacement procedures. These acetabular components are inserted into a reamed acetabula cavity by either impacting their inner polar surface (shells) or outer rim (cups). Two-dimensional explicit dynamics axisymmetric finite element models were developed to simulate these impaction methods. Greater impact velocities were needed to insert the components when the interference fit was increased; a minimum velocity of 2 m/s was required to fully seat a component with a 2 mm interference between the bone and outer diameter. Changing the component material from cobalt-chromium to titanium alloy resulted in a reduction in the number of impacts on the pole to seat it from 14 to nine. Of greatest significance, it was found that locking a rigid cap to the cup or shell rim resulted in up to nine fewer impactions being necessary to seat it than impacting directly on the polar surface or using a cap free from the rim of the component, as is the case with many commercial resurfacing cup impaction devices currently used. This is important to impactor design and could make insertion easier and also reduce acetabula bone damage. PMID:21485331

  16. Hip Replacement

    MedlinePlus

    ... replacement is an operation in which a damaged hip joint is removed and replaced with an artificial joint. ... are many medical conditions that can damage the hip joint. (Watch the video to learn about what goes ...

  17. Hip Replacement

    MedlinePlus

    ... surgeon removes damaged cartilage and bone from your hip joint and replaces them with new, man-made parts. A hip replacement can Relieve pain Help your hip joint work better Improve walking and other movements The ...

  18. ULTRA-LIGHTWEIGHT CEMENT

    SciTech Connect

    Fred Sabins

    2002-07-30

    The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). This report includes results from laboratory testing of ULHS systems along with other lightweight cement systems, including foamed and sodium silicate slurries. During this project quarter, a comparison study of the three cement systems examined the effect that cement drillout has on the three cement systems. Testing to determine the effect of pressure cycling on the shear bond properties of the cement systems was also conducted. This report discusses testing that was performed to analyze the alkali-silica reactivity of ULHS in cement slurries.

  19. Traumatic medial displacement of Rotalok uncemented acetabular component. A case report.

    PubMed

    Charnley, G J; Ridge, J; Ribbans, W J

    1994-04-01

    The failure of uncemented acetabular components has been described in association with component wear, disassembly, and proximal migration. The authors report a case of medial displacement following minor trauma some 18 months after surgery. The component involved differs in design from both press-fit, porous-coated or screw-in, fully threaded acetabular cups. The authors suggest that additional screws should be inserted to enhance long-term stability. PMID:8014654

  20. Rapid resolution of femoral head osteonecrosis after rotational acetabular osteotomy.

    PubMed

    Nozawa, Masahiko; Matsuda, Keiji; Maezawa, Katsuhiko; Kim, Sungon; Maeda, Kouichi; Ikegami, Takashi; Kubota, Reiko; Hayashi, Kentaro; Nagayama, Masataka; Kaneko, Haruka

    2008-12-01

    The natural history of osteonecrosis of the femoral head is generally thought to be one of progressive deterioration if no intervention is undertaken. However, it is unknown whether surgical intervention is beneficial for patients with a small region of osteonecrosis. We observed rapid improvement of MRI findings after rotational acetabular osteotomy (RAO) was performed in a young patient with osteonecrosis of the femoral head. The band-like low signal area on T2-weighted images almost resolved by six months after surgery. He returned to work as an electrician by six months after surgery. Early surgical intervention such as RAO that alters the mechanical force acting on the necrotic region of the femoral head may accelerate the recovery of osteonecrosis and the improvement of symptoms. PMID:19384490

  1. Retained Sponge: A Rare Complication in Acetabular Osteosinthesis

    PubMed Central

    Chana-Rodríguez, Francisco; Mañanes, Rubén Pérez; Rojo-Manaute, José; Moran-Blanco, Luz María; Vaquero-Martín, Javier

    2015-01-01

    Retained sponges after a surgical treatment of polytrauma may cause a broad spectrum of clinical symptoms and present a difficult diagnostic problem. We report a case of retained surgical sponge in a 35-year-old man transferred from another hospital, that sustained a open acetabular fracture. The fracture was reduced through a limited ilio-inguinal approach. After 4 days, he presented massive wound dehiscence of the surgical approach. An abdominal CT scan showed, lying adjacent to the outer aspect of the left iliac crest, a mass of 10 cm, identified as probable foreign body. The possibility of this rare complication should be in the differential diagnosis of any postoperative patient who presents with pain, infection, or palpable mass. PMID:26312116

  2. A histological study of retrieved Cambridge acetabular components.

    PubMed

    Brooks, Roger A; Field, Richard E; Jones, Eric; Sood, Asheesh; Rushton, Neil

    2010-01-01

    A new uncemented acetabular component, the Cambridge cup, has been designed to mimic the anatomy and physiology of subchondral bone in order to minimise stress shielding and enhance long-term component stability. Cambridge cups were implanted in a cohort of 50 women who presented with displaced sub-capital fracture of the femoral neck. The cups were manufactured with an hydroxyapatite (HA) coating. Twenty six cups were implanted after removal of the HA. Twelve Cambridge cups were retrieved post-mortem between two and 84 months after implantation. Histological and histomorphometric testing was undertaken to analyse the residual HA coating thickness, bone apposition to the implant surface and particulate wear debris in the surrounding tissues. The HA-coated implants showed significantly greater bone apposition to the implant surface with significantly less fibrous tissue formation than the uncoated implants. Where HA resorption occurred, bone and bone marrow was seen adjacent to the implant. Excessive wear of the ultra high molecular weight polyethylene liner was not seen. The HA-coated components demonstrated good initial bone implant bonding and the flexible carbon polymer appeared to maintain stability following HA resorption. The uncoated implants showed little or no bony apposition but had a fibrous membrane apposed to the implant surface. This may be explained by a combination of micro-motion at the bone implant interface and having a component surface finish that was poorly suited to osseous attachment. Hydroxyapatite coated acetabular components can provide reliable osseous attachment. Subsequent HA resorption need not compromise medium-term osseous fixation to an appropriate implant surface. PMID:20235075

  3. Hip Arthroscopy in the Presence of Acetabular Dysplasia

    PubMed Central

    Jayasekera, Narlaka; Aprato, Alessandro; Villar, Richard N

    2015-01-01

    Purpose : Hip arthroscopy is a well established therapeutic intervention for an increasing number of painful hip conditions. Developmental dysplasia of the hip (DDH) is commonly associated with intra-articular hip pathology. However, some surgeons perceive patients with hip dysplasia as poor candidates for hip arthroscopy. Our aim was to describe early outcomes of arthroscopic treatment for patients with DDH, who also had femoroacetabular impingement (FAI) treated when necessary, and to compare these outcomes against a control group of patients without DDH. Methods : Prospective case-control study of 68 consecutive hip arthroscopy patients assessed with a modified Harris Hip Score (mHHS) preoperatively and at six weeks, six months, and one year after surgery. Presence of DDH was determined using a standard anteroposterior (AP) pelvic radiograph to measure the centre-edge angle (CEA) of Wiberg, with a CEA < 20º used as threshold for diagnosis of DDH. Results : 12 patients (eight female and four male) with acetabular dysplasia and mean CEA of 15.4º (9º to 19º). The control, nondysplastic group comprised 54 patients (23 females and 31 males) with a mean CEA of 33.1º (22º to 45º). All patients in the dysplastic group had a labral tear and 11 (91.7%) had associated femoral cam impingement lesion addressed at arthroscopy. Our study demonstrates a significant (p=0.02) improvement in outcome in the dysplastic group at one year using the mHHS. Conclusion : Hip arthroscopy in the presence of DDH is effective in relieving pain for at least one year after surgery although does not address underlying acetabular abnormality. PMID:26069512

  4. About Calcium Phosphate Cements (CPC)

    NASA Astrophysics Data System (ADS)

    Piñera, Silvia; Piña, Cristina

    2006-09-01

    Calcium phosphate cements (CPC) are used in orthopaedic surgery as bone substitution and fixation of metallic implants, showing advantages with respect to other materials like polymeric cements or ceramic blocks also used for bone repair. For example, they are easy to shape and fill bone defects, react at low temperature and their setting product is hydroxyapatite, mineral from it's composed the inorganic part of the bone, resulting a bioabsorbable material that can be replaced by new bone. Nevertheless there are still some complications like their low absorption rate, inyectability, setting times and their low strength that limits their use to only non load bearing applications. In this work we present a brief resume of some investigations that has been proposed to solve some of these problems, like the addition of phosphates solutions or seeds to increase the reaction rate, or fibers and hard particles to produce a composite material.

  5. Quantitative Computerized Assessment of the Degree of Acetabular Bone Deficiency: Total radial Acetabular Bone Loss (TrABL).

    PubMed

    Gelaude, Frederik; Clijmans, Tim; Delport, Hendrik

    2011-01-01

    A novel quantitative, computerized, and, therefore, highly objective method is presented to assess the degree of total radical acetabular bone loss. The method, which is abbreviated to "TrABL", makes use of advanced 3D CT-based image processing and effective 3D anatomical reconstruction methodology. The output data consist of a ratio and a graph, which can both be used for direct comparison between specimens. A first dataset of twelve highly deficient hemipelves, mainly Paprosky types IIIB, is used as illustration. Although generalization of the findings will require further investigation on a larger population, it can be assumed that the presented method has the potential to facilitate the preoperative use of existing classifications and related decision schemes for treatment selection in complex revision cases. PMID:22013539

  6. Stress shielding in bone of a bone-cement interface.

    PubMed

    Zhang, Qing-Hang; Cossey, Andrew; Tong, Jie

    2016-04-01

    Cementation is one of the main fixation methods used in joint replacement surgeries such as Total Knee Replacement (TKR). This work was prompted by a recent retrieval study, which shows losses up to 75% of the bone stock at the bone-cement interface ten years post TKR. It aims to examine the effects of cementation on the stress shielding of the interfacing bone, when the influence of an implant is removed. A micromechanics finite element study of a generic bone-cement interface is presented here, where bone elements in the partially and the fully interdigitated regions were evaluated under selected load cases. The results revealed significant stress shielding effect in the bone of all bone-cement interface regions, particularly in fully interdigitated region. This finding may be useful in the studies of implant fixation and other related orthopedic treatment strategies. PMID:26904919

  7. Utilization of waste glass in ECO-cement: Strength properties and microstructural observations

    SciTech Connect

    Sobolev, Konstantin Tuerker, Pelin; Soboleva, Svetlana; Iscioglu, Gunsel

    2007-07-01

    Waste glass creates a serious environmental problem, mainly because of the inconsistency of the waste glass streams. The use of waste glass as a finely ground mineral additive (FGMA) in cement is a promising direction for recycling. Based on the method of mechano-chemical activation, a new group of ECO-cements was developed. In ECO-cement, relatively large amounts (up to 70%) of portland cement clinker can be replaced with waste glass. This report examines the effect of waste glass on the microstructure and strength of ECO-cement based materials. Scanning electron microscopy (SEM) investigations were used to observe the changes in the cement hydrates and interface between the cement matrix and waste glass particles. According to the research results, the developed ECO-cement with 50% of waste glass possessed compressive strength properties at a level similar to normal portland cement.

  8. ULTRA-LIGHTWEIGHT CEMENT

    SciTech Connect

    Fred Sabins

    2003-10-31

    The objective of this project is to develop an improved ultra- lightweight cement using ultra-lightweight hollow glass spheres (ULHS). This report discusses testing that was performed for analyzing the alkali-silica reactivity of ULHS in cement slurries.

  9. The contemporary cement cycle of the United States

    USGS Publications Warehouse

    Kapur, A.; Van Oss, H. G.; Keoleian, G.; Kesler, S.E.; Kendall, A.

    2009-01-01

    A country-level stock and flow model for cement, an important construction material, was developed based on a material flow analysis framework. Using this model, the contemporary cement cycle of the United States was constructed by analyzing production, import, and export data for different stages of the cement cycle. The United States currently supplies approximately 80% of its cement consumption through domestic production and the rest is imported. The average annual net addition of in-use new cement stock over the period 2000-2004 was approximately 83 million metric tons and amounts to 2.3 tons per capita of concrete. Nonfuel carbon dioxide emissions (42 million metric tons per year) from the calcination phase of cement manufacture account for 62% of the total 68 million tons per year of cement production residues. The end-of-life cement discards are estimated to be 33 million metric tons per year, of which between 30% and 80% is recycled. A significant portion of the infrastructure in the United States is reaching the end of its useful life and will need to be replaced or rehabilitated; this could require far more cement than might be expected from economic forecasts of demand for cement. ?? 2009 Springer Japan.

  10. Radiopacity in bone cements using an organo-bismuth compound.

    PubMed

    Deb, S; Abdulghani, S; Behiri, J C

    2002-08-01

    In a joint replacement surgery it is vital for bone cement to be radiologically detectable. Consequently, heavy metal salts of barium and zirconia are incorporated as a contrast medium for this purpose. The addition of such particulate additives, however, can be detrimental to some of the physical, mechanical and biological properties. The present study reports the feasibility of using an organo-bismuth compound, namely. triphenyl bismuth (TPB) as a radiopaque agent for orthopaedic bone cements. TPB was incorporated in the bone cement matrix by two methods, (i) blending: TPB was added to the polymer phase of the bone cement and (ii) dissolution: by dissolving TPB in the monomer phase methylmethacrylate. The results showed that the inclusion of TPB at concentrations of 15% and 25% by weight of the polymer, in the bone cement matrix did not affect the polymerisation exotherm temperature and setting time. Furthermore, the addition of TPB via the dissolution method provided a statistically significant increase in the strain to failure in comparison to commercial acrylic cements containing barium sulphate, thus reducing the brittleness of the cement. The detrimental effects on the mechanical properties post conditioning in water, was also much less pronounced in the homogeneous TPB cements in comparison to barium sulphate containing cements. These observations can be attributed to the formation of a homogeneous and continuous matrix of the resultant bone cement with a much lower porosity. PMID:12099281

  11. Surgical exposure and cement removal in revision total hip arthroplasty.

    PubMed

    Mallory, T H

    1992-10-01

    The surgical approach in revision total hip arthroplasty (THA) must conform to the preoperative goals of revision surgery. Factors to be considered include adequate visualization, assessment of remaining bone stock, presence or absence of cement, status of the trochanter, leg length discrepancies, and previous surgical approaches. To maintain neurovascular structures, blood supply to the involved bone, postoperative abductor function, stability, and gait normalcy, an anterolateral approach is best used. Three anterolateral approaches are used to address various aspects of revision THA. Approach 1 allows for exposure of the acetabulum and proximal femur. The associated abductor muscle split allows for excellent proximal exposure. Approach 2 is performed when acetabular reconstruction is neither complex nor involved, and when extended access to the femur is necessary. The lateral-distal incision is determined by the need for adequate femur exposure for implant removal, cement removal, and any bone grafting procedures to reconstitute osseous structures. Approach 3 is further developed proximally to expose necessary anatomic regions of the acetabulum while preserving the underlying neurovascular structures. Using special instrumentation and controlled femoral perforations, cement mantles are quickly removed, minimizing damage to the bone and preserving the osseous structures. For all three approaches, abductor muscle separation repair and/or reattachment is performed with a heavy, no. 5, nonabsorbable suture. Postoperative patient management depends on the degree of dissection and extent of reconstruction. PMID:10147935

  12. Shoulder replacement

    MedlinePlus

    ... the opening at the end of the shoulder blade, called the socket. This type of joint allows ... head. The socket part (glenoid) of your shoulder blade will be replaced with a smooth plastic shell ( ...

  13. Knee Replacement

    MedlinePlus

    ... doctor may recommend it if you have knee pain and medicine and other treatments are not helping you anymore. When you have a total knee replacement, the surgeon removes damaged cartilage and bone ...

  14. Radiological evaluation of acetabular erosion after antibiotic-impregnated polymethylmethacrylate spacer (Spacer-G).

    PubMed

    García-Oltra, Ester; Bori, Guillem; Tomas, Xavier; Gallart, Xavier; Garcia, Sebastian; Soriano, Alex

    2013-06-01

    Different types of hip spacers have been described (hand-made, custom-molded or prefabricated) for treatment of a chronic hip infection. A potential disadvantage of monoblock prefabricated spacer is that it may cause acetabular bone loss. This study assesses the radiological acetabular erosion using an antibiotic-impregnated pre-fabricated polymethylmethacrylate Spacer-G. We retrospectively reviewed the radiographs of thirty five patients who were managed with Spacer-G to treat chronic hip infection. No acetabular erosion were observed in thirty two patients with a mean time from the first to second stage and from the first to the last radiograph of 5.09 and 3.77 months respectively. In three patients the time between the radiographs was more than one year and the second stage was not performed; two developed a protrusion acetabuli whereas the other one a destruction of the acetabular roof. Using a Spacer-G in chronic hip infection treatment for less than one year is not associated with radiological acetabular erosion if the patient is maintained at partial weight bearing. PMID:23142448

  15. Morphometric assessment of the canine hip joint using the acetabular angle of retrotorsion.

    PubMed

    Doskarova, B; Kyllar, M; Paral, V

    2010-01-01

    Morphometric assessment of the canine hip joint using acetabular angle of retrotorsion was used in this study. The aim of our study was to compare the acetabular angle of retrotorsion (AAR) with values of the Norberg angle (NA) and the hip score (HS) in the Leonberger dog breed and to determine the cut-off point of AAR that distinguish between normal and dysplastic hip status on the basis of Fédération Cynologique Internationale (FCI) hip evaluation. Retrospective analysis of NA and AAR was measured from standard ventrodorsal pelvic radiographs with extended femurs in 387 Leonberger dogs (141 males and 246 females) from 18 to 63 months of age, which were then divided into five age-groups. Through analysis of these radiographs, it was determined that the cut-off point for NA was 105°, AAR was 15°, and the acetabular angle of retrotorsion was positively correlated with Norberg angle and negatively correlated with hip score. The results of our study indicate that the acetabular angle of retrotorsion may represent a reliable morphometric assessment tool in evaluating acetabular cup conformation, and values of AAR may help to assess the FCI grade of canine hip dysplasia. PMID:20740259

  16. Acetabular rim and surface segmentation for hip surgery planning and dysplasia evaluation

    NASA Astrophysics Data System (ADS)

    Tan, Sovira; Yao, Jianhua; Yao, Lawrence; Summers, Ronald M.; Ward, Michael M.

    2008-03-01

    Knowledge of the acetabular rim and surface can be invaluable for hip surgery planning and dysplasia evaluation. The acetabular rim can also be used as a landmark for registration purposes. At the present time acetabular features are mostly extracted manually at great cost of time and human labor. Using a recent level set algorithm that can evolve on the surface of a 3D object represented by a triangular mesh we automatically extracted rims and surfaces of acetabulae. The level set is guided by curvature features on the mesh. It can segment portions of a surface that are bounded by a line of extremal curvature (ridgeline or crestline). The rim of the acetabulum is such an extremal curvature line. Our material consists of eight hemi-pelvis surfaces. The algorithm is initiated by putting a small circle (level set seed) at the center of the acetabular surface. Because this surface distinctively has the form of a cup we were able to use the Shape Index feature to automatically extract an approximate center. The circle then expands and deforms so as to take the shape of the acetabular rim. The results were visually inspected. Only minor errors were detected. The algorithm also proved to be robust. Seed placement was satisfactory for the eight hemi-pelvis surfaces without changing any parameters. For the level set evolution we were able to use a single set of parameters for seven out of eight surfaces.

  17. Research synthesis of recommended acetabular cup orientations for total hip arthroplasty.

    PubMed

    Harrison, Claire L; Thomson, Avril I; Cutts, Steven; Rowe, Philip J; Riches, Philip E

    2014-02-01

    Total hip arthroplasty (THA) is regarded as one of the most successful surgical procedures of modern times yet continues to be associated with a small but significant complication rate. Many early failures may be associated with poor component positioning with, in particular, acetabular component orientation dependent on the subjective judgement of the surgeon. In this paper, we compare the manufacturers' instructions on acetabular cup orientation with the literature-based recommended safety zones and surgical technique, by transforming them onto a single, clinically-relevant framework in which the different reference systems, safety guidelines and current instrumentation surgical techniques can be evaluated. The observed limited consensus between results reflects ongoing uncertainty regarding the optimum acetabular component positioning. As malpositioning of the acetabular cup increases the risk of revision surgery, any ambiguity over the correct position can have a causal effect. Our analysis highlights the need for a surgical reference system which can be used to describe the position of the acetabular cup intra-operatively. PMID:23958234

  18. Management of an Open Acetabular Fracture in a Skeletally Immature Patient

    PubMed Central

    Clutter, Sarah Y; Morgan, Steven J; Erickson, Mark; Smith, Wade R; Stahel, Philip F

    2007-01-01

    Background: Open acetabular fractures in children are rare, but potentially devastating injuries. Secondary to the low incidence, there is an apparent lack of reports on appropriate management strategies for open pediatric acetabular fractures in the literature. Methods: Description of a case study. Results: A 3 years and ten months-old girl was ejected as a passenger from an all terrain vehicle. She sustained a displaced, grade IIIA open left anterior column acetabular fracture. The injury was treated by extending the open wound to a formal first window of the ilioinguinal approach. After surgical debridement, the anterior column was reduced anatomically and fixed by two lag screws which avoided the tri-radiate cartilage. A vaginal laceration was debrided and repaired. The patient was treated in a spica cast without weight bearing on the left lower extremity for 8 weeks. No perioperative complications occurred. The acetabular fracture healed in an anatomic position within 8 weeks. To avoid premature closure of the tri-radiate cartilage, the patient underwent a physeal bar resection at one year after injury. At two-year follow up, she was walking and running without pain and had a free range of motion of her left hip. Conclusions: Operative management should represent the therapy of choice for open, displaced pediatric acetabular fractures. After fracture healing, a scheduled physeal bar resection may be required for injuries which involve the tri-radiate cartilage. PMID:19461903

  19. ULTRA-LIGHTWEIGHT CEMENT

    SciTech Connect

    Fred Sabins

    2001-04-15

    The objective of this project is to develop an improved ultra-lightweight cement using ultralight hollow glass spheres (ULHS). Work reported herein addresses Task 1: Assess Ultra-Lightweight Cementing Problems and Task 3: Test Ultra-Lightweight Cements. Results reported this quarter include a review and summary of Halliburton Energy Services (HES) and BJ Services historical performance data for lightweight cement applications. These data are analyzed and compared to ULHS cement and foamed cement performances. Similar data is expected from Schlumberger, and an analysis of this data will be completed in the following phases of the project. Quality control testing of materials used to formulate ULHS cements in the laboratory was completed to establish baseline material performance standards. A testing protocol was developed employing standard procedures as well as procedures tailored to evaluate ULHS and foamed cement. This protocol is presented and discussed. Results of further testing of ULHS cements are presented along with an analysis to establish cement performance design criteria to be used during the remainder of the project. Finally, a list of relevant literature on lightweight cement performance is compiled for review during the next quarter.

  20. Magnesia-Based Cements: A Journey of 150 Years, and Cements for the Future?

    PubMed

    Walling, Sam A; Provis, John L

    2016-04-13

    This review examines the detailed chemical insights that have been generated through 150 years of work worldwide on magnesium-based inorganic cements, with a focus on both scientific and patent literature. Magnesium carbonate, phosphate, silicate-hydrate, and oxysalt (both chloride and sulfate) cements are all assessed. Many such cements are ideally suited to specialist applications in precast construction, road repair, and other fields including nuclear waste immobilization. The majority of MgO-based cements are more costly to produce than Portland cement because of the relatively high cost of reactive sources of MgO and do not have a sufficiently high internal pH to passivate mild steel reinforcing bars. This precludes MgO-based cements from providing a large-scale replacement for Portland cement in the production of steel-reinforced concretes for civil engineering applications, despite the potential for CO2 emissions reductions offered by some such systems. Nonetheless, in uses that do not require steel reinforcement, and in locations where the MgO can be sourced at a competitive price, a detailed understanding of these systems enables their specification, design, and selection as advanced engineering materials with a strongly defined chemical basis. PMID:27002788

  1. ULTRA-LIGHTWEIGHT CEMENT

    SciTech Connect

    Fred Sabins

    2001-07-18

    The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). Work reported herein addresses Task 1: Assess Ultra-Lightweight Cementing Issues, Task 2: Review Russian Ultra-Lightweight Cement Literature, Task 3: Test Ultra-Lightweight Cements, and Task 8: Develop Field ULHS Cement Blending and Mixing Techniques. Results reported this quarter include: preliminary findings from a literature review focusing on problems associated with ultra-lightweight cements; summary of pertinent information from Russian ultra-lightweight cement literature review; laboratory tests comparing ULHS slurries to foamed slurries and sodium silicate slurries for two different applications; and initial laboratory studies with ULHS in preparation for a field job.

  2. ULTRA-LIGHTWEIGHT CEMENT

    SciTech Connect

    Fred Sabins

    2002-04-29

    The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). This report includes results from laboratory testing of ULHS systems along with other lightweight cement systems, including foamed and sodium silicate slurries. During this project quarter, comparison studies of the three cement systems examined several properties: tensile strength, Young's modulus, and shear bond. Testing to determine the effect of temperature cycling on the shear bond properties of the cement systems was also conducted. In addition, the stress-strain behavior of the cement types was studied. This report discusses a software program that is being developed to help design ULHS cements and foamed cements.

  3. ULTRA-LIGHTWEIGHT CEMENT

    SciTech Connect

    Fred Sabins

    2002-10-31

    The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). This report includes results from laboratory testing of ULHS systems along with other lightweight cement systems, including foamed and sodium silicate slurries. During this project quarter, a comparison study of the three cement systems examined the effect that cement drillout has on the three cement systems. Testing to determine the effect of pressure cycling on the shear bond properties of the cement systems was also conducted. This report discusses testing that will be performed for analyzing the alkali-silica reactivity of ULHS in cement slurries, as well as the results of Field Tests 1 and 2.

  4. Acetabular cup liner and prosthetic head exchange to increase the head diameter for management of recurrent luxation of a prosthetic hip in two dogs.

    PubMed

    Roe, S C; Sidebotham, C; Marcellin-Little, D J

    2015-01-01

    Component malalignment and impingement are possible causes of recurrent luxation following total hip replacement in the dog. In the two cases presented in this report, luxation that was probably due to impingement was managed by exchanging the standard 17 mm prosthetic head for a 24 mm prosthetic head. This required removal of the original acetabular cup liner and placement of a new polyethylene liner that would accept the 24 mm head into the stable acetabular shell. In the first case, a 50 kg Malamute dog, recurrent luxation was initially managed by component alignment revision, iliofemoral suture, triple pelvic osteotomy and a novel lasso technique, without long-term success. After exchanging the head and cup liner, luxation did not recur over a 12-month period. In the second case, a 65 kg Newfoundland dog, impingement was suspected after a second luxation event. Luxation did not recur during the nine months after exchange of the head and cup liner. The larger prosthetic head used in these two cases increased the impingement-free range-of-motion of the joint and increased the translation distance required for luxation (jump distance). PMID:25448927

  5. The effect of acetabular cup size on the short-term stability of revision hip arthroplasty: a finite element investigation.

    PubMed

    Phillips, A T M; Pankaj; Usmani, A S; Howie, C R

    2004-01-01

    The study uses idealized two-dimensional finite element models to examine the behaviour of the acetabular construct following revision hip arthroplasty, carried out using the Slooff-Ling impaction grafting technique. The behaviour of bone graft was considered in detail, with non-linear elasticity and non-associated plasticity being adopted. Load was applied to the acetabular construct through a femoral head using smooth sliding surfaces. In particular, four models were subjected to two idealized cyclic load cases to investigate the effect of acetabular cup size on the short-term stability of the acetabular construct. The study suggests that benefits may be gained by using the largest practical size of acetabular cup. PMID:15376726

  6. Midterm survivorship of a press-fit, plasma-sprayed, tri-spike acetabular component.

    PubMed

    Klaassen, Mark A; Martínez-Villalobos, Mario; Pietrzak, William S; Mangino, Gerardo P; Guzman, Delfino Carranza

    2009-04-01

    Press-fit acetabular cups without screw holes can limit migration of particulate wear debris and reduce risk of acetabular osteolysis and device loosening. The Tri-Spike cup (Biomet, Inc, Warsaw, Ind) includes a titanium alloy plasma spray porous surface and does not require screw fixation. We retrospectively examined the incidence of cup loosening and acetabular osteolysis after implantation of 45 cups (44 patients) with mean follow-up of 7.3 years (range, 4-9 years). Only one patient (one cup) had evidence of less than 1 mm of retroacetabular radiolucency at 3 years (nonprogressive), which was found to remain firmly fixed during revision of the aseptically loosened femoral component. No cups were removed or revised at latest follow-up. Projected Kaplan-Meier survivorship at 9 years was 100% for cup loosening/revision and 97.8% for radiolucency. PMID:18534453

  7. Biomechanical Analysis of the Fixation System for T-Shaped Acetabular Fracture

    PubMed Central

    Fan, Yanping; Lei, Jianyin; Zhu, Feng; Li, Zhiqiang; Chen, Weiyi; Liu, Ximing

    2015-01-01

    This study aims to evaluate the biomechanical mechanism of fixation systems in the most frequent T-shaped acetabular fracture using finite element method. The treatment of acetabular fractures was based on extensive clinical experience. Three commonly accepted rigid fixation methods (double column reconstruction plates (P × 2), anterior column plate combined with posterior column screws (P + PS), and anterior column plate combined with quadrilateral area screws (P + QS)) were chosen for evaluation. On the basis of the finite element model, the biomechanics of these fixation systems were assessed through effective stiffness levels, stress distributions, force transfers, and displacements along the fracture lines. All three fixation systems can be used to obtain effective functional outcomes. The third fixation system (P + QS) was the optimal method for T-shaped acetabular fracture. This fixation system may reduce many of the risks and limitations associated with other fixation systems. PMID:26495030

  8. Effect of Metakaolin on Strength and Efflorescence Quantity of Cement-Based Composites

    PubMed Central

    Weng, Tsai-Lung; Lin, Wei-Ting; Cheng, An

    2013-01-01

    This study investigated the basic mechanical and microscopic properties of cement produced with metakaolin and quantified the production of residual white efflorescence. Cement mortar was produced at various replacement ratios of metakaolin (0, 5, 10, 15, 20, and 25% by weight of cement) and exposed to various environments. Compressive strength and efflorescence quantify (using Matrix Laboratory image analysis and the curettage method), scanning electron microscopy, and X-ray diffraction analysis were reported in this study. Specimens with metakaolin as a replacement for Portland cement present higher compressive strength and greater resistance to efflorescence; however, the addition of more than 20% metakaolin has a detrimental effect on strength and efflorescence. This may be explained by the microstructure and hydration products. The quantity of efflorescence determined using MATLAB image analysis is close to the result obtained using the curettage method. The results demonstrate the best effectiveness of replacing Portland cement with metakaolin at a 15% replacement ratio by weight. PMID:23737719

  9. Patient-specific acetabular shape modelling: comparison among sphere, ellipsoid and conchoid parameterisations.

    PubMed

    Cerveri, Pietro; Manzotti, Alfonso; Baroni, Guido

    2014-04-01

    The shape of the human acetabular cup was commonly represented as a hemisphere, but different geometries and patient-specific shapes have been recently proposed in the literature. Our aim was to test the limits of the sphericity assumption by comparing three different parameterisations, namely the sphere, the ellipsoid and the rotational conchoid. Models of hip surfaces, reconstructed from CT scans taken from Caucasian race cadavers and patients, were automatically processed to extract the acetabular surface. Two separate analyses were carried out on the overall acetabular shape, including both the acetabular fossa and the lunate surface (case A) and acetabular cup represented by the lunate surface only (case B). Nonlinear gradient-based and evolutionary computation approaches were implemented for the fitting process. Minor differences from the three idealised geometries were detected (median values of the fitting errors < 1 mm). Nonetheless, the sphere fitting was found to be statistically different from both the ellipsoid (p < 2.50e - 10) and the conchoid (p < 1.07e - 09), whereas no statistical difference was detected between the ellipsoid and the conchoid for case A. Significance of the difference between ellipsoid and sphere (p < 4.55e - 12) and between conchoid and sphere (p < 1.93e - 11) was found for case B as well. Interestingly, for case B statistical difference was detected between the ellipsoid and the conchoid. In conclusion, we synthesise that the morphology of the overall acetabular cup can be parameterised both with an ellipsoid shape and with a conchoid shape as well with superior quality than the simple sphere. Differently, if one considers just the lunate surface, better fitting results are expected when using the ellipsoid. PMID:22789071

  10. [Acetabular fractures in the elderly. Outcome of open reduction and internal fixation].

    PubMed

    Tosounidis, G; Culemann, U; Bauer, M; Holstein, J H; Garcia, P; Kurowski, R; Pizanis, A; Aghayev, E; Pohlemann, T

    2011-08-01

    The aim of this study was to analyze the clinical outcome and incidence of hip arthritis in elderly patients with acetabular fractures. Because of poor bone quality in the elderly, even a low-energy trauma may lead to an acetabular fracture. An anatomical reconstruction of the acetabulum is necessary to achieve sufficient stability also for a potential hip arthroplasty. So far, there is very limited information on the outcome of acetabular fractures in the elderly. During a period of 6 years (2001-2006), 48 patients older than 60 years were admitted to our department with an acetabular fracture. Thirty-nine patients were treated operatively and nine patients non-operatively. Twenty-nine operatively treated patients were followed up. Nineteen of them were assessed using EQ-5D, SF-12 and Merle d'Aubigné questionnaires in addition to their clinical examination. Ten other surgical patients were only examined using the questionnaires. Of the 29 patients that were followed up, 5 underwent total hip arthroplasty due to secondary post-traumatic hip arthritis after open reduction and internal fixation (ORIF). The range of motion of the operated hip was comparable to that of the non-operated contralateral side. However, the internal rotation was found to be slightly decreased at the operated side when compared to the non-operated contralateral side. Merle d'Aubigné score and physical and mental SF-12 score components as well as quality of life were better in patients treated with ORIF compared to those patients that were treated by secondary hip arthroplasty. Regarding the different treatment strategies (ORIF vs primary hip arthroplasty vs non-operative treatment) of acetabular fractures in the elderly, data from the literature are conflicting. Our results indicate that ORIF represents a good treatment option for acetabular fractures in the elderly. In patients that did not develop secondary hip arthritis, a good clinical outcome and quality of life was documented. PMID

  11. Acetabular labral tears: focused review of anatomy, diagnosis, and current management.

    PubMed

    Huang, Ronald; Diaz, Claudio; Parvizi, Javad

    2012-05-01

    Acetabular labral tears have become an increasingly common diagnosis with the advancement of imaging techniques and hip arthroscopy. Therefore, understanding the anatomic significance, healing potential, and associated pathologies of labral tears is helpful. Furthermore, recognizing the clinical picture and understanding appropriate imaging techniques, such as magnetic resonance arthrography, are essential to making a correct diagnosis. This article reviews the relevant anatomy, diagnosis, and management of acetabular labral tears for physicians of all specialties who may be involved in the care of patients with labral tears. Short-term results of labral repair have been promising, but further studies are needed to clarify appropriate indications and long-term results of treatment. PMID:22759609

  12. Methods and Guidelines for Venous Thromboembolism Prevention in Polytrauma Patients with Pelvic and Acetabular Fractures

    PubMed Central

    Chana-Rodríguez, Francisco; Mañanes, Rubén Pérez; Rojo-Manaute, José; Haro, José Antonio Calvo; Vaquero-Martín, Javier

    2015-01-01

    Sequential compression devices and chemical prophylaxis are the standard venous thromboembolism (VTE) prevention for trauma patients with acetabular and pelvic fractures. Current chemical pharmacological contemplates the use of heparins or fondaparinux. Other anticoagulants include coumarins and aspirin, however these oral agents can be challenging to administer and may need monitoring. When contraindications to anticoagulation in high-risk patients are present, prophylactic inferior vena cava filters can be an option to prevent pulmonary emboli. Unfortunately strong evidence about the most effective method, and the timing of their commencement, in patients with pelvic and acetabular fractures remains controversial. PMID:26312115

  13. Abyssal seep site cementation

    SciTech Connect

    Neumann, A.C.; Paull, C.K.; Commeau, R.; Commeau, J.

    1988-01-01

    The deepest submarine cements known so far occur along the 3,300-m deep base of the Florida escarpment and are associated with methane-bearing brine seeps, which emanate there. These deep Holocene carbonates, which occur as surficial and buried crusts, burrow fillings, and friable horizons, were sampled via ALVIN. The carbonates form irregular halos extending up to 20 m from seeps colonized by chemosynthetic fauna. Mussels, gastropods, and clams, the carbonate components of the community, produce a shell hash that is locally cemented by coarsely crystalline low-Mg calcite. Halos of palisade calcite are reminiscent of ancient examples of marine cements. Also present are carbonate hemipelagics cemented by micrite into crusts and burrow fillings. The degree of cementation varies from pervasive to light. Slabs of cemented crust up to 30 cm thick contrast with typical shallow crusts and exhibit irregular tops and smooth bottoms indicating different chemical gradients and pathways.

  14. ULTRA-LIGHTWEIGHT CEMENT

    SciTech Connect

    Fred Sabins

    2003-01-31

    The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). This report discusses testing that was performed for analyzing the alkali-silica reactivity of ULHS in cement slurries. DOE joined the Materials Management Service (MMS)-sponsored joint industry project ''Long-Term Integrity of Deepwater Cement under Stress/Compaction Conditions.'' Results of the project contained in two progress reports are also presented in this report.

  15. Pain Palliation by Percutaneous Acetabular Osteoplasty for Metastatic Hepatocellular Carcinoma

    SciTech Connect

    Hokotate, Hirofumi; Baba, Yasutaka; Churei, Hisahiko; Nakajo, Masayuki; Ohkubo, Kouichi; Hamada, Kenji

    2001-09-15

    A 68-year-old man with hepatocellular carcinoma and known skeletal metastasis developed right hip pain and gait disturbance due to an osteolytic metastasis in the right acetabulum. This was treated initially with chemoembolization and radiation therapy. When these procedures proved unsuccessful percutaneous injection of acrylic bone cement into the acetabulum was undertaken. Immediately after this procedure, he obtained sufficient pain relief and improved walking ability, which continued for 3 months until he died of hepatic insufficiency.

  16. Biomechanical Study of Acetabular Tridimensional Memoryalloy Fixation System

    NASA Astrophysics Data System (ADS)

    Liu, Xin-Wei; Xu, Shuo-Gui; Zhang, Yun-Tong; Zhang, Chun-Cai

    2011-07-01

    We developed the acetabular tridimensional memoryalloy fixation system (ATMFS), which is made of NiTi shape memory alloy, according to the specific mechanical properties of biological memory material, NiTi shape memory alloy and measured distribution of contact area and pressure between the acetabulum and the femoral head of cadaveric pelvis. Seven formalin-preserved cadaveric pelves were used for this investigation. Pressure-sensitive film was used to measure contact area and pressure within the anterior, superior, and posterior regions of the acetabulum. The pelves were loaded under the following four conditions: (1) intact; (2) following a creation posterior wall fracture defect; (3) following reduction and standard internal fixation with reconstruction plate; and (4) following reduction and internal fixation with a new shape memory alloy device named ATMFS. A posterior wall fracture was created along an arc of 40° to 90° about the acetabulur rim. Creation of a posterior wall defect resulted in increased load in the superior acetabulum (1485 N) as compared to the intact condition (748 N, P = 0.009). Following reduction and internal fixation, the load distributed to the superior acetabulum (1545 N) was not statistically different from the defect condition. Following the fixation with ATMFS, the load seen at the superior region of the actabulum (964 N) was familiar with fixation with reconstruction plate and was not different from intact state ( P = 0.45). These data indicate that the use of ATMFS as a fracture internal fixation device resulted a partial restoration of joint loading parameters toward the intact state. ATMFS fixation may result in a clinical benefit.

  17. Cements from nanocrystalline hydroxyapatite.

    PubMed

    Barralet, J E; Lilley, K J; Grover, L M; Farrar, D F; Ansell, C; Gbureck, U

    2004-04-01

    Calcium phosphate cements are used as bone substitute materials because they may be moulded to fill a void or defect in bone and are osteoconductive. Although apatite cements are stronger than brushite cements, they are potentially less resorbable in vivo. Brushite cements are three-component systems whereby phosphate ions and water react with a soluble calcium phosphate to form brushite (CaHPO4 x 2H2O). Previously reported brushite cement formulations set following the mixture of a calcium phosphate, such as beta-tricalcium phosphate (beta-TCP), with an acidic component such as H3PO4 or monocalcium phosphate monohydrate (MCPM). Due to its low solubility, hydroxyapatite (HA) is yet to be reported as a reactive component in calcium phosphate cement systems. Here we report a new cement system setting to form a matrix consisting predominantly of brushite following the mixture of phosphoric acid with nanocrystalline HA. As a result of the relative ease with which ionic substitutions may be made in apatite this route may offer a novel way to control cement composition or setting characteristics. Since kinetic solubility is dependent on particle size and precipitation temperature is known to affect precipitated HA crystal size, the phase composition and mechanical properties of cements made from HA precipitated at temperatures between 4 and 60 degrees C were investigated. PMID:15332608

  18. Shoulder replacement - discharge

    MedlinePlus

    Total shoulder arthroplasty - discharge; Endoprosthetic shoulder replacement - discharge; Partial shoulder replacement - discharge; Partial shoulder arthroplasty - discharge; Replacement - shoulder - discharge; ...

  19. Reuse of fresh water sludge in cement making.

    PubMed

    Pan, R; Huang, C; Lin, S

    2004-01-01

    With the increasing demand for high quality water, a large quantity of chemical agent must be added in the water purification process, which in turn generates enormous amount of fresh water sludge. Of all the options for sludge disposal, sludge reuse has been considered most economical and environmentally sound. This study evaluated the possibility of incorporating fresh water sludge in the making of Portland cement through the sintering process. The goal was to search for the optimal condition to maximize the replacement of clay with the fresh water sludge. Characteristics of fresh water sludge were collected and analyzed. The analysis showed that water source and water treatment process dominate th characteristics, particularly the chemical composition of the fresh water sludge. The fresh water sludge was mixed with the cement clay in various percentages, from 0% to 100%, as raw material for cement-making. The effects of its addition on the sintering condition and the quality of cement were evaluated. The analysis of the clinkers showed that the addition of the fresh water sludge did not change the phase form and the f-CaO content of the cement. The compressive strength of the masonry increased with the increasing addition of fresh water sludge. All cement products made from various replacement ratios met the Chinese National Standard of first degree Portland cement. PMID:15581011

  20. Uncemented acetabular components with femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip: a concise follow-up report at a mean of twenty years.

    PubMed

    Abdel, Matthew P; Stryker, Louis S; Trousdale, Robert T; Berry, Daniel J; Cabanela, Miguel E

    2014-11-19

    We previously reported the five to twelve-year results of total hip arthroplasty with an uncemented acetabular component and an autogenous femoral head graft in forty-four consecutive hips with developmental dysplasia. The goal of the present study was to report the implant survival rate, status of bone grafts, and clinical outcomes in thirty-five of these hips (in twenty-nine patients) followed for a mean of 21.3 years. Functional, radiographic, and survivorship results were examined. Radiographic analysis revealed an average cup inclination angle of 43° and a mean arc of cup coverage by the graft of 30°. The twenty-year survivorship free from acetabular revision was 66% (twelve acetabular revisions; eight since our previous report). Of the twelve revisions, nine were for liner wear and/or osteolysis, one was for a liner fracture, one was for aseptic loosening, and one was for instability. All bone grafts healed to the pelvis. The graft facilitated revision cup placement as no additional structural grafts or metal augments were required. We concluded that an uncemented porous-coated socket used in conjunction with a bulk femoral head autograft provides good long-term fixation and restores bone stock. PMID:25410505

  1. Accuracy and Precision of Three-Dimensional Low Dose CT Compared to Standard RSA in Acetabular Cups: An Experimental Study.

    PubMed

    Brodén, Cyrus; Olivecrona, Henrik; Maguire, Gerald Q; Noz, Marilyn E; Zeleznik, Michael P; Sköldenberg, Olof

    2016-01-01

    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. Twelve repeated stereoradiographs and CT scans with double examinations in each position and gradual migration of the implants were made. Precision and accuracy of the 3D CT were calculated. Results. The accuracy of the 3D CT ranged between 0.07 and 0.32 mm for translations and 0.21 and 0.82° for rotation. The precision ranged between 0.01 and 0.09 mm for translations and 0.06 and 0.29° for rotations, respectively. For standard RSA, the precision ranged between 0.04 and 0.09 mm for translations and 0.08 and 0.32° for rotations, respectively. There was no significant difference in precision between 3D CT and standard RSA. The effective radiation dose of the 3D CT method, comparable to RSA, was estimated to be 0.33 mSv. Interpretation. Low dose 3D CT is a comparable method to standard RSA in an experimental setting. PMID:27478832

  2. Accuracy and Precision of Three-Dimensional Low Dose CT Compared to Standard RSA in Acetabular Cups: An Experimental Study

    PubMed Central

    Olivecrona, Henrik; Maguire, Gerald Q.; Noz, Marilyn E.; Zeleznik, Michael P.

    2016-01-01

    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. Twelve repeated stereoradiographs and CT scans with double examinations in each position and gradual migration of the implants were made. Precision and accuracy of the 3D CT were calculated. Results. The accuracy of the 3D CT ranged between 0.07 and 0.32 mm for translations and 0.21 and 0.82° for rotation. The precision ranged between 0.01 and 0.09 mm for translations and 0.06 and 0.29° for rotations, respectively. For standard RSA, the precision ranged between 0.04 and 0.09 mm for translations and 0.08 and 0.32° for rotations, respectively. There was no significant difference in precision between 3D CT and standard RSA. The effective radiation dose of the 3D CT method, comparable to RSA, was estimated to be 0.33 mSv. Interpretation. Low dose 3D CT is a comparable method to standard RSA in an experimental setting. PMID:27478832

  3. Percutaneous screw placement in acetabular posterior column surgery: gender differences in implant positioning.

    PubMed

    Dienstknecht, Thomas; Müller, Michael; Sellei, Richard; Nerlich, Michael; Pfeifer, Christian; Krutsch, Werner; Fuechtmeier, Bernd; Berner, Arne

    2014-04-01

    Percutaneous reduction and periarticular screw implantation techniques have been successfully introduced in acetabular surgery. Image guided navigation techniques might be beneficial in increasing accuracy. However, a thorough understanding of standard values is needed to oversee pitfalls. This cadaver study was designed to identify reliable angulation values for screw implantation in the posterior acetabular column and to provide knowledge of the bony thickness for the periarticular corridor. Gender differences were specifically addressed. 27 embalmed cadaveric hemipelvic specimens (13 male, 14 female) were used. After soft-tissue removal posterior column acetabular screw placement was conducted by one experienced orthopaedic trauma surgeon under visibility. Radiographic verification of ideal screw placement was followed by radiographic assessment in three standard views and angulation values were assessed. Through bony dissection the maximal periarticular canal width was assessed. Various angulation values with regard to anatomical landmarks could be determined in the anteroposterior radiograph, as well as in the iliac oblique and the obturator oblique view. Gender differences were significant for all reference points with the pubic rami involved. The minimal canal width was 1.1cm in female and 1.6 cm in male specimen. The findings provide standard values for safe passages in percutaneous posterior column acetabular surgery. Gender differences have to be taken in consideration when planning the drill corridor. By adherence to standard values, screw placement can be performed safely. PMID:24182644

  4. Effect of acetabular orientation on stress distribution of highly cross-linked polyethylene liners.

    PubMed

    Lam, Luthan; Drew, Timothy; Boscainos, Petros

    2013-11-01

    Several case reports have documented the fracture of highly cross-linked polyethylene (HCLPE) liners used in total hip arthroplasty (THA). Although uncommon, fractured liners result in considerable morbidity for patients and require revision surgery. One postulated mechanism that leads to this type of implant failure is malorientation of the acetabular component. The purpose of this study was to investigate the effect of acetabular orientation on the stress distribution of HCLPE liners used in THA by means of finite element analysis. Three-dimensional models of a commonly used HCLPE liner were created corresponding to 12 different acetabular component orientations (inclination ranging from 20° to 70° and version ranging from 20° of retroversion to 40° of anteversion). A static stress analysis of the finite element models was performed under conditions simulating peak gait loads. The results of the analysis revealed that excessive inclination and extremes of version were associated with an increase in peak stress magnitudes. The locations of peak stress also were found to lie within the rim notch and locking ring groove regions, which were consistent with the fracture locations reported in published case reports. Therefore, the acetabular component should be oriented carefully during implantation to reduce the risk of rim loading and subsequent liner fracture. In addition, an alternative liner design may further help reduce stress risers and risk of fracture. PMID:24200436

  5. Relationship between developmental dislocation of the hip in infant and acetabular dysplasia at skeletal maturity.

    PubMed

    Okano, Kunihiko; Yamaguchi, Kazumasa; Ninomiya, Yoshikazu; Matsubayashi, Shohei; Aoyagi, Kiyoshi; Osaki, Makoto; Enomoto, Hiroshi; Takahashi, Katsuro

    2015-01-01

    Previous reports demonstrated 8-60% patients treated for developmental dislocation of hip (DDH) in infancy have residual acetabular dysplasia (AD) at skeletal maturity. AD patients reportedly exhibit abnormal morphology of the pelvis, high rates of comorbid spinal congenital anomalies and high bone mineral density. These physical findings suggest that AD patients have genetic background. We examined the percentage of AD patients with hip pain at skeletal maturity having a history of DDH in infancy and the correlation between the severity of AD at skeletal maturity and history of DDH treatment to investigate the relationship between AD and DDH.A total of 245 patients were radiographically examined for any history of DDH treatment in infancy. The study included 226 women and 19 men with a mean age at examination of 40.7 years (range 17-59 years).Eighty-eight patients (36%) had a history of DDH treatment (DDH group) and the remaining 157 patients (64%) had no history of DDH treatment (non-DDH group). The average age was lower and acetabular angle was larger in the DDH group. There was a significant increasing trend of the percentage of DDH patients associated with the severity of AD classified with CE, acetabular angle, and acetabular roof angle.Our data suggest that there are several AD patients without a history of DDH in Japan, and AD in patients without a history of DDH has different characteristics from AD in patients with a history of DDH. PMID:25569642

  6. The effect of incisional negative pressure therapy on wound complications after acetabular fracture surgery.

    PubMed

    Reddix, Robert N; Leng, Xiaoyan Iris'; Woodall, James; Jackson, Benjamin; Dedmond, Barnaby; Webb, Lawrence X

    2010-01-01

    The purpose of the study was to determine if the use of incisional negative pressure therapy affected the rate of wound complications after acetabular fracture surgery. Between August 1996 to April 2005, 301 patients were found to have had an operatively treated acetabular fracture. There were 235 patients who had placement of incisional vacuum-assisted closure (VAC) who had three (1.27%) deep wound infections and one (0.426%) wound dehiscence. There were 66 consecutive patients who were available in the 5 years preceding the usage of the incisional VAC who had four (6.06%) deep wound infections and two (3.03%) wound dehiscences. This is less than the published infection rate of 4% for patients undergoing operative treatment of acetabular fractures and less than the authors' rate of 6.15% in the time period before the use of the incisional negative pressure wound therapy (p=.0414). The use of incisional negative pressure wound therapy significantly decreases perioperative wound complications after acetabular fracture surgery. PMID:20727304

  7. The role of cages in the management of severe acetabular bone defects at revision arthroplasty.

    PubMed

    Mäkinen, T J; Fichman, S G; Watts, E; Kuzyk, P R T; Safir, O A; Gross, A E

    2016-01-01

    An uncemented hemispherical acetabular component is the mainstay of acetabular revision and gives excellent long-term results. Occasionally, the degree of acetabular bone loss means that a hemispherical component will be unstable when sited in the correct anatomical location or there is minimal bleeding host bone left for biological fixation. On these occasions an alternative method of reconstruction has to be used. A major column structural allograft has been shown to restore the deficient bone stock to some degree, but it needs to be off-loaded with a reconstruction cage to prevent collapse of the graft. The use of porous metal augments is a promising method of overcoming some of the problems associated with structural allograft. If the defect is large, the augment needs to be protected by a cage to allow ingrowth to occur. Cup-cage reconstruction is an effective method of treating chronic pelvic discontinuity and large contained or uncontained bone defects. This paper presents the indications, surgical techniques and outcomes of various methods which use acetabular reconstruction cages for revision total hip arthroplasty. PMID:26733646

  8. Unsatisfactory results with the cementless Omnifit acetabular component due to polyethylene and severe osteolysis.

    PubMed

    Nieuwenhuis, Jeroen J; Malefijt, Jan de Waal; Hendriks, Jan C M; Gosens, Taco; Bonnet, Michel

    2005-06-01

    A high incidence of acetabular osteolysis (43%), associated with osteolytic lesions in the proximal femur (22.6%) and leading to a high revision rate, was experienced with the Omnifit total hip prosthesis. We reviewed the clinical and radiological results with 429 Omnifit total hips in 356 patients after a mean follow-up of 60 months. Time to revision and wear of the polyethylene liner with different acetabular shell types were specifically analysed. Pelvic osteolysis first became manifest in the acetabular bone opposite to the holes in the metal shell. Osteolysis occurred predominantly adjacent to the central hole in the metal shell of threaded cups; widespread and larger defects were found in press fit cups with peripheral screw holes. Kaplan Meier survival analysis demonstrated a higher probability for retaining the threaded cup at 6 years (96%; 95%-confidence interval: 93-99%) compared to the survival of the press fit cup (66%; 95%-CI: 56-77%). The results suggest a negative relationship between backside wear, the larger number of holes in the cup, the extent of osteolysis and survival rate of the press fit cups. Based on these findings and supported by similar reports about osteolysis related to the same cup design, it was hypothesised that backside wear due to the insufficient locking mechanism of the Omnifit acetabular cup was the major cause of the unsatisfactory results in our patients. For this reason we discontinued using this type of uncemented socket. PMID:16035702

  9. Catastrophic Failure of the Acetabular Polyethylene Liner in Ceramic-on-Polyethylene Total Hip Arthroplasty

    PubMed Central

    Manzano, Givenchy; Levin, Rayna A. C.; Mayor, Michael B.; Schwarzkopf, Ran

    2014-01-01

    Introduction: Catastrophic polyethylene failure is a rare complication of ceramic-on-polyethylene total hip arthroplasty due to the favorable tribological characteristics of ceramic. Failure of the polyethylene liner can be disastrous, increasing periprosthetic osteolysis, metallosis, and risk of dislocation. Complications associated with ceramic-on-polyethylene articulations have been studied extensively, however, only few reports have described its catastrophic wear. We report such a case of complete wear of the acetabular liner in a ceramic-on-polyethylene prosthesis in a 57-year adult male. Case Report: A 57-year adult male with a history of bilateral total hip arthroplasty presented to our institution with bilateral hip pain worst on the right. Range of motion was limited by pain on the right hip at the extremes of motion. Radiographs revealed severe osteolysis, heterotopic ossification, complete wear of the acetabular liner, bony impingement of the femoral greater trochanter on the acetabular rim and superior migration of the femoral head. All findings were confirmed intraoperatively. Revision of the acetabular components was performed, which successfully alleviated the patient’s symptoms. Conclusion: Failure of the ceramic-on-polyethylene liner in our patient is due to the use of a non-cross linked polyethylene liner, a highly active lifestyle, and poor follow up. Arthroplasty surgeons should be aware of this complication especially in highly active patients with a conventional polyethylene liner and chronic hip pain. PMID:27298960

  10. ULTRA-LIGHTWEIGHT CEMENT

    SciTech Connect

    Fred Sabins

    2004-01-30

    The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). This report discusses testing that was performed for analyzing the alkali-silica reactivity of ULHS in cement slurries.

  11. Mechanical and physical properties of cement blended with sewage sludge ash.

    PubMed

    Garcés, P; Pérez Carrión, M; García-Alcocel, E; Payá, J; Monzó, J; Borrachero, M V

    2008-12-01

    The aim of this paper is to evaluate the compatibility of sewage sludge ash (SSA) with various types of commercially available cements (CEM I and CEM II types, cements with several proportions of clinker). The behaviour of mortars fabricated with various percentages (10-30% by weight) of the cement replaced by SSA has been analyzed in terms of workability, mechanical strength, porosity and shrinkage/expansion. SSA exhibits moderate pozzolanic activity; the highest compressive strengths were obtained with 10% of the cement replaced by SSA. The CEM II/B-M (V-LL) 42.5R cement is considered ideal for preparing mortars containing SSA. Shrinkage data demonstrate that sulphates present in SSA are not reactive towards cement. PMID:18424024

  12. Reduction of soil pollution by usingwaste of the limestone in the cement industry

    NASA Astrophysics Data System (ADS)

    Muñoz, M. Cecilia Soto; Robles Castillo, Marcelo; Blanco Fernandez, David; Diaz Gonzalez, Marcos; Naranjo Lamilla, Pedro; Moore Undurraga, Fernando; Pardo Fabregat, Francisco; Vidal, Manuel Miguel Jordan; Bech, Jaume; Roca, Nuria

    2016-04-01

    In the cement manufacturing process (wet) a residue is generated in the flotation process. This builds up causing contamination of soil, groundwater and agricultural land unusable type. In this study to reduce soil and water pollution 10% of the dose of cement was replaced by waste of origin limestone. Concretes were produced with 3 doses of cement and mechanical strengths of each type of concrete to 7, 28 and 90 days were determined. the results indicate that the characteristics of calcareous residue can replace up to 10% of the dose of cement without significant decreases in strength occurs. It is noted that use of the residue reduces the initial resistance, so that the dose of cement should not be less than 200 kg of cement per m3. The results allow recommends the use of limestone waste since it has been observed decrease in soil and water contamination without prejudice construction material Keywords: Soil contamination; Limestone residue; Adding concrete

  13. ULTRA-LIGHTWEIGHT CEMENT

    SciTech Connect

    Fred Sabins

    2002-01-23

    The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). This report includes results from laboratory testing of ULHS systems along with other lightweight cement systems: foamed and sodium silicate slurries. Comparison studies of the three cement systems examined several properties: tensile strength, Young's modulus, water permeability, and shear bond. Testing was also done to determine the effect that temperature cycling has on the shear bond properties of the cement systems. In addition, analysis was carried out to examine alkali silica reactivity of slurries containing ULHS. Data is also presented from a study investigating the effects of mixing and pump circulation on breakage of ULHS. Information is also presented about the field application of ULHS in cementing a 7-in. intermediate casing in south Texas.

  14. Recycling of ladle slag in cement composites: Environmental impacts.

    PubMed

    Serjun, Vesna Zalar; Mladenovič, Ana; Mirtič, Breda; Meden, Anton; Ščančar, Janez; Milačič, Radmila

    2015-09-01

    In the present work compact and ground cement composites in which 30% of cement by mass was replaced by ladle slag were investigated for their chemical and physico-mechanical properties. To evaluate long-term environmental impacts, leachability test based on diffusion, which combined both, diffusion and dissolution of contaminants, was performed in water and saline water. Total element concentrations and Cr(VI) were determined in leachates over a time period of 180days. At the end of the experiment, the mineralogical composition and the physico-mechanical stability of cement composites was also assessed. The results revealed that Cr(III) and Cr(VI) were immobilized by the hydration products formed in the cement composites with the addition of ladle slag. Cr(VI) content originating from the cement was also appreciably reduced by Fe(II) from minerals present in the added ladle slag, which thus had significant positive environmental effects. Among metals, only Mo and Ba were leached in elevated concentrations, but solely in ground cement composites with the addition of ladle slag. Lower V concentrations were observed in leachates of ground than compact composite. It was demonstrated that the presence of ladle slag in cement composites can even contribute to improved mortar resistance. The investigated ladle slag can be successfully implemented in cement composites as supplementary cementitious material. PMID:26008145

  15. Thin-Walled Cross-Linked Acetabular Liners Need Not Exhibit Reduced Locking Strength.

    PubMed

    Murtha, Andrew S; Roy, Marcel E; Whiteside, Leo A; Tilden, David S; Schmitt, Krystal L

    2015-08-01

    Use of larger diameter femoral heads has emerged as a promising strategy to reduce the risk of dislocation after total hip arthroplasty, but thinning the walls of cross-linked ultra-high-molecular-weight polyethylene (UHMWPE) acetabular liners to accommodate these larger heads may compromise the locking mechanism of the liner. The purpose of this study was to test the mechanical integrity of the locking mechanism in cross-linked and re-melted UHMWPE acetabular components with reduced wall thickness. The locking mechanism of cross-linked (100 kGy/re-melted) acetabular liners in sizes 50/28, 50/36, and 52/36 mm of 1 design was evaluated by lever-out tests and torsion tests. Torsion tests were performed at 2 angles to isolate the liner's locking tabs independent of the contribution of its central post. Lever-out testing demonstrated nominally reduced failure strength in 50/36-mm liners (13.3 N · m) compared with 50/28-mm liners (12.3 N · m; P=.0502), whereas the lever-out strength of 52/36-mm liners was 12.2±0.94 N · m. Failure torques were similar between 50/28- and 50/36-mm liners at 45° and 90°, but the failure torque of size 52/36-mm liners was significantly higher at each angle. The use of larger diameter femoral heads does not compromise the locking mechanism of thinned MicroSeal (Signal Medical Corp, Marysville, Michigan) acetabular liners. Use of a cross-linked UHMWPE acetabular liner, with a locking mechanism that is not compromised when the liner is thinned to a thickness of at least 2.86 mm, appears to be a biomechanically sound construct when articulated with large diameter femoral heads. PMID:26270761

  16. Influence of clinical and radiological variables on the extent and distribution of periprosthetic osteolysis in total hip arthroplasty with a hydroxyapatite-coated multiple-hole acetabular component: a magnetic resonance imaging study.

    PubMed

    Pérez-Coto, Iván; Hernández-Vaquero, Daniel; Suárez-Vázquez, Abelardo; Sandoval-García, Manuel Ángel; Escandon-Rodriguez, Ana

    2014-10-01

    Polyethylene wear-induced osteolysis constitutes the most severe long-term complication of total hip arthroplasties (THA). Our aim was to assess through MRI the severity and growth pattern of osteolysis, as well as the influence clinical-radiographic variables exert. We analyzed 75 THA with an average evolution time of 13.67years. The implant was a titanium alloy, non-cemented, multiple-hole model with hydroxyapatite coating. Osteolysis was found with a peripheral pattern in 48 and a central pattern in 6; in 52 cases it was continuous, and in 4, isolated. Out of 118 screws, 20 exhibited lysis. There was a proportional correlation between osteolysis severity and wear rate with age, physical activity and acetabular abduction, as well as an association between said variables and peripheral and continuous patterns. PMID:24986509

  17. Molecular replacement.

    PubMed

    Toth, Eric A

    2007-01-01

    As more protein structures are solved, the likelihood that current structural investigations will involve proteins for which there exists no homologous structure continually decreases. The extraction of phase information from diffraction experiments is one of several great barriers that crystallographers must overcome on the path to structure solution. One means to overcome this obstacle, the technique of molecular replacement, uses the structural similarity between proteins with similar sequences to give a good first estimate of the phases for the diffraction data of the protein of interest. The programs that execute this technique currently come in many flavors, from traditional Patterson-based methods, to stochastic searches in greater than three dimensions, to maximum likelihood-enhanced molecular replacement, each possessing unique advantages that can shake loose a recalcitrant solution. As crystallographers aim to solve larger macromolecular complexes that more faithfully depict the actors in cellular events, having existing phase information for parts of those biological machines will reinforce the technological advancements in data collection and structure solution that have already produced mammoth structures like the ribosome, yielding an ever-clearer picture of the inner workings of biology. PMID:17172763

  18. Alternative Fuel for Portland Cement Processing

    SciTech Connect

    Schindler, Anton K; Duke, Steve R; Burch, Thomas E; Davis, Edward W; Zee, Ralph H; Bransby, David I; Hopkins, Carla; Thompson, Rutherford L; Duan, Jingran; Venkatasubramanian, Vignesh; Stephen, Giles

    2012-06-30

    at a full-scale cement plant with alternative fuels to examine their compatibility with the cement production process. Construction and demolition waste, woodchips, and soybean seeds were used as alternative fuels at a full-scale cement production facility. These fuels were co-fired with coal and waste plastics. The alternative fuels used in this trial accounted for 5 to 16 % of the total energy consumed during these burns. The overall performance of the portland cement produced during the various trial burns performed for practical purposes very similar to the cement produced during the control burn. The cement plant was successful in implementing alternative fuels to produce a consistent, high-quality product that increased cement performance while reducing the environmental footprint of the plant. The utilization of construction and demolition waste, woodchips and soybean seeds proved to be viable replacements for traditional fuels. The future use of these fuels depends on local availability, associated costs, and compatibility with a facility's production process.

  19. Chromium stabilization chemistry of paint removal wastes in Portland cement and blast furnace slag

    SciTech Connect

    Boy, J.H.; Race, T.D.; Reinbold, K.A.

    1995-12-31

    The use of cement based systems for solidification and stabilization of hazardous wastes has been proposed. The stabilization of Cr contaminated paint removal wastes in ordinary Portland cement and in a Portland cement and blast furnace slag matrix was investigated. A loading by volume of 75% waste and 25% cement (or cement + slag) was used. The expression of pore solution was utilized to determine the chemical environment encountered by the waste species in the cement matrix. The highly alkaline conditions of ordinary Portland cement determined the stability of the metal species, with Cr being highly soluble. The replacement of 25% of the Portland cement by blast furnace slag was found to decrease the [OH-] of the pore solution resulting in a decrease of the Cr concentration. For cement wastes forms hydrated for 28 days, the Cr concentration decreased in the expressed pore solution. During the TCLP tests the cement waste form and extraction solution were found to react, changing the chemistry of the extraction solution. The expression of pore solution was found to give a direct measure of the chemistry of the waste species in the cement matrix. This avoids the reaction of the TCLP extraction solution with the cement matrix which changes the solubility of the hazardous metals. 15 refs., 4 figs., 6 tabs.

  20. Cement-cement interface strength: influence of time to apposition.

    PubMed

    Park, S H; Silva, M; Park, J S; Ebramzadeh, E; Schmalzried, T P

    2001-01-01

    Cement-cement interfaces were created under simulated operating-room conditions. In order to analyze the effect of time to apposition on interface strength, two cement surfaces were brought together 1, 2, 4, and 6 min after 1 min of mixing and 45 s of waiting. Cement-cement interface strength was evaluated with the use of a three-point bending to failure test. Scanning electron microscopy (SEM) images of the failed interface were obtained. The mean interface strength decreased when the cement-cement interface was time delayed. Compared to bulk cement, interface strength in time-delayed groups decreased 8% after 1-min delay (p=.037), 18% after 2-min delay (p=.0004), 20% after 4-min delay (p=.0005), and 42% after 6-min delay (p<.0001). No statistically significant differences in interface strength were found between the 2- and 4-min delayed groups (p=.73). SEM images revealed that after 6-min delay, up to 50% of the cement surface can remain unbonded, explaining the decrease in strength of the cement-cement interface as a function of time to apposition. This laboratory study indicates that time to apposition plays a critical role in cement-cement interface strength. If any cementing technique involves the joining of two cement surfaces, it is recommended that the two cement surfaces be mated together within 5 min and 45 s after the start of mixing (1 min mixing; 45 s waiting; 4 min delay), in order to obtain a strong cement-cement interface bond. Delay beyond this can result in substantial reduction in the strength of the cement-cement interface bond. PMID:11745529

  1. ULTRA-LIGHTWEIGHT CEMENT

    SciTech Connect

    Fred Sabins

    2003-07-31

    The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). This report discusses testing that was performed for analyzing the alkali-silica reactivity of ULHS in cement slurries. Laboratory testing during the eleventh quarter focused on evaluation of the alkali-silica reaction of eight different cement compositions, four of which contain ULHS. This report provides a progress summary of ASR testing. The original laboratory procedure for measuring set cement expansion resulted in unacceptable erosion of the test specimens. In subsequent tests, a different expansion procedure was implemented and an alternate curing method for cements formulated with TXI Lightweight cement was employed to prevent sample failure caused by thermal shock. The results obtained with the modified procedure showed improvement over data obtained with the original procedure, but data for some compositions were still questionable. Additional modification of test procedures for compositions containing TXI Lightweight cement were implemented and testing is ongoing.

  2. Timing of syntaxial cement

    SciTech Connect

    Perkins, R.D.

    1985-02-01

    Echinodermal fragments are commonly overgrown in ancient limestones, with large single crystals growing in optical continuity over their skeletal hosts (i.e., syntaxial overgrowths). Such syntaxial cements are usually considered to have precipitated from meteoric pore waters associated with a later stage of subaerial exposure. Although several examples have been reported from ancient carbonates where petrographic relationships may indicate an early submarine formation of syntaxial cement, no occurrences have been noted in Holocene submarine-cemented rocks. Syntaxial cements of submarine origin have been found in Bermuda beachrock where isopachous high-magnesian calcite cements merge with large optically continuous crystals growing on echinodermal debris. Examination of other Holocene sediments cemented by magnesian calcite indicates that echinodermal fragments are not always overgrown syntaxially, but may be rimmed by microcrystalline calcite. The reason for this difference is not clear, although it may be a function of the spacing of nucleation sites and rates of crystal growth. A review of syntaxial cements from several localities in ancient carbonate sequences reveals that many are best interpreted as having formed in the submarine setting, whereas it is more clear that others formed from meteoric precipitation. These occurrences suggest that care should be exercised in inferring meteoric diagenesis from syntaxial overgrowths and that the possibility of submarine formation should be considered.

  3. Tantalum acetabular augments in one-stage exchange of infected total hip arthroplasty: a case-control study.

    PubMed

    Klatte, Till Orla; Kendoff, Daniel; Sabihi, Reza; Kamath, Atul F; Rueger, Johannes M; Gehrke, Thorsten

    2014-07-01

    During the one-stage exchange procedure for periprosthetic joint infection (PJI) after total hip arthroplasty (THA), acetabular defects challenge reconstructive options. Porous tantalum augments are an established tool for addressing acetabular destruction in aseptic cases, but their utility in septic exchange is unknown. This retrospective case-control study presents the initial results of tantalum augmentation during one-stage exchange for PJI. Primary endpoints were rates of re-infection and short-term complications associated with this technique. Study patients had no higher risk of re-infection with equivalent durability at early follow-up with a re-infection rate in both groups of 4%. In conclusion, tantalum augments are a viable option for addressing acetabular defects in one-stage exchange for septic THA. Further study is necessary to assess long-term durability when compared to traditional techniques for acetabular reconstruction. PMID:24559522

  4. 21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ankle joint metal/polymer semi-constrained... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  5. 21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ankle joint metal/polymer semi-constrained... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  6. 21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ankle joint metal/polymer semi-constrained... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  7. 21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint... replace a hip joint. The device prevents dislocation in more than one anatomic plane and has...

  8. 21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint... replace a hip joint. The device prevents dislocation in more than one anatomic plane and has...

  9. 21 CFR 888.3310 - Hip joint metal/polymer constrained cemented or uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal/polymer constrained cemented or... Hip joint metal/polymer constrained cemented or uncemented prosthesis. (a) Identification. A hip joint... replace a hip joint. The device prevents dislocation in more than one anatomic plane and has...

  10. 21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Elbow joint metal/polymer semi-constrained... Elbow joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An elbow joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  11. 21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Elbow joint metal/polymer semi-constrained... Elbow joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An elbow joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  12. 21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Elbow joint metal/polymer semi-constrained... Elbow joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An elbow joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  13. 21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Elbow joint metal/polymer semi-constrained... Elbow joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An elbow joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  14. 21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ankle joint metal/polymer semi-constrained... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  15. 21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Elbow joint metal/polymer semi-constrained... Elbow joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An elbow joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  16. 21 CFR 888.3110 - Ankle joint metal/polymer semi-constrained cemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ankle joint metal/polymer semi-constrained... Ankle joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an...

  17. Stage cementing apparatus

    SciTech Connect

    Blamford, D.M.; Easter, J.H.

    1988-06-21

    A stage cementing apparatus for selectively passing cement from the interior passage of a casing to the annulus between the exterior of the casing and borehole, the casing having an upper portion and a lower portion, is described comprising: a barrel secured to the upper portion of the casing; a mandrel secured to the lower portion of the casing, and a stage cementing tool having a generally cylindrical configuration adapted for attachment to the lower end of the barrel about a portion of the mandrel.

  18. Cement and concrete

    NASA Technical Reports Server (NTRS)

    Corley, Gene; Haskin, Larry A.

    1992-01-01

    To produce lunar cement, high-temperature processing will be required. It may be possible to make calcium-rich silicate and aluminate for cement by solar heating of lunar pyroxene and feldspar, or chemical treatment may be required to enrich the calcium and aluminum in lunar soil. The effects of magnesium and ferrous iron present in the starting materials and products would need to be evaluated. So would the problems of grinding to produce cement, mixing, forming in vacuo and low gravity, and minimizing water loss.

  19. Short stem shoulder replacement

    PubMed Central

    Bell, Simon N.; Coghlan, Jennifer A.

    2014-01-01

    Context: It is agreed that it is important to anatomically reproduce the proximal humeral anatomy when performing a prosthetic shoulder replacement. This can be difficult with a long stemmed prosthesis, in particular if there is little relationship of the metaphysis to the humeral shaft. The ‘short stem’ prosthesis can deal with this problem. Aims: A prospective study assessed the results of total shoulder arthroplasty using a short stem humeral prosthesis, a ceramic humeral head, and a pegged cemented polyethylene glenoid. Materials and methods: Patients with primary shoulder osteoarthritis were recruited into this prospective trial and pre-operatively had the ASES, Constant, SPADI, and DASH scores recorded. The patients were clinically reviewed at the two weeks, eight weeks, one year, and two year mark with completion of a data form. Radiological evaluation was at the eight week, one year and two year follow-up. At the one and two year follow-up the satisfaction rating, the range of passive and active motion, Constant, ASES, SPADI, DASH and pain results were recorded and analysed with SPPS 20. Results: During the study period 97 short stem, ceramic head total shoulder replacements were carried out. At the time of follow-up 12 were two years from operation and 38 one year from operation. Active elevation was overall mean 160 degrees. Constant scores were 76 at 1 year, and 86 at 2 years, ASES 88 and 93, and satisfaction 96% and 98% respectively at one and 2 year follow up. There were no problems during insertion of the humeral prosthesis, or any radiolucent lines or movement of the prosthesis on later radiographs. Conclusion: The short stem prosthesis had no complications, and on follow up radiographs good bone fixation. These fairly short term clinical results were overall good. PMID:25258497

  20. A geometric morphometric analysis of acetabular shape of the primate hip joint in relation to locomotor behaviour.

    PubMed

    San Millán, Marta; Kaliontzopoulou, Antigoni; Rissech, Carme; Turbón, Daniel

    2015-06-01

    The description of acetabular shape variation among primates is essential for our understanding of the locomotor behaviour and ecology of both extant and fossil species. In this study, we use two-dimensional geometric morphometrics to examine variation in acetabular shape in human and non-human primates and to determine the degree to which it co-varies with locomotor behaviour, while taking both intra and inter-specific variation into account. To these ends, we examined the acetabulum of 303 left hip bones of 27 extant genera of primates (including humans) with different locomotor behaviours. After accounting for shape variation due to sex, size, and phylogeny, the results confirm that acetabular shape varies significantly across locomotor groups. The two most differentiated locomotor groups are leapers and slow-climbing quadrupeds, which exhibit a unique acetabular shape. Furthermore, the acetabulum of humans differed significantly from all other groups, while no significant differences existed between chimpanzees and gorillas. The most noticeable differences are detected in both cranial and dorsal areas and around the acetabular horns. This variation in acetabular morphology may have biomechanical implications at the level of the hip joint, potentially determining joint range motion and load distribution during locomotion. Given the increasing number of published studies on fossil pelves, our results are widely applicable to fossil analyses, with critical implications for paleoanthropological analyses about the complex locomotor behaviour of fossil specimens and their classification into locomotor groups, which may enhance our understanding of their ecological habits. PMID:25929707

  1. Porous Surface Modified Bioactive Bone Cement for Enhanced Bone Bonding

    PubMed Central

    Huang, Li; Dong, Jingjing; Guo, Dagang; Mao, Mengmeng; Kong, Liang; Li, Yang; Wu, Zixiang; Lei, Wei

    2012-01-01

    Our findings suggested a new bioactive bone cement for prosthetic fixation in total joint replacement. PMID:22905143

  2. Global warming impact on the cement and aggregates industries

    SciTech Connect

    Davidovits, J. . Geopolymer Inst.)

    1994-06-01

    CO[sub 2] related energy taxes are focusing essentially on fuel consumption, not on actual CO[sub 2] emission measured at the chimneys. Ordinary Portland cement, used in the aggregates and industries, results from the calcination of limestone and silica. The production of 1 ton of cement directly generates 0.55 tons of chemical-CO[sub 2] and requires the combustion of carbon-fuel to yield an additional 0.40 tons of CO[sub 2]. The 1987 1 billion metric tons world production of cement accounted for 1 billion metric tons of CO[sub 2], i.e., 5% of the 1987 world CO[sub 2] emission. A world-wide freeze of CO[sub 2] emission at the 1990 level as recommended by international institutions, is incompatible with the extremely high cement development needs of less industrialized countries. Present cement production growth ranges from 5% to 16% and suggests that in 25 years from now, world cement CO[sub 2] emissions could equal 3,500 million tons. Eco-taxes when applied would have a spectacular impact on traditional Portland cement based aggregates industries. Taxation based only on fuel consumption would lead to a cement price increase of 20%, whereas taxation based on actual CO[sub 2] emission would multiply cement price by 1.5 to 2. A 25--30% minor reduction of CO[sub 2] emissions may be achieved through the blending of Portland cement with replacement materials such as coal-fly ash and iron blast furnace slag.

  3. Thermodynamics and cement science

    SciTech Connect

    Damidot, D.; Lothenbach, B.; Herfort, D.; Glasser, F.P.

    2011-07-15

    Thermodynamics applied to cement science has proved to be very valuable. One of the most striking findings has been the extent to which the hydrate phases, with one conspicuous exception, achieve equilibrium. The important exception is the persistence of amorphous C-S-H which is metastable with respect to crystalline calcium silicate hydrates. Nevertheless C-S-H can be included in the scope of calculations. As a consequence, from comparison of calculation and experiment, it appears that kinetics is not necessarily an insuperable barrier to engineering the phase composition of a hydrated Portland cement. Also the sensitivity of the mineralogy of the AFm and AFt phase compositions to the presence of calcite and to temperature has been reported. This knowledge gives a powerful incentive to develop links between the mineralogy and engineering properties of hydrated cement paste and, of course, anticipates improvements in its performance leading to decreasing the environmental impacts of cement production.

  4. [Allergy towards bone cement].

    PubMed

    Thomas, P; Schuh, A; Summer, B; Mazoochian, F; Thomsen, M

    2006-09-01

    Bone cements based on polymethylmethacrylate are typically used for fixation of artificial joints. Intolerance reactions to endoprostheses not explained by infection or mechanical failure may lead to allergological diagnostics, which mostly focuses on metal allergy. However, also bone cement components may provoke hypersensitivity reactions leading to eczema, implant loosening, or fistula formation. Elicitors of such reactions encompass acrylates and additives such as benzoyl peroxide, N,N-dimethyl-p-toluidine, hydroquinone, or antibiotics (particularly gentamicin). Upon repeated contact with bone cement components, e.g., acrylate monomers, also in medical personnel occasionally hand eczema or even asthma may develop. Therefore, in the case of suspected hypersensitivity reactions to arthroplasty, the allergological diagnostics should include bone cement components. PMID:16865384

  5. Environmentally compatible spray cement

    SciTech Connect

    Loeschnig, P.

    1995-12-31

    Within the framework of a European research project, Heidelberger Zement developed a quickly setting and hardening binder for shotcrete, called Chronolith S, which avoids the application of setting accelerators. Density and strength of the shotcrete produced with this spray cement correspond to those of an unaccelerated shotcrete. An increased hazard for the heading team and for the environment, which may occur when applying setting accelerators, can be excluded here. Owing to the special setting properties of a spray cement, the process engineering for its manufacturing is of great importance. The treatment of a spray cement as a dry concrete with kiln-dried aggregates is possible without any problems. The use of a naturally damp pre-batched mixture is possible with Chronolith S but requires special process engineering; spray cement and damp aggregate are mixed with one another immediately before entering the spraying machinery.

  6. Durability of pulp fiber-cement composites

    NASA Astrophysics Data System (ADS)

    Mohr, Benjamin J.

    Wood pulp fibers are a unique reinforcing material as they are non-hazardous, renewable, and readily available at relatively low cost compared to other commercially available fibers. Today, pulp fiber-cement composites can be found in products such as extruded non-pressure pipes and non-structural building materials, mainly thin-sheet products. Although natural fibers have been used historically to reinforce various building materials, little scientific effort has been devoted to the examination of natural fibers to reinforce engineering materials until recently. The need for this type of fundamental research has been emphasized by widespread awareness of moisture-related failures of some engineered materials; these failures have led to the filing of national- and state-level class action lawsuits against several manufacturers. Thus, if pulp fiber-cement composites are to be used for exterior structural applications, the effects of cyclical wet/dry (rain/heat) exposure on performance must be known. Pulp fiber-cement composites have been tested in flexure to examine the progression of strength and toughness degradation. Based on scanning electron microscopy (SEM), environmental scanning electron microscopy (ESEM), energy dispersive spectroscopy (EDS), a three-part model describing the mechanisms of progressive degradation has been proposed: (1) initial fiber-cement/fiber interlayer debonding, (2) reprecipitation of crystalline and amorphous ettringite within the void space at the former fiber-cement interface, and (3) fiber embrittlement due to reprecipitation of calcium hydroxide filling the spaces within the fiber cell wall structure. Finally, as a means to mitigate kraft pulp fiber-cement composite degradation, the effects of partial portland cement replacement with various supplementary cementitious materials (SCMs) has been investigated for their effect on mitigating kraft pulp fiber-cement composite mechanical property degradation (i.e., strength and toughness

  7. Calcite cement generations after sulphate dissolution - Evidence for uplift diagenesis in Capitan and Zechstein carbonates

    SciTech Connect

    Harwood, G. ); Lee, M. ); Darke, G. )

    1991-03-01

    Upper Permian Capitan shelf margin and U.K. Zechstein carbonates contain evidence of former replacive anhydrite, formed early during their diagenetic histories. Both sequences were uplifted during the last 90 Ma with consequent sulfate hydration and dissolution. Resultant open cavities are occluded by calcite cements. Cement generations in the two areas are strikingly similar, although the areas were in contrasting climatic belts during uplift. Earliest uplift cements contain relics/evidence of former sulfates with minor bacteriogenic sulfide and precipitation from sulfate reduction. Two major generations of cavity-lining calcite cements formed after sulfate dissolution. Geochemical and isotopic analyses demonstrate these cements to be aquifer-related. The earlier luminescent cements, precipitated from stagnant anoxic waters, were etched and corroded, before minor iron oxide precipitation. These iron oxides enable paleomagnetic dating of uplift. The corrosion marks an anoxic-oxic transition within the pore fluids, with a later incursion of active oxic fluids, from which were precipitated iron-free nonluminescent columnar cements. Cores through the Zechstein carbonates show that cement phases develop successively as uplift proceeds. Thus cement generations were not precipitated synchronously but are representative of different levels within a downwards-penetrating aquifer. The cements relate to successive stages of aquifer evolution and allow a common history of uplift diagenesis to be determined for both areas, although on different continents and within different climatic zones. A similar cement sequence related to downwards aquifer penetration is thus predicted for other areas where sulfate dissolution has occurred on uplift.

  8. Evaluation of acetabular cup initial fixation by using resonance frequency principle.

    PubMed

    Henys, Petr; Capek, Lukas; Fencl, Jaroslav; Prochazka, Egon

    2015-01-01

    The clinical practice shows that the loosening of acetabular cups is more frequent than stem loosening. With standard cups, the incidence of dislocation failure is highest in the first year after arthroplasty implantation. The aim of the study was to quantitatively evaluate the implant-bone stability of a cementless acetabular cup prosthesis by using a device based on resonance frequency analysis. The evaluation of this device was done by finite element analysis and in vitro experiments. It was shown that not all the resonance frequencies can be measured by our device. The resonance frequencies vary within the range of 500-3000 Hz. The proposed power spectrum measurement gives the information about the absolute stiffness of the press-fit implant. PMID:25655952

  9. Uncemented acetabular components. Histologic analysis of retrieved hydroxyapatite-coated and porous implants.

    PubMed

    Bauer, T W; Stulberg, B N; Ming, J; Geesink, R G

    1993-04-01

    Histologic sections of five hydroxyapatite-coated acetabular components retrieved at autopsy (2 dual geometry and 3 threaded cup designs) were analyzed, and the extent and pattern of bone apposition were compared with that of an uncoated, porous (beaded) dual geometry acetabular cup that had been removed for repeated dislocations. The results show hydroxyapatite and bone apposition most prominent in areas of likely load transmission, primarily around the peripheral rim of the dual-geometry cups and at the peaks of the threads of the screw cups. Hydroxyapatite and bone may have been removed by remodeling from the grooves between the threads. Although no significant wear debris was identified, the screw holes were incompletely covered by bone. The dual-geometry designs generally showed somewhat more bone apposition than the threaded cups, but all implants demonstrated less bone than might have been predicted from radiographs. PMID:8386747

  10. Advanced material modelling in numerical simulation of primary acetabular press-fit cup stability.

    PubMed

    Souffrant, R; Zietz, C; Fritsche, A; Kluess, D; Mittelmeier, W; Bader, R

    2012-01-01

    Primary stability of artificial acetabular cups, used for total hip arthroplasty, is required for the subsequent osteointegration and good long-term clinical results of the implant. Although closed-cell polymer foams represent an adequate bone substitute in experimental studies investigating primary stability, correct numerical modelling of this material depends on the parameter selection. Material parameters necessary for crushable foam plasticity behaviour were originated from numerical simulations matched with experimental tests of the polymethacrylimide raw material. Experimental primary stability tests of acetabular press-fit cups consisting of static shell assembly with consecutively pull-out and lever-out testing were subsequently simulated using finite element analysis. Identified and optimised parameters allowed the accurate numerical reproduction of the raw material tests. Correlation between experimental tests and the numerical simulation of primary implant stability depended on the value of interference fit. However, the validated material model provides the opportunity for subsequent parametric numerical studies. PMID:22817471

  11. Ionic modification of calcium phosphate cement viscosity. Part II: hypodermic injection and strength improvement of brushite cement.

    PubMed

    Barralet, J E; Grover, L M; Gbureck, U

    2004-05-01

    Brushite-forming calcium phosphate cements are of great interest as bone replacement materials because they are resorbable in physiological conditions. However, their short setting times, low mechanical strengths and limited injectability limit broad clinical application. In this study, we showed that a significant improvement of these properties of brushite cement could be achieved by the use of sodium citrate or citric acid as setting retardants, such that workable cement pastes with a powder to liquid ratio of up to 5 could be manufactured. The cement used in this study consisted of an equimolar powder mixture of beta-tricalcium phosphate and monocalcium phosphate hydrate The use of 500 mM-1M retardant solutions as liquid phase enabled initial setting times of 8-12 min. Wet compressive strength were found to be in the range between 12-18 MPa after immersion of uncompacted cement samples in serum for 24 h. A further strength improvement to 32 MPa was obtained by compaction of the cement paste during samples preparation. This is significant because high-temperature processes cannot be used to fabricate hydrated calcium phosphate materials. Cement pastes were injectable through a hypodermic needle at a powder to liquid ratio of 3.3 g/ml when a 1M citric acid was used as liquid phase, thus enabling precise controlled delivery to small defects. PMID:14741635

  12. Spontaneous Acetabular Periprosthetic Fracture in a Patient Continuously Having Zoledronic Acid

    PubMed Central

    Tantavisut, Saran; Thanakit, Voranuch; Ngarmukos, Srihatach; Wilairatana, Vajara; Wangroongsub, Yongsak

    2014-01-01

    Zoledronic acid has been used for prevention of osteolytic and osteoblastic bone metastasis. This case report illustrates an undesirable consequence from prolonged usage of zoledronic acid in bone metastasis prevention. Periprosthetic acetabular fracture in a patient treated with zoledronic acid for 7 years was reported. The clinical presentation, radiographic and pathological results were described. This is a rare complication after total hip arthroplasty which should not be ignored especially in patients who received long term bisphosphonate. PMID:25177464

  13. Retrograde Transpubic Approach for Percutaneous Radiofrequency Ablation and Cementoplasty of Acetabular Metastasis

    PubMed Central

    Bauones, Salem; Freire, Veronique; Moser, Thomas P.

    2015-01-01

    We report a case of painful and disabling anterior acetabular bone metastasis treated with bipolar radiofrequency ablation and cementoplasty. Due to the high risk of complications related to the proximity of the femoral neurovascular structures with a direct approach, we successfully performed a retrograde transpubic approach under combined CT and fluoroscopic guidance. In the present report, we describe this approach detailing its indications, advantages, and the technical tips to achieve a safe and satisfactory procedure. PMID:26491595

  14. Custom-made locked plating for acetabular fracture: a pilot study in 24 consecutive cases.

    PubMed

    Xu, Meng; Zhang, Li-Hai; Zhang, Ying-Ze; Zhang, Li-Cheng; He, Chun-Qing; Wang, Yan; Tang, Pei-Fu

    2014-07-01

    Clinical implementation of site-specific locking plates for acetabular fracture remains untested. Custom-made locking plates were manufactured using computer-aided design and computer-aided manufacture techniques for acetabular fractures to test this procedure. The 3-dimensional images constructed from computed tomography data of pelvises in patients with acetabular fractures were used for preoperative planning and to design the plates. Data for each plate were input into software for programming, and the generated code was transferred into a computerized numerical control digital milling machine for manufacturing. These plates were clinically implemented, and the implementation parameters, reduction quality, and Postel Merle d'Aubigné score were evaluated. Forty-nine custom-made locking plates were manufactured for 24 unilateral acetabular fractures. The manufacturing process for the plates averaged 6.9±2.2 days. Processing the plates delayed operations by 2.6±1.3 days in one-third of the cases. Plate contouring was avoided in 48 plates. The plates had anatomical shapes, excellently matching reduced bone surface. The screws locked with the obtained plates avoided intra-articular penetration and provided secure fixation that allowed early out-of-bed rehabilitation. No indications of implant failures or observations of screw back-outs were observed during follow-up. The clinical application of such plates is associated with the avoidance of plate contouring, low risk of intra-articular penetration, early out-of-bed rehabilitation, and a low rate of implant failure. Implementing such plates in clinical practice is worthy of further investigation, with a focus on selecting patient population and minimizing the time required for and cost of plate manufacturing. PMID:24992064

  15. Articular cartilage friction increases in hip joints after the removal of acetabular labrum.

    PubMed

    Song, Yongnam; Ito, Hiroshi; Kourtis, Lampros; Safran, Marc R; Carter, Dennis R; Giori, Nicholas J

    2012-02-01

    The acetabular labrum is believed to have a sealing function. However, a torn labrum may not effectively prevent joint fluid from escaping a compressed joint, resulting in impaired lubrication. We aimed to understand the role of the acetabular labrum in maintaining a low friction environment in the hip joint. We did this by measuring the resistance to rotation (RTR) of the hip, which reflects the friction of the articular cartilage surface, following focal and complete labrectomy. Five cadaveric hips without evidence of osteoarthritis and impingement were tested. We measured resistance to rotation of the hip joint during 0.5, 1, 2, and 3 times body weight (BW) cyclic loading in the intact hip, and after focal and complete labrectomy. Resistance to rotation, which reflects articular cartilage friction in an intact hip was significantly increased following focal labrectomy at 1-3 BW loading, and following complete labrectomy at all load levels. The acetabular labrum appears to maintain a low friction environment, possibly by sealing the joint from fluid exudation. Even focal labrectomy may result in increased joint friction, a condition that may be detrimental to articular cartilage and lead to osteoarthritis. PMID:22176711

  16. Postural correction reduces hip pain in adult with acetabular dysplasia: a case report

    PubMed Central

    Lewis, Cara L.; Khuu, Anne; Marinko, Lee

    2015-01-01

    Developmental dysplasia of the hip is often diagnosed in infancy, but less severe cases of acetabular dysplasia are being detected in young active adults. The purpose of this case report is to present a non-surgical intervention for a 31-year-old female with mild acetabular dysplasia and an anterior acetabular labral tear. The patient presented with right anterior hip and groin pain, and she stood with the trunk swayed posterior to the pelvis (swayback posture). The hip pain was reproduced with the anterior impingement test. During gait, the patient maintained the swayback posture and reported 6/10 hip pain. Following correction of the patient’s posture, the patient’s pain rating was reduced to a 2/10 while walking. The patient was instructed to maintain the improved posture. At the 1 year follow-up, she demonstrated significantly improved posture in standing and walking. She had returned to recreational running and was generally pain-free. The patient demonstrated improvement on self-reported questionnaires for pain, function and activity. These findings suggest that alteration of posture can have an immediate and lasting effect on hip pain in persons with structural abnormality and labral pathology. PMID:25731688

  17. ANALYSIS OF THE SEGMENTAL IMPACTION OF FEMORAL HEAD FOLLOWING AN ACETABULAR FRACTURE SURGICALLY MANAGED

    PubMed Central

    Guimarães, Rodrigo Pereira; Kaleka, Camila Cohen; Cohen, Carina; Daniachi, Daniel; Keiske Ono, Nelson; Honda, Emerson Kiyoshi; Polesello, Giancarlo Cavalli; Riccioli, Walter

    2015-01-01

    Objective: Correlate the postoperative radiographic evaluation with variables accompanying acetabular fractures in order to determine the predictive factors for segmental impaction of femoral head. Methods: Retrospective analysis of medial files of patients submitted to open reduction surgery with internal acetabular fixation. Within approximately 35 years, 596 patients were treated for acetabular fractures; 267 were followed up for at least two years. The others were excluded either because their follow up was shorter than the minimum time, or as a result of the lack of sufficient data reported on files, or because they had been submitted to non-surgical treatment. The patients were followed up by one of three surgeons of the group using the Merle d'Aubigné and Postel clinical scales as well as radiological studies. Results: Only tow studied variables-age and amount of postoperative reductionshowed statistically significant correlation with femoral head impaction. Conclusions: The quality of reduction-anatomical or with up to 2mm residual deviation-presents a good radiographic evolution, reducing the potential for segmental impaction of the femoral head, a statistically significant finding. PMID:27004191

  18. Temporary Balloon Occlusion of the Abdominal Aorta in Treatment of Complex Acetabular Fracture

    PubMed Central

    Hao, Zhenhai; Zhou, Dongsheng; Wang, Fu; Li, Lianxin; He, Jiliang

    2016-01-01

    Background The aim of this study was to explore the efficacy of temporary balloon occlusion of the abdominal aorta assisting open reduction and internal fixation (ORIF) in the treatment of complex acetabular fracture. Material/Methods From August 2000 to October 2011, a total of 48 patients with complex acetabular fracture were enrolled in this study. Average operative time, intraoperative blood loss volume, blood transfusion volume, satisfactory reduction, and postoperative functional recovery rate were recorded and compared between the 2 groups. Results A significant difference was observed between the 2 groups in operative time (P=0.003). For intraoperative blood loss and blood transfusion, ORIF combined with temporary balloon occlusion of abdominal aorta techniques appeared to be superior to normal ORIF (blood loss: P=0.007; and blood transfusion: P=0.019, respectively). However, no differences were observed in postoperative blood loss or transfusion (P>0.05). Patients in group A showed better hip function than those in group B (group A: a good-to-excellent rate of 77.8%; group B: a good-to-excellent rate of 78.3%; P>0.05). With regard to the incidence of postoperative complications, there were no significant differences between the 2 groups (group A: 9/18; group B: 11/23; P=0.890). Conclusions In the treatment of complex acetabular fracture, temporary balloon occlusion of the abdominal aorta is a reliable technique to assist ORIF surgery to staunch the flow of blood. PMID:27367975

  19. Histology of damaged acetabular cartilage in symptomatic femoroacetabular impingement: an observational analysis.

    PubMed

    Kohl, Sandro; Hosalkar, Harish S; Mainil-Varlet, P; Krueger, Andreas; Buechler, Lorenz; Siebenrock, Klaus

    2011-01-01

    This prospective study on symptomatic adult patients with femoroacetabular impingement (FAI) who underwent open surgical intervention for management was designed to identify any obvious histological differences in the damaged acetabular cartilage within different subgroups of FAI. 20 patients underwent surgical intervention following safe surgical dislocation of the hip. There were 6 cases of cam impingement, 5 cases of pincer impingement and 9 of the mixed type. Pincer impingement cases demonstrated a characteristic focal, well-circumscribed and localized area of severe damage. On the other hand, cases with cam impingement showed a diffuse area of involvement affecting a larger surface of the acetabular cartilage, with degenerative changes, superficial erosions and some discontinuities. A small biopsy specimen of the acetabular rim including bone, cartilage and labrum from the affected zone was obtained in all cases. Histological evaluation was performed under normal and polarized light microscopy. Histological findings helped corroborate the pre-operative diagnosis and also define the unique nature of impingement and specific damage according to the type of impingement. PMID:21484743

  20. Reuse of grits waste for the production of soil--cement bricks.

    PubMed

    Siqueira, F B; Holanda, J N F

    2013-12-15

    This investigation focuses on the reuse of grits waste as a raw material for replacing Portland cement by up to 30 wt.% in soil-cement bricks. The grits waste was obtained from a cellulose factory located in south-eastern Brazil. We initially characterized the waste sample with respect to its chemical composition, X-ray diffraction, fineness index, morphology, pozzolanic activity, and pollution potential. Soil-cement bricks were then prepared using the waste material and were tested to determine their technological properties (e.g., water absorption, apparent density, volumetric shrinkage, and compressive strength). Microstructural evolution was accompanied by confocal microscopy. It was found that the grits waste is mainly composed of calcite (CaCO3) particles. Our results indicate that grits waste can be used economically, safely, and sustainably at weight percentages of up to 20% to partially replace Portland cement in soil-cement bricks. PMID:24140481

  1. ULTRA-LIGHTWEIGHT CEMENT

    SciTech Connect

    Fred Sabins

    2001-10-23

    The objective of this project is to develop an improved ultra-lightweight cement using ultra-lightweight hollow glass spheres (ULHS). Work reported herein addresses tasks performed in the fourth quarter as well as the other three quarters of the past year. The subjects that were covered in previous reports and that are also discussed in this report include: Analysis of field laboratory data of active cement applications from three oil-well service companies; Preliminary findings from a literature review focusing on problems associated with ultra-lightweight cements; Summary of pertinent information from Russian ultra-lightweight cement literature review; and Comparison of compressive strengths of ULHS systems using ultrasonic and crush methods Results reported from the fourth quarter include laboratory testing of ULHS systems along with other lightweight cement systems--foamed and sodium silicate slurries. These comparison studies were completed for two different densities (10.0 and 11.5 lb/gal) and three different field application scenarios. Additional testing included the mechanical properties of ULHS systems and other lightweight systems. Studies were also performed to examine the effect that circulation by centrifugal pump during mixing has on breakage of ULHS.

  2. System for radioactive waste cementation

    SciTech Connect

    Dmitriev, S.A.; Barinov, A.S.; Varlakov, A.P.; Volkov, A.S.; Karlin, S.V.

    1995-12-31

    NPP, research reactors and radiochemical enterprises produce a great amount of liquid radioactive waste (LRW). One of the methods of LRW solidification is cementation. The recent investigations demonstrated possible inclusion of sufficient amount of waste in the cement matrix (up to 20--30 mass% on dry residue). In this case the cementation process becomes competitive with bituminization process, where the matrix can include 40--50 mass% and the solidified product volume is equal to the volume, obtained by cementation. Additionally, the cement matrix in contrast with the bituminous one is unburnable. Many countries are investigating the cementation process. The main idea governing technological process is the waste and cement mixing method and type of mixer. In world practice some principal types of cementation systems are used. The paper describes the SIA Radon industrial plant in Moscow.

  3. Recycled rubber in cement composites

    SciTech Connect

    Raghavan, D.; Tratt, K.; Wool, R.P.

    1994-12-31

    Disposal of 200 million waste tires in the US each year has become a major problem. An environmentally sound innovative technology of recycling rubber in cement matrix was examined. Using silane coupling agent the rubber was bonded to the hydrating cement making a lighter composite, which absorbed more energy than ordinary Portland cement. The bonding information was obtained by peel strength analysis. SEM was used to understand the mode of fracture in pure cement paste, cement bonded rubber composite and rubber filled cement paste. It was found that cracks propagate through the rubber particle in rubber bonded cement composite while in unbonded rubber cement mix, the cracks propagate around the interface. The density and shrinkage measurements are also discussed.

  4. OPERATIVE TREATMENT OF TRANSVERSE ACETABULAR FRACTURES: IS IT REALLY NECESSARY TO FIX BOTH COLUMNS?

    PubMed Central

    Giordano, Vincenzo; do Amaral, Ney Pecegueiro; Pallottino, Alexandre; Albuquerque, Rodrigo Pires e; Franklin, Carlos Eduardo; Labronici, Pedro José

    2009-01-01

    Objective: we prospectively evaluated clinical and radiographic outcomes in patients with displaced combined transverse-posterior wall acetabular fractures managed at our Institution over a period of seven years by posterolateral single approach, direct posterior wall and posterior column reduction and plating, and indirect reduction of anterior column controlled by fluoroscopic images with or without lag-screw fixation. The aim was to identify if the obtained immediate postoperative Matta radiographic roof-arc angles after fracture reduction and fixation alters in the postoperative period when comparing posterior plating alone versus posterior plate and anterior column lag-screw fixation. Patients and Methods: 35 skeletally mature patients (31 male and four female, with mean age of 39.9 years old [range, 23.3 to 66.7 y/o]) with combined transverse-posterior wall acetabular fractures surgically treated by a posterolateral single approach were enrolled in this prospective investigation. Nineteen patients had associated orthopaedic injuries. The first part of the acetabular fracture management was similar to all patients and consisted in anatomical reduction and fixation of the transverse posterior component followed by anatomical reduction and fixation of the posterior wall component. The transverse anterior component reduction was controlled by fluoroscopic images (anteroposterior (AP), iliac oblique, and obturator oblique views) and digital palpation through the greater sciatic notch. Fifteen of the 35 patients had an additional lag-screw fixation from the posterior to the anterior columns with an extra-long small-fragment cortical screw. AP and Judet oblique radiographic views were taken at the end of the procedure and roof-arc angles were measured. Clinical results were assigned according to the grading system of Merle D'Aubigne´ and Postel as modified by Matta et al. Radiographic roof-arc angles were checked and compared between the two groups of patients to

  5. Small-particle-size cement

    SciTech Connect

    Ewert, D.P.; Almond, S.W.; Blerhaus, W.M. II )

    1991-05-01

    Successful remedial cementing has historically been difficult in wells with large-interval, multizone, gravel-packed completions. The reason is the inability of conventional oilfield cements to penetrate gravel packs adequately. Small-particle-size cement (SPSC) was developed to penetrate gravel packs and to provide the zonal isolation required. This paper details the laboratory work, job design, and field implementation of this new cement.

  6. Cement Mason's Curriculum. Instructional Units.

    ERIC Educational Resources Information Center

    Hendirx, Laborn J.; Patton, Bob

    To assist cement mason instructors in providing comprehensive instruction to their students, this curriculum guide treats both the skills and information necessary for cement masons in commercial and industrial construction. Ten sections are included, as follow: related information, covering orientation, safety, the history of cement, and applying…

  7. High temperature lightweight foamed cements

    DOEpatents

    Sugama, Toshifumi.

    1989-10-03

    Cement slurries are disclosed which are suitable for use in geothermal wells since they can withstand high temperatures and high pressures. The formulation consists of cement, silica flour, water, a retarder, a foaming agent, a foam stabilizer, and a reinforcing agent. A process for producing these cements is also disclosed. 3 figs.

  8. High temperature lightweight foamed cements

    DOEpatents

    Sugama, Toshifumi

    1989-01-01

    Cement slurries are disclosed which are suitable for use in geothermal wells since they can withstand high temperatures and high pressures. The formulation consists of cement, silica flour, water, a retarder, a foaming agent, a foam stabilizer, and a reinforcing agent. A process for producing these cements is also disclosed.

  9. Cementing a wellbore using cementing material encapsulated in a shell

    DOEpatents

    Aines, Roger D.; Bourcier, William L.; Duoss, Eric B.; Spadaccini, Christopher M.; Cowan, Kenneth Michael

    2016-08-16

    A system for cementing a wellbore penetrating an earth formation into which a pipe extends. A cement material is positioned in the space between the wellbore and the pipe by circulated capsules containing the cement material through the pipe into the space between the wellbore and the pipe. The capsules contain the cementing material encapsulated in a shell. The capsules are added to a fluid and the fluid with capsules is circulated through the pipe into the space between the wellbore and the pipe. The shell is breached once the capsules contain the cementing material are in position in the space between the wellbore and the pipe.

  10. Retention of posts cemented with various dentinal bonding cements.

    PubMed

    Mendoza, D B; Eakle, W S

    1994-12-01

    This investigation evaluated the retention of preformed posts with four different cements: C & B Metabond, Panavia, All-Bond 2, and Ketac-Cem. Sixty intact maxillary canines were selected for the study. The clinical crowns were removed and endodontic therapy done on each root, which was then prepared to receive prefabricated posts. The 60 samples were divided into four groups of 15, and the posts in each group were cemented with one of the four cements. The roots were mounted in acrylic resin blocks and the posts were separated from the canals with an Instron testing machine. Analysis of the forces needed to dislodge the posts with analysis of variance and Student-Newman-Keuls test disclosed that C & B Metabond cement was the most retentive (p < 0.05). No difference in retention was recorded between Ketac-Cem and Panavia cements. All-Bond 2 cement was the least retentive of cements. PMID:7853255

  11. In vivo performance of a reduced-modulus bone cement

    NASA Astrophysics Data System (ADS)

    Forehand, Brett Ramsey

    Total joint replacement has become one of the most common procedures in the area of orthopedics and is often the solution in patients with diseased or injured hip joints. Component loosening is a significant problem and is primarily caused by bone resorption at the bone-cement interface in cemented implants. It is our hypothesis that localized shear stresses are responsible for the resorption. It was previously shown analytically that local stresses at the interface could be reduced by using a cement of lower modulus. A new reduced modulus cement, polybutyl methylmethacrylate (PBMMA), was developed to test the hypothesis. PBMMA was formulated to exist as polybutyl methacrylate filler in a polymethyl methacrylate matrix. The success of PBMMA cement is based largely on the fact that the polybutyl component of the cement will be in the rubbery state at body temperature. In vitro characterization of the cement was undertaken previously and demonstrated a modulus of approximately one-eighth that of conventional bone cement, polymethyl methacrylate (PMMA) and increased fracture toughness. The purpose of this experiment was to perform an in vivo comparison of the two cements. A sheep model was selected. Total hip arthroplasty was performed on 50 ewes using either PBMMA or PMMA. Radiographs were taken at 6 month intervals. At one year, the contralateral femur of each sheep was implanted so that each animal served as its own control, and the animals were sacrificed. The stiffness of the bone-cement interface of the femoral component within the femur was assessed by applying a torque to the femoral component and demonstrated a significant difference in loosening between the cements when the specimens were tested in external rotation (p < 0.007). Evaluation of the mechanical data also suggests that the PBMMA sheep had a greater amount of loosening for each subject, 59% versus 4% for standard PMMA. A radiographic analysis demonstrated more signs of loosening in the PMMA series

  12. Cement compositions for cementing wells allowing pressure gas channeling in the cemented annulus to be controlled

    SciTech Connect

    Porcevaux, P. A.; Piot, B. M.; Vercaemer, C. J.

    1985-08-27

    The invention relates to cement compositions for cementing wells, which allow pressure gas-channeling to be effectively controlled up to more than about 485 F. The cement composition contains a styrene-butadiene latex and a stabilizer. The film of latex interrupts gas-channeling after an extremely brief path.

  13. Rubber cement poisoning

    MedlinePlus

    ... common household glue. It is often used for arts and crafts projects. Breathing in large amounts of rubber cement fumes or swallowing any amount can be extremely dangerous, especially for a small child. This article is for information only. Do NOT ...

  14. Exposure of the superior gluteal neurovascular bundle for the safe application of acetabular reinforcement cages in complex revisions.

    PubMed

    Smitham, Peter J; Kosuge, Dennis; Howie, Donald W; Solomon, Lucian B

    2016-05-16

    The posterior approach to the hip is the most common extensile approach used, however exposure is limited superiorly by the superior gluteal neurovascular bundle (SGNB). The extra-pelvic course of the SGNB demonstrates variability between individuals, occasionally located only 1 cm from the acetabular rim. In complex acetabular reconstructions where the application of a reinforcement cage maybe required protecting the SGNB is challenging. The flanges of these cages are designed to sit on the ilium superior to the acetabular rim and to receive screws for fixation. The application of such cages may result in iatrogenic injury to the SGNB by way of forceful retraction or entrapment. We describe a technique that involves exposure and release of the SGNB such that the flanges of cage constructs may be safely applied. PMID:27079287

  15. Antibiotic-loaded bone cement in total joint arthroplasty.

    PubMed

    Soares, Daniel; Leite, Pedro; Barreira, Pedro; Aido, Ricardo; Sousa, Ricardo

    2015-06-01

    Periprosthetic joint infection is a devastating complication after total joint replacement. Prevention is mandatory and systemic antibiotic prophylaxis is nowadays a recognized cornerstone. Further addition of local antibiotics eluting from bone cement is a real possibility but its routine use is controversial. Pros and cons of its routine use in primary and revision total joint arthroplasty will be discussed. Cement spacers carrying high doses of antibiotic(s) are currently accepted during two-stage treatment of infected prosthetic joints. Several issues such as alternatives to classic antibiotics, optimal dosages and others will also be explored. PMID:26280954

  16. Optimal acetabular component orientation estimated using edge-loading and impingement risk in patients with metal-on-metal hip resurfacing arthroplasty.

    PubMed

    Mellon, Stephen J; Grammatopoulos, George; Andersen, Michael S; Pandit, Hemant G; Gill, Harinderjit S; Murray, David W

    2015-01-21

    Edge-loading in patients with metal-on-metal resurfaced hips can cause high serum metal ion levels, the development of soft-tissue reactions local to the joint called pseudotumours and ultimately, failure of the implant. Primary edge-loading is where contact between the femoral and acetabular components occurs at the edge/rim of the acetabular component whereas impingement of the femoral neck on the acetabular component's edge causes secondary or contrecoup edge-loading. Although the relationship between the orientation of the acetabular component and primary edge-loading has been identified, the contribution of acetabular component orientation to impingement and secondary edge-loading is less clear. Our aim was to estimate the optimal acetabular component orientation for 16 metal-on-metal hip resurfacing arthroplasty (MoMHRA) subjects with known serum metal ion levels. Data from motion analysis, subject-specific musculoskeletal modelling and Computed Tomography (CT) measurements were used to calculate the dynamic contact patch to rim (CPR) distance and impingement risk for 3416 different acetabular component orientations during gait, sit-to-stand, stair descent and static standing. For each subject, safe zones free from impingement and edge-loading (CPR <10%) were defined and, consequently, an optimal acetabular component orientation was determined (mean inclination 39.7° (SD 6.6°) mean anteversion 14.9° (SD 9.0°)). The results of this study suggest that the optimal acetabular component orientation can be determined from a patient's motion and anatomy. However, 'safe' zones of acetabular component orientation associated with reduced risk of dislocation and pseudotumour are also associated with a reduced risk of edge-loading and impingement. PMID:25482661

  17. Reuse of cement-solidified municipal incinerator fly ash in cement mortars: physico-mechanical and leaching characteristics.

    PubMed

    Cinquepalmi, Maria Anna; Mangialardi, Teresa; Panei, Liliana; Paolini, Antonio Evangelista; Piga, Luigi

    2008-03-01

    The reuse of cement-solidified Municipal Solid Waste Incinerator (MSWI) fly ash (solidified/stabilised (S/S) product) as an artificial aggregate in Portland cement mortars was investigated. The S/S product consisted of a mixture of 48 wt.% washed MSWI fly ash, 20 wt.% Portland cement and 32 wt.% water, aged for 365 days at 20 degrees C and 100% RH. Cement mortars (water/cement weight ratio=0.62) were made with Portland cement, S/S product and natural sand at three replacement levels of sand with S/S product (0%, 10% and 50% by mass). After 28 days of curing at 20 degrees C and 100% RH, the mortar specimens were characterised for their physico-mechanical (porosity, compressive strength) and leaching behaviour. No retardation in strength development, relatively high compressive strengths (up to 36 N/mm2) and low leaching rates of heavy metals (Cr, Cu, Pb and Zn) were always recorded. The leaching data from sequential leach tests on monolithic specimens were successfully elaborated with a pseudo-diffusional model including a chemical retardation factor related to the partial dissolution of contaminant. PMID:17658684

  18. Bone cement improves suture anchor fixation.

    PubMed

    Giori, Nicholas J; Sohn, David H; Mirza, Faisal M; Lindsey, Derek P; Lee, Arthur T

    2006-10-01

    Suture anchor fixation failure can occur if the anchor pulls out of bone. We hypothesized that suture anchor fixation can be augmented with polymethylmethacrylate cement, and that polymethylmethacrylate can be used to improve fixation in a stripped anchor hole. Six matched cadaveric proximal humeri were used. On one side, suture anchors were placed and loaded to failure using a ramped cyclic loading protocol. The stripped anchor holes then were injected with approximately 1 cc polymethylmethacrylate, and anchors were replaced and tested again. In the contralateral humerus, polymethylmethacrylate was injected into anchor holes before anchor placement and testing. In unstripped anchors, polymethylmethacrylate increased the number of cycles to failure by 34% and failure load by 71% compared with anchors not augmented with polymethylmethacrylate. Polymethylmethacrylate haugmentation of stripped anchors increased the cycles to failure by 31% and failure load by 111% compared with unstripped uncemented anchors. No difference was found in cycles to failure or failure load between cemented stripped anchors and cemented unstripped anchors. Polymethylmethacrylate can be used to augment fixation, reducing the risk of anchor pull-out failure, regardless whether the suture anchor hole is stripped or unstripped. PMID:16702922

  19. Morphometric assessment of the canine hip joint using the dorsal acetabular rim view and the centre-edge angle.

    PubMed

    Meomartino, L; Fatone, G; Potena, A; Brunetti, A

    2002-01-01

    The dorsal acetabular rim (DAR) view of the hip joint can be used to assess the weightbearing portion of the acetabulum and the acetabular coverage, providing an adjunct to the conventional ventrodorsal (VD) view in the radiographic evaluation of hip dysplasia in the dog. A quantitative index of acetabular coverage in the DAR view, the acetabular slope (AS) angle, was originally proposed in 1990. The aim of the present study was to make a prospective, comparative assessment of a new parameter, the centre-edge (CE) angle, with the AS angle, for the evaluation of the acetabular coverage of the femoral head in the DAR view. The reliability and repeatability of the two parameters was assessed using the r(I) value of intraclass correlation coefficient (ICC) in a prospective study of 208 hip joints in large and giant breed dogs. An estimation of the added value of using the DAR view, compared with that of the VD standard view alone, was also assessed. The CE angle showed a higher r(I) value compared with the AS angle; in 26 per cent of hips of FCI classes A, B and C, the DAR view provided additional diagnostic information compared with the VD view, with respect to lateralisation and/or initial changes to the dorsal rim. It is concluded that the CE angle is more reliable than the AS angle in the evaluation of acetabular coverage, and that the DAR view provides valuable data compared with the VD view alone in the early stages of canine hip dysplasia. PMID:11833819

  20. Cross-sectional Anatomy of Ilium for Guiding Acetabular Component Placement Using High Hip Center Technique in Asian Population

    PubMed Central

    Xiao, Jian-Lin; Zuo, Jian-Lin; Liu, Peng; Qin, Yan-Guo; Li, Xue-Zhou; Liu, Tong; Gao, Zhong-Li

    2015-01-01

    Background: Many clinical studies have been published involving the use of a high hip center (HHC), achieved good follow-up. However, there is a little anatomic guidance in the literature regarding the amount of bone stock available for initial implant coverage in this area of the ilium. The purpose of this study was to evaluate the thickness and width of the human ilium and related acetabular cup coverage for guiding acetabular component placement in HHC. Methods: A total of 120 normal hips in 60 cases of adult patients from lower extremities computer tomographic angiography Digital Imaging and Communications in Medicine data were chosen for the study. After importing the data to the mimics software, we chose the cross sections every 5-mm increments from the rotational center of the hip to the cephalic of the ilium according the body sagittal axis, then we measured the thickness and width of the ilium for each cross section in axial plane, calculated the cup coverage at each chosen section. Results: At the acetabular dome, the mean thickness and width of the ilium were 49.71 ± 4.88 mm and 38.92 ± 3.67 mm, respectively, whereas at 1 cm above the dome, decreased to 41.35 ± 5.13 and 31.13 ± 3.37 respectively, and 2 cm above the dome, decreased to 31.25 ± 4.04 and 26.65 ± 3.43, respectively. Acetabular cup averaged coverage for 40-, 50-, and 60-mm hemispheric shells, was 100%, 89%, and 44% at the acetabular dome, 100%, 43.7%, and 27.5% for 1 cm above the dome, and 37.5%, 21.9%, and 14.2% for 2 cm above the dome. Conclusions: HHC reconstructions within 1 cm above the acetabular dome will be an acceptable and smaller diameter prosthesis would be better. PMID:26063357

  1. Hip joint replacement

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002975.htm Hip joint replacement To use the sharing features on this page, please enable JavaScript. Hip joint replacement is surgery to replace all or part ...

  2. Knee joint replacement

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/002974.htm Knee joint replacement To use the sharing features on this page, please enable JavaScript. Knee joint replacement is a surgery to replace a knee ...

  3. Current topics in the radiology of joint replacement surgery

    SciTech Connect

    Weissman, B.N. )

    1990-09-01

    Several methods of total hip joint replacement are currently used. Radiographic appearances after cemented, bone ingrowth, press-fit, and bipolar hip prostheses are reviewed. The roles of nuclear medicine and arthrographic procedures for identifying complications are discussed. Total knee prostheses and, in particular, complications related to the patellar component are described.115 references.

  4. Examination and treatment of a professional ballet dancer with a suspected acetabular labral tear: A case report.

    PubMed

    Khoo-Summers, Lynnette; Bloom, Nancy J

    2015-08-01

    Dancers are at risk for developing groin pain that is due to acetabular labral tears. Although surgical management of labral tears has been reported extensively, conservative management has been poorly described. This case report describes the examination, diagnosis, and treatment of groin pain in a professional ballet dancer with a suspected acetabular labral tear. Treatment focused on decreasing anterior hip joint stresses and improving the precision of hip motion through correction of alignment and movement impairments noted during functional activities and dance. Successful outcomes included a reduction in pain and return to professional ballet dancing. PMID:25725589

  5. Current concept in dysplastic hip arthroplasty: Techniques for acetabular and femoral reconstruction

    PubMed Central

    Bicanic, Goran; Barbaric, Katarina; Bohacek, Ivan; Aljinovic, Ana; Delimar, Domagoj

    2014-01-01

    Adult patients with developmental dysplasia of the hip develop secondary osteoarthritis and eventually end up with total hip arthroplasty (THA) at younger age. Because of altered anatomy of dysplastic hips, THA in these patients represents technically demanding procedure. Distorted anatomy of the acetabulum and proximal femur together with conjoined leg length discrepancy present major challenges during performing THA in patients with developmental dysplasia of the hip. In addition, most patients are at younger age, therefore, soft tissue balance is of great importance (especially the need to preserve the continuity of abductors) to maximise postoperative functional result. In this paper we present a variety of surgical techniques available for THA in dysplastic hips, their advantages and disadvantages. For acetabular reconstruction following techniques are described: Standard metal augments (prefabricated), Custom made acetabular augments (3D printing), Roof reconstruction with vascularized fibula, Roof reconstruction with pedicled iliac graft, Roof reconstruction with autologous bone graft, Roof reconstruction with homologous bone graft, Roof reconstruction with auto/homologous spongious bone, Reinforcement ring with the hook in combination with autologous graft augmentation, Cranial positioning of the acetabulum, Medial protrusion technique (cotyloplasty) with chisel, Medial protrusion technique (cotyloplasty) with reaming, Cotyloplasty without spongioplasty. For femoral reconstruction following techniques were described: Distraction with external fixator, Femoral shortening through a modified lateral approach, Transtrochanteric osteotomies, Paavilainen osteotomy, Lesser trochanter osteotomy, Double-chevron osteotomy, Subtrochanteric osteotomies, Diaphyseal osteotomies, Distal femoral osteotomies. At the end we present author’s treatment method of choice: for acetabulum we perform cotyloplasty leaving only paper-thin medial wall, which we break during

  6. Current concept in dysplastic hip arthroplasty: Techniques for acetabular and femoral reconstruction.

    PubMed

    Bicanic, Goran; Barbaric, Katarina; Bohacek, Ivan; Aljinovic, Ana; Delimar, Domagoj

    2014-09-18

    Adult patients with developmental dysplasia of the hip develop secondary osteoarthritis and eventually end up with total hip arthroplasty (THA) at younger age. Because of altered anatomy of dysplastic hips, THA in these patients represents technically demanding procedure. Distorted anatomy of the acetabulum and proximal femur together with conjoined leg length discrepancy present major challenges during performing THA in patients with developmental dysplasia of the hip. In addition, most patients are at younger age, therefore, soft tissue balance is of great importance (especially the need to preserve the continuity of abductors) to maximise postoperative functional result. In this paper we present a variety of surgical techniques available for THA in dysplastic hips, their advantages and disadvantages. For acetabular reconstruction following techniques are described: Standard metal augments (prefabricated), Custom made acetabular augments (3D printing), Roof reconstruction with vascularized fibula, Roof reconstruction with pedicled iliac graft, Roof reconstruction with autologous bone graft, Roof reconstruction with homologous bone graft, Roof reconstruction with auto/homologous spongious bone, Reinforcement ring with the hook in combination with autologous graft augmentation, Cranial positioning of the acetabulum, Medial protrusion technique (cotyloplasty) with chisel, Medial protrusion technique (cotyloplasty) with reaming, Cotyloplasty without spongioplasty. For femoral reconstruction following techniques were described: Distraction with external fixator, Femoral shortening through a modified lateral approach, Transtrochanteric osteotomies, Paavilainen osteotomy, Lesser trochanter osteotomy, Double-chevron osteotomy, Subtrochanteric osteotomies, Diaphyseal osteotomies, Distal femoral osteotomies. At the end we present author's treatment method of choice: for acetabulum we perform cotyloplasty leaving only paper-thin medial wall, which we break during acetabular

  7. Analysis of spinal alignment and pelvic parameters on upright radiographs: implications for acetabular development

    PubMed Central

    Pytiak, Andrew; Bomar, James D.; Peterson, Jonathan B.; Schmitz, Matthew R.; Pennock, Andrew T.; Wenger, Dennis R.; Upasani, Vidyadhar V.

    2016-01-01

    The purpose of this study was to correlate measures of sagittal spinopelvic alignment [lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI)] and measures of acetabular coverage [lateral center edge angle (LCEA) and Tonnis angle] in asymptomatic adolescents on standing biplanar radiographs. We hypothesized that subjects with increased pelvic incidence and LL would have increased anterior PT and increased measures of acetabular coverage. Upright anteroposterior and lateral spinopelvic radiographs were obtained using EOS imaging technique. LCEA and Tonnis angle were calculated on the anteroposterior images and the lateral images were analyzed for LL, PI, PT and SS. LL was found to have a strong correlation with SS (rs = 0.786, P  <  0.001), moderate correlation with PI (rs  =  0.529, P  <  0.001), and a poor inverse correlation with PT (rs  = −0.167, P  =  0.018). However, LCEA was not found to be significantly correlated with PT (rs  =  0.084, P  =  0.238) and Tonnis angle was not found to be correlated with any of the sagittal spinopelvic measures. Healthy, asymptomatic adolescents with increased pelvic incidence and lumbar lordosis did not have increased anterior PT or increased measures of acetabular coverage. The correlations identified in previous cadaveric studies or clinical studies evaluating changes between supine and standing radiographs are not supported in this healthy adolescent population. Our findings may suggest that an individual’s acetabulum develops as a dynamic adaptation to one's particular sagittal spinopelvic alignment to optimize femoral head coverage. Level III. Diagnostic – Investigating a diagnostic test. PMID:27583160

  8. Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

    PubMed Central

    Firoozabadi, Reza; Stafford, Paul; Routt, Milton

    2015-01-01

    Background: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon. Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted. Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized. Results: Clinical Study- 5.7% (5/87) of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36) of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28) compared to 16 mm (11-22) in normal cords, which was statistically significant. Discussion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities. PMID

  9. Primary stability of two uncemented acetabular components of different geometry: hemispherical or peripherally enhanced?

    PubMed Central

    Antoniades, G.; Smith, E. J.; Deakin, A. H.; Wearing, S. C.; Sarungi, M.

    2013-01-01

    Objective This study compared the primary stability of two commercially available acetabular components from the same manufacturer, which differ only in geometry; a hemispherical and a peripherally enhanced design (peripheral self-locking (PSL)). The objective was to determine whether altered geometry resulted in better primary stability. Methods Acetabular components were seated with 0.8 mm to 2 mm interference fits in reamed polyethylene bone substrate of two different densities (0.22 g/cm3 and 0.45 g/cm3). The primary stability of each component design was investigated by measuring the peak failure load during uniaxial pull-out and tangential lever-out tests. Results There was no statistically significant difference in seating force (p = 0.104) or primary stability (pull-out p = 0.171, lever-out p = 0.087) of the two components in the low-density substrate. Similarly, in the high-density substrate, there was no statistically significant difference in the peak pull-out force (p = 0.154) or lever-out moment (p = 0.574) between the designs. However, the PSL component required a significantly higher seating force than the hemispherical cup in the high-density bone analogue (p = 0.006). Conclusions Higher seating forces associated with the PSL design may result in inadequate seating and increased risk of component malpositioning or acetabular fracture in the intra-operative setting in high-density bone stock. Our results, if translated clinically, suggest that a purely hemispherical geometry may have an advantage over a peripherally enhanced geometry in high density bone stock. Cite this article: Bone Joint Res 2013;2:264–9. PMID:24326398

  10. Differences in Acetabular Rim Thickness in Patients with Unilateral Symptomatic Pincer-Type Femoroacetabular Impingement

    PubMed Central

    Weber, Alexander E.; Kuhns, Benjamin; Cvetanovich, Gregory; Inoue, Nozomu; Nho, Shane Jay

    2016-01-01

    Objectives: The objective of this study was to identify the location and magnitude of difference in acetabular rim morphology between the symptomatic and asymptomatic acetabula in a cohort of patients with symptomatic unilateral pincer-type FAI. Methods: After IRB approval, computed tomography (CT) scans of 43 patients (22 males, 21 females) diagnosed with unilateral pincer-type FAI were obtained. CT images of both hips were imported in DICOM format and segmented into 3-dimensional (3D) hemi-pelvises using 3D reconstruction software (Mimics, Materialise, Leuven, Belgium). The point-cloud data of the asymptomatic hemi-pelvis was mirrored onto the symptomatic side. Protrusion of the symptomatic side was recorded as a positive value and appeared as red on the color map (Figure 1). Data was collected in 3° intervals and analyzed by quadrant using the clock face method; reflecting the 12-3, 3-6, 6-9, and 9-12 o’clock positions. Results: The symptomatic acetabular rim was on average 0.39 ± 0.36 mm thicker than the corresponding location on the asymptomatic rim. When the acetabular clock face was broken up into quadrants, reflecting the 12-3, 3-6, 6-9, and 9-12 o’clock positions, the 12-3 o’clock position demonstrated the greatest difference between symptomatic and asymptomatic sides (Table 1). The 12-3 o’clock quadrant demonstrated significantly greater difference between symptomatic and asymptomatic sides (0.53±0.22 mm) as compared to the 3-6 o’clock position (0.39±0.27 mm; p=0.006), the 6-9 o’clock position (0.34±0.05 mm; p<0.001), and the 9-12 o’clock position (0.33±0.03; p<0.001). There was no correlation between gender and magnitude of difference at any location. Conclusion: Small changes in acetabular rim morphology, on the order of 0.5 mm or less can be the difference between symptomatic pincer-type FAI and the asymptomatic state. Knowledge of the healthy, unaffected side in unilateral FAI may provide a better template for rim recession rather

  11. All-Arthroscopic Reconstruction of the Acetabular Labrum by Capsular Augmentation

    PubMed Central

    Nwachukwu, Benedict U.; Alpaugh, Kyle; McCormick, Frank; Martin, Scott D.

    2015-01-01

    The acetabular labrum plays an important role in hip joint stability and articular cartilage maintenance. As such, reconstitution of the labral complex is ideal. In cases in which the labrum is too degenerative to allow adequate reconstruction with current repair techniques, a capsular augmentation is a novel technique that can be used to restore the labral structure. Use of capsular augmentation enables preservation of the donor-tissue blood supply with local tissue transfer, without adding significant complexity to the procedure or significant donor-site morbidity. PMID:26052488

  12. Mineral resource of the month: hydraulic cement

    USGS Publications Warehouse

    van Oss, Hendrik G.

    2012-01-01

    Hydraulic cements are the binders in concrete and most mortars and stuccos. Concrete, particularly the reinforced variety, is the most versatile of all construction materials, and most of the hydraulic cement produced worldwide is portland cement or similar cements that have portland cement as a basis, such as blended cements and masonry cements. Cement typically makes up less than 15 percent of the concrete mix; most of the rest is aggregates. Not counting the weight of reinforcing media, 1 ton of cement will typically yield about 8 tons of concrete.

  13. Mechanical, material, and antimicrobial properties of acrylic bone cement impregnated with silver nanoparticles.

    PubMed

    Slane, Josh; Vivanco, Juan; Rose, Warren; Ploeg, Heidi-Lynn; Squire, Matthew

    2015-03-01

    Prosthetic joint infection is one of the most serious complications that can lead to failure of a total joint replacement. Recently, the rise of multidrug resistant bacteria has substantially reduced the efficacy of antibiotics that are typically incorporated into acrylic bone cement. Silver nanoparticles (AgNPs) are an attractive alternative to traditional antibiotics resulting from their broad-spectrum antimicrobial activity and low bacterial resistance. The purpose of this study, therefore, was to incorporate metallic silver nanoparticles into acrylic bone cement and quantify the effects on the cement's mechanical, material and antimicrobial properties. AgNPs at three loading ratios (0.25, 0.5, and 1.0% wt/wt) were incorporated into a commercial bone cement using a probe sonication technique. The resulting cements demonstrated mechanical and material properties that were not substantially different from the standard cement. Testing against Staphylococcus aureus and Staphylococcus epidermidis using Kirby-Bauer and time-kill assays demonstrated no antimicrobial activity against planktonic bacteria. In contrast, cements modified with AgNPs significantly reduced biofilm formation on the surface of the cement. These results indicate that AgNP-loaded cement is of high potential for use in primary arthroplasty where prevention of bacterial surface colonization is vital. PMID:25579913

  14. US cement industry

    SciTech Connect

    Nisbet, M.A.

    1997-12-31

    This paper describes the cement and concrete industry, and provides data on energy use and carbon dioxide emissions. The potential impact of an energy tax on the industry is briefly assessed. Opportunities identified for reducing carbon dioxide emissions include improved energy efficiency, alternative fuels, and alternative materials. The key factor in determining CO{sub 2} emissions is the level of domestic production. The projected improvement in energy efficiency and the relatively slow growth in domestic shipments indicate that CO{sub 2} emissions in 2000 should be about 5% above the 1990 target. However, due to the cyclical nature of cement demand, emissions will probably be above target levels during peak demand and below target levels during demand troughs. 7 figs., 2 tabs.

  15. Early hydration of portland cement with crystalline mineral additions

    SciTech Connect

    Rahhal, V. . E-mail: vrahhal@fio.unicen.edu.ar; Talero, R.

    2005-07-01

    This research presents the effects of finely divided crystalline mineral additions (quartz and limestone), commonly known as filler, on the early hydration of portland cements with very different mineralogical composition. The used techniques to study the early hydration of blended cements were conduction calorimeter, hydraulicity (Fratini's test), non-evaporable water and X-ray diffraction. Results showed that the stimulation and the dilution effects increase when the percentage of crystalline mineral additions used is increased. Depending on the replacement proportion, the mineralogical cement composition and the type of crystalline addition, at 2 days, the prevalence of the dilution effect or the stimulation effect shows that crystalline mineral additions could act as sites of heat dissipation or heat stimulation, respectively.

  16. Peri-implant stress correlates with bone and cement morphology: Micro-FE modeling of implanted cadaveric glenoids.

    PubMed

    Wee, Hwabok; Armstrong, April D; Flint, Wesley W; Kunselman, Allen R; Lewis, Gregory S

    2015-11-01

    Aseptic loosening of cemented joint replacements is a complex biological and mechanical process, and remains a clinical concern especially in patients with poor bone quality. Utilizing high resolution finite element analysis of a series of implanted cadaver glenoids, the objective of this study was to quantify relationships between construct morphology and resulting mechanical stresses in cement and trabeculae. Eight glenoid cadavers were implanted with a cemented central peg implant. Specimens were imaged by micro-CT, and subject-specific finite element models were developed. Bone volume fraction, glenoid width, implant-cortex distance, cement volume, cement-cortex contact, and cement-bone interface area were measured. Axial loading was applied to the implant of each model and stress distributions were characterized. Correlation analysis was completed across all specimens for pairs of morphological and mechanical variables. The amount of trabecular bone with high stress was strongly negatively correlated with both cement volume and contact between the cement and cortex (r = -0.85 and -0.84, p < 0.05). Bone with high stress was also correlated with both glenoid width and implant-cortex distance. Contact between the cement and underlying cortex may dramatically reduce trabecular bone stresses surrounding the cement, and this contact depends on bone shape, cement amount, and implant positioning. PMID:25929691

  17. Well cementing in permafrost

    SciTech Connect

    Wilson, W.N.

    1980-01-01

    A process for cementing a string of pipe in the permafrost region of a borehole of a well wherein aqueous drilling fluid actually used in drilling the wellbore in the permafrost region of a wellbore is employed. The drilling fluid contains or is adjusted to contain from about 2 to about 16 volume percent solids. Mixing with the drilling fluid (1) an additive selected from the group consisting of ligno-sulfonate, lignite, tannin, and mixtures thereof, (2) sufficient base to raise the pH of the drilling fluid into the range of from about 9 to about 12, and (3) cementitious material which will harden in from about 30 to about 40 hours at 40/sup 0/F. The resulting mixture is pumped into the permafrost region of a wellbore to be cemented and allowed to harden in the wellbore. There is also provided a process for treating an aqueous drilling fluid after it has been used in drilling the wellbore in permafrost, and a cementitious composition for cementing in a permafrost region of a wellbore.

  18. Tympanoplasty with ionomeric cement.

    PubMed

    Kjeldsen, A D; Grøntved, A M

    2000-01-01

    Patients with isolated erosion of the long incus process suffer from severe hearing loss caused by lack of continuity of the ossicular chain. This study is a retrospective evaluation of the hearing results using two different surgical procedures. Since January 1993, 12 consecutive patients with isolated erosion of the long incus process have been treated with a new surgical technique in which the ossicular chain was rebuilt with ionomeric cement. The results in hearing performance (mean pure-tone average (PTA) 0.5, 1 and 2 kHz) were evaluated pre- and post-surgery, and compared to those in a group of 20 historical controls who underwent surgery in 1991 and 1992 using incus autograft interposition. Among the 12 index patients, 7 (58%) achieved improvement in PTA of > 10 dB, in 3 there was no difference and in 2 a slight decline. Among the 20 controls, 14 (70%) achieved improvement in PTA of > 10 dB, in 4 there was a slight improvement and in 2 a decline. The difference was not statistically significant. Hearing improvement using ionomeric cement in type II tympanoplasty was satisfactory. Reconstruction of the ossicular chain with ionomeric cement is recommended, as the procedure is easy to perform, presents less risk of damage to the stapes and cochlea, requires less extensive surgery and does not exclude other surgical methods in cases of reoperation. PMID:10909000

  19. Alumina-alumina hip replacement in patients younger than 50 years old.

    PubMed

    Sedel, L; Nizard, R S; Kerboull, L; Witvoet, J

    1994-01-01

    From April 1977 to December 1990, 131 total hip arthroplasties were performed on 113 patients younger than 50 years of age (median, 41 years); 64 were men and 49 women. The majority were active people. Sixty-six hips had no previous operations, and 33 had at least one previous arthroplasty. The femoral component was a cemented collared titanium alloy stem, and alumina socket was cemented for 99 hips and press-fit for 32. The mean follow-up period was five years, with 32 hips followed for more than ten years. Revision arthroplasty was considered as a failure. Survivorship analysis depicted a 97.5% rate of survival at five years, an 89.4% rate at ten years, and an 86.2% at 11 years. Nine revisions were performed: one experienced a femoral head rupture after three years, one had bipolar loosening, one experienced femoral cystic formation, and six were revised for acetabular cup loosening, all from the cemented group. Two revisions occurred on the same patient. No stem revision was necessary before ten years. Only one of these revisions was required in patients aged 40 or younger (64 patients). Alumina-alumina friction is an extremely interesting phenomenon in young patients, and could be related to the low wear debris production. PMID:8118972

  20. Biomechanical analysis of the acetabular buttress-plate: are complex acetabular fractures in the quadrilateral area stable after treatment with anterior construct plate-1/3 tube buttress plate fixation?

    PubMed Central

    Wu, Yong-De; Cai, Xian-Hua; Liu, Xi-Ming; Zhang, Hong-Xi

    2013-01-01

    OBJECTIVE: The acetabular buttress-plate has been widely used in treating difficult cases with satisfying clinical results. However, the biomechanical properties of a postoperative acetabular fracture fixed by the buttress-plate are not clear. The purpose of this study was to evaluate the biomechanical properties of stability after the anterior tube buttress-plate fixation of complex acetabular fractures in the quadrilateral area. METHODS: A construct was proposed based on anterior construct plate - 1/3 tube buttress plate fixation for acetabular both-column fractures. Two groups of six formalin-preserved cadaveric pelvises were analyzed: (1) group A, the normal pelvis and (2) group B, anterior construct plate-1/3 tube buttress plate with quadrilateral area fixation. The displacements were measured, and cyclical loads were applied in both standing and sitting simulations. RESULTS: As the load was added, the displacements were A

  1. Cementing oil and gas wells

    SciTech Connect

    Bloys, J.B.; Wilson, W.N.; Bradshaw, R.D.

    1991-08-13

    This patent describes a method for cementing a wellbore penetrating an earth formation to which a conduit extends, the wellbore having a space occupied by a fluid composition to be converted to cement for cementing the space to form a seal between spaced apart points in the formation. It comprises providing means for adding cementitious material and a dispersant to the fluid, circulating the fluid and adding the cementitious material and the dispersant to a quantity of the fluid in predetermined proportions to form a settable cement composition comprising a major portion of the drilling fluid in the well as it was drilled; and water; a lesser proportion of dry cementitious material; a minor amount of a dispersant that does not effect a satisfactory set cement within an acceptable time interval; and a compatible accelerator selected from the class consisting of acetic acid; the first four carbon esters thereof; and acedamide and filling the wellbore with the cement composition.

  2. Alkali burns from wet cement.

    PubMed Central

    Peters, W. J.

    1984-01-01

    When water is added to the dry materials of Portland cement calcium hydroxide is formed; the wet cement is caustic (with a pH as high as 12.9) and can produce third-degree alkali burns after 2 hours of contact. Unlike professional cement workers, amateurs are usually not aware of any danger and may stand or kneel in the cement for long periods. As illustrated in a case report, general physicians may recognize neither the seriousness of the injury in its early stages nor the significance of a history of prolonged contact with wet cement. All people working with cement should be warned about its dangers and advised to immediately wash and dry the skin if contact does occur. Images Fig. 1 PMID:6561052

  3. Mineral of the month: cement

    USGS Publications Warehouse

    van Oss, Hendrik G.

    2006-01-01

    Hydraulic cement is a virtually ubiquitous construction material that, when mixed with water, serves as the binder in concrete and most mortars. Only about 13 percent of concrete by weight is cement (the rest being water and aggregates), but the cement contributes all of the concrete’s compressional strength. The term “hydraulic” refers to the cement’s ability to set and harden underwater through the hydration of the cement’s components.

  4. Cement penetration after patella venting.

    PubMed

    Jones, Christopher W; Lam, Li-On; Butler, Adam; Wood, David J; Walsh, William R

    2009-01-01

    There is a high rate of patellofemoral complications following total knee arthroplasty. Optimization of the cement-bone interface by venting and suction of the tibial plateau has been shown to improve cement penetration. Our study was designed to investigate if venting the patella prior to cementing improved cement penetration. Ten paired cadaver patellae were allocated prior to resurfacing to be vented or non-vented. Bone mineral density (BMD) was measured by DEXA scanning. In vented specimens, a 1.6 mm Kirschner wire was used to breach the anterior cortex at the center. Specimens were resurfaced with standard Profix instrumentation and Versabond bone cement (Smith and Nephew PLC, UK). Cement penetration was assessed from Faxitron and sectioned images by a digital image software package (ImageJ V1.38, NIH, USA). Wilcoxon rank sum test was used to assess the difference in cement penetration between groups. The relationship between BMD and cement penetration was analyzed by Pearson correlation coefficient. There was a strong negative correlation between peak BMD and cement penetration when analyzed independent of experimental grouping (r(2)=-0.812, p=0.004). Wilcoxon rank sum testing demonstrated no significant difference (rank sum statistic W=27, p=0.579) in cement penetration between vented (10.53%+/-4.66; mean+/-std dev) and non-vented patellae (11.51%+/-6.23; mean+/-std dev). Venting the patella using a Kirschner wire does not have a significant effect on the amount of cement penetration achieved in vitro using Profix instrumentation and Versabond cement. PMID:19010682

  5. [Haemotoxicity of dental luting cements].

    PubMed

    Anders, A; Welker, D

    1989-06-01

    A glass ionomer luting cement (AquaCem) shows a relatively low haemolytic activity in comparison with two zinc phosphate cements. Especially the initial irritation by this cement is smaller. Although it is possible that AquaCem particularly, in unfavourable cases, may damage the pulpa dentin system; this is due to the slowly decrease of the haemolytic activity with increasing of the probes. We found that Adhesor showed in dependence of the batches a varying quality. PMID:2626769

  6. Multitechnique characterization of articular surfaces of retrieved ultrahigh molecular weight polyethylene acetabular sockets.

    PubMed

    Magnissalis, E A; Eliades, G; Eliades, T

    1999-01-01

    The articular surfaces of 10 retrieved ultrahigh molecular weight polyethylene acetabular sockets were studied by optical microscopy, X-ray fluorescence spectrometry, multiple internal reflectance FTIR spectroscopy, scanning electron microscopy, and wavelength dispersive X-ray microanalysis. The results revealed characteristic wear patterns including polishing, scratching, pitting, cratering, folding, shredding, burnishing, cracking, embedding of particles, and development of acquired biofilms with various degrees of mineralization. The biofilms formed were mainly of proteinaceous origin, and mineralized regions were composed of calcium phosphates with carbonate impurities. The crystallinity of the polyethylene at the articular surfaces was enhanced compared to the bulk, which was possibly due to the cold work produced in vivo. The mineralized regions were classified into two groups based on the grey levels of the backscattered images obtained. The high-contrast regions that were mainly composed of Ca and P with traces of Al and Si were associated with bone fragments; the low-contrast regions composed of K, Na, Ca, Mg, Si, Al, Fe, Cl, and P were associated with acquired biofilm calcification, which implies the active engagement of biofilms in the long term performance of acetabular sockets in vivo. PMID:10398042

  7. Towards the optimal design of an uncemented acetabular component using genetic algorithms

    NASA Astrophysics Data System (ADS)

    Ghosh, Rajesh; Pratihar, Dilip Kumar; Gupta, Sanjay

    2015-12-01

    Aseptic loosening of the acetabular component (hemispherical socket of the pelvic bone) has been mainly attributed to bone resorption and excessive generation of wear particle debris. The aim of this study was to determine optimal design parameters for the acetabular component that would minimize bone resorption and volumetric wear. Three-dimensional finite element models of intact and implanted pelvises were developed using data from computed tomography scans. A multi-objective optimization problem was formulated and solved using a genetic algorithm. A combination of suitable implant material and corresponding set of optimal thicknesses of the component was obtained from the Pareto-optimal front of solutions. The ultra-high-molecular-weight polyethylene (UHMWPE) component generated considerably greater volumetric wear but lower bone density loss compared to carbon-fibre reinforced polyetheretherketone (CFR-PEEK) and ceramic. CFR-PEEK was located in the range between ceramic and UHMWPE. Although ceramic appeared to be a viable alternative to cobalt-chromium-molybdenum alloy, CFR-PEEK seems to be the most promising alternative material.

  8. New method for determining in vitro structure stiffness of ceramic acetabular liners under different impact conditions.

    PubMed

    Eichhorn, Stefan; Steinhauser, Erwin; Gradinger, Reiner; Burgkart, Rainer

    2012-05-01

    Increasing both patient mobility and prosthesis life span requires improvements in the range of motion and wear behavior of the liner. With the use of new composite alumina-zirconia ceramic materials, the same stability of the liner can be achieved at lower wall thickness than it is possible with alumina-only materials. The aim of this study was developing a method for determining the in vitro structure stiffness of ceramic acetabular liners against impact stresses. The first trials were performed with a common alumina acetabular liner type (Ceramtec; Biolox forte; diameter 28 mm; thickness 7 mm) and a new type of alumina-zirconia (Ceramtec Biolox delta; same dimensions) liner. The clinically established alumina liner was reproducibly damaged using worst case Separation/subluxation equivalent to one-fourth or half of the head diameter, and an impact load of 15 J. The liners containing the new alumina-zirconia material were not damaged in any of the trials up to an impact load of 20 J and half head diameter offset. PMID:22197061

  9. Vibrational spectroscopy study of the oxidation of Hylamer UHMWPE explanted acetabular cups sterilized differently

    NASA Astrophysics Data System (ADS)

    Reggiani, Matteo; Tinti, Anna; Visentin, Manuela; Stea, Susanna; Erani, Paolo; Fagnano, Concezio

    2007-05-01

    Ultra-high-molecular-weight polyethylene (UHMWPE) has been used for over 40 years for acetabular cups in total hip joint prosthesis. Hylamer is a hot isostatically pressed material with high crystallinity. Early loosening due to extensive oxidation and phase transformation has been observed for this material. To analyze the reasons for its high tendency to oxidize, we have examined by FT-IR spectroscopy explanted acetabular cups γ-sterilized in different ways. The oxidation and wear rate observed were: Hylamer cups γ-sterilized in air with a long shelf life > Hylamer cups γ-sterilized in air with short shelf life ⩾ Hylamer cups γ-sterilized in nitrogen. Our data indicate the important role of the shelf life on the oxidation of the cups: the samples γ-sterilized in air characterized by a shelf life greater than 3 years showed severe oxidation, a high wear rate, and marked debris production with delamination and the formation of a brittle zone in the more oxidated regions. In these regions we observed an increase in crystallinity, which was probably due to the decrease in the molecular weight of PE. The high oxidation was probably due to the modifications induced by the material treatment.

  10. Preliminary analysis on the MD-4® plasma-sprayed titanium acetabular component☆

    PubMed Central

    de Araújo Loures, Elmano; Simoni, Leandro Furtado; Leite, Isabel Cristina Gonçalves; Loures, Daniel Naya; Loures, Clarice Naya

    2015-01-01

    Objectives To evaluate the short-term performance of a type of implant manufactured in Brazil. Methods This study analyzed a cohort of 60 patients who underwent implantation of MD-4® acetabular components during primary hip arthroplasty procedures performed between January 1, 2010, and August 1, 2012. The patients were studied retrospectively with regard to clinical behavior, stability and radiological osseointegration. The patients were followed up for a minimum of 12 months and a maximum of 42 months (mean: 27) and were evaluated by means of the Harris Hip Score, SF-36 questionnaire and serial conventional radiographs. Results All the components were radiologically stable, without evidence of migration or progressive radiolucency lines. On average, the Harris Hip Score evolved from 36.1 to 92.1 (p < 0.001) and the SF-36 showed significant increases in all its domains (p < 0.001). No differences were observed among patients with osteoarthrosis, osteonecrosis, hip dysplasia or other conditions. Conclusions The short-term results showed clinical and radiological signs of stability and osseointegration of the implants, which may represent a predictive factor regarding medium-term survival of this acetabular component. PMID:26229918

  11. Wear versus Thickness and Other Features of 5-Mrad Crosslinked UHMWPE Acetabular Liners

    PubMed Central

    Shen, Fu-Wen; Lu, Zhen

    2010-01-01

    Background The low wear rates of crosslinked polyethylenes provide the potential to use larger diameters to resist dislocation. However, this requires the use of thinner liners in the acetabular component, with concern that higher contact stresses will increase wear, offsetting the benefits of the crosslinking. Questions/purposes We asked the following questions: Is the wear of conventional and crosslinked polyethylene liners affected by ball diameter, rigidity of backing, and liner thickness? Are the stresses in the liner affected by thickness? Methods Wear rates were measured in a hip simulator and stresses were calculated using finite element modeling. Results Without crosslinking, the wear rate was 4% to 10% greater with a 36-mm diameter than a 28-mm diameter. With crosslinking, wear was 9% lower with a 36-mm diameter without metal backing and 4% greater with metal backing. Reducing the thickness from 6 mm to 3 mm increased the contact stress by 46%, but the wear rate decreased by 19%. Conclusions The reduction in wear with 5 Mrad of crosslinking was not offset by increasing the diameter from 28 mm to 36 mm or by using a liner as thin as 3 mm. Clinical Relevance The results indicate, for a properly positioned 5-Mrad crosslinked acetabular component and within the range of dimensions evaluated, neither wear nor stresses in the polyethylene are limiting factors in the use of larger-diameter, thinner cups to resist dislocation. PMID:20848244

  12. Fixation of acetabular fractures via the ilioinguinal versus pararectus approach: a direct comparison.

    PubMed

    Märdian, S; Schaser, K D; Hinz, P; Wittenberg, S; Haas, N P; Schwabe, P

    2015-09-01

    This study compared the quality of reduction and complication rate when using a standard ilioinguinal approach and the new pararectus approach when treating acetabular fractures surgically. All acetabular fractures that underwent fixation using either approach between February 2005 and September 2014 were retrospectively reviewed and the demographics of the patients, the surgical details and complications were recorded. A total of 100 patients (69 men, 31 women; mean age 57 years, 18 to 93) who were consecutively treated were included for analysis. The quality of reduction was assessed using standardised measurement of the gaps and steps in the articular surface on pre- and post-operative CT-scans. There were no significant differences in the demographics of the patients, the surgical details or the complications between the two approaches. A significantly better reduction of the gap, however, was achieved with the pararectus approach (axial: p = 0.025, coronal: p = 0.013, sagittal: p = 0.001). These data suggest that the pararectus approach is at least equal to, or in the case of reduction of the articular gap, superior to the ilioinguinal approach. This approach allows direct buttressing of the dome of the acetabulum and the quadrilateral plate, which is particularly favourable in geriatric fracture patterns. PMID:26330596

  13. Effect of Lime on Mechanical and Durability Properties of Blended Cement Based Concrete

    NASA Astrophysics Data System (ADS)

    Acharya, Prasanna Kumar; Patro, Sanjaya Kumar; Moharana, Narayana C.

    2016-05-01

    This work presents the results of experimental investigations performed to evaluate the effect of lime on mechanical and durability properties of concrete mixtures made with blended cement like Portland Slag Cement (PSC) and Portland Pozzolana Cement (PPC) with lime content of 0, 5, 7 and 10 %. Test result indicated that inclusion of hydraulic lime on replacement of cement up to 7 % increases compressive strength of concrete made with both PSC and PPC. Flexural strength increased with lime content. Highest flexural strength is reported at 7 % lime content for both PSC and PPC. Workability is observed to decrease with lime addition which could be compensated with introduction of super plasticizer. Acid and sulphate resistance increase slightly up to 7 % of lime addition and is found to decrease with further addition of lime. Lime addition up to 10 % does not affect the soundness of blended cements like PSC and PPC.

  14. Effect of Lime on Mechanical and Durability Properties of Blended Cement Based Concrete

    NASA Astrophysics Data System (ADS)

    Acharya, Prasanna Kumar; Patro, Sanjaya Kumar; Moharana, Narayana C.

    2016-06-01

    This work presents the results of experimental investigations performed to evaluate the effect of lime on mechanical and durability properties of concrete mixtures made with blended cement like Portland Slag Cement (PSC) and Portland Pozzolana Cement (PPC) with lime content of 0, 5, 7 and 10 %. Test result indicated that inclusion of hydraulic lime on replacement of cement up to 7 % increases compressive strength of concrete made with both PSC and PPC. Flexural strength increased with lime content. Highest flexural strength is reported at 7 % lime content for both PSC and PPC. Workability is observed to decrease with lime addition which could be compensated with introduction of super plasticizer. Acid and sulphate resistance increase slightly up to 7 % of lime addition and is found to decrease with further addition of lime. Lime addition up to 10 % does not affect the soundness of blended cements like PSC and PPC.

  15. Combined actions for the improvement of properties of cement-ash binder systems

    SciTech Connect

    Grankovskii, I.G.; Uglyrenko, T.V.

    1983-01-20

    The use of fly ash from thermal electric power generating stations in concrete technology as a hydraulic additive to improve the quality of concretes and cement slurries has been shown to be effective in many studies. However, under natural hardening conditions, cement-ash compositions acquire strength very slowly, and their favorable qualities are manifested at an age of approximately three months. On the basis of new data on the structurizing and strengthening effects of small amounts of mineral additives in the mixing water, along with studies of the optimal mechanical activation by mixing the cement slurries in accordance with the kinetics of structurization, in this paper the results from studies of combined actions on binder systems with the aim of improving the engineering characteristics of slurries used in cementing, increasing the slurry mobility, accelerating the hardening, and increasing the strength of hardened compositions in which up to 30% of the cement is replaced by fly ash, are presented.

  16. Reinforcement of bone cement around prostheses by pre-coated wire coil: a preliminary study.

    PubMed

    Kim, J K; Park, J B

    1994-01-01

    The longevity of the cemented total hip joint replacement depends on the integrity of the cement fixation with respect to the interfaces of the metal stem and bone, and stress/strain transmission and its distribution. A simple coil made of stainless steel wires was placed around a tapered stem in a simulated cement mantle to counteract the radial- and hoop-stress and static push-out mechanical tests were performed. The results show statistically significant increases in ultimate strain (+17.62%), ultimate load (+110.34%), stiffness (+117.63%), and fracture toughness (+153.63%) exhibited by the wire reinforcement over the control. Precoating with thin layer of polymethylmethacrylate may also enhance the mechanical properties of the reinforced cement mantle. This simple device may contribute to the longevity of the cement mantle by virtue of the enhanced mechanical properties, which in turn will be able to absorb more energy transmitted through the metal stem. PMID:8000291

  17. Nano-scale hydrogen-bond network improves the durability of greener cements

    PubMed Central

    Jacobsen, Johan; Rodrigues, Michelle Santos; Telling, Mark T. F.; Beraldo, Antonio Ludovico; Santos, Sérgio Francisco; Aldridge, Laurence P.; Bordallo, Heloisa N.

    2013-01-01

    More than ever before, the world's increasing need for new infrastructure demands the construction of efficient, sustainable and durable buildings, requiring minimal climate-changing gas-generation in their production. Maintenance-free “greener” building materials made from blended cements have advantages over ordinary Portland cements, as they are cheaper, generate less carbon dioxide and are more durable. The key for the improved performance of blends (which substitute fine amorphous silicates for cement) is related to their resistance to water penetration. The mechanism of this water resistance is of great environmental and economical impact but is not yet understood due to the complexity of the cement's hydration reactions. Using neutron spectroscopy, we studied a blend where cement was replaced by ash from sugar cane residuals originating from agricultural waste. Our findings demonstrate that the development of a distinctive hydrogen bond network at the nano-scale is the key to the performance of these greener materials. PMID:24036676

  18. Caustic reaction caused by cement.

    PubMed

    Rados, Jaka; Lipozencić, Jasna; Milavec-Puretić, Visnja

    2005-01-01

    A case is reported of a patient who developed full thickness chemical burns of the skin after a prolonged contact while working with wet cement. The history, course of disease, and therapy are described. Cement is an alkaline substance (pH >12) leading to colliquative necrosis. Tissue damage is due to the exothermic reaction of calcium oxide and water forming calcium hydroxide. Patch test was performed to test sensitization to chromium, chromate and cobalt, the usual cement ingredients. In our opinion, such lesions may not be rare because cement is widely used in construction, but are rarely described or under-recognized. PMID:16324425

  19. [Allergy to bone cement components].

    PubMed

    Thomas, P; Schuh, A; Eben, R; Thomsen, M

    2008-02-01

    Intolerance reactions to endoprostheses may lead to allergological diagnostics, which focus mainly on metal allergy. However, bone cement may also contain potential allergens, e.g. acrylates and additives such as benzoyl peroxide (BPO), N,N-dimethyl-p-toluidine, hydroquinone, and antibiotics (particularly gentamicin). In the Munich implant allergy clinic, we found that 28 of 113 patients (24.8%) with cemented prostheses had contact allergies to bone cement components, mostly to gentamicin (16.8%) and BPO (8.0%). The clinical significance of test results cannot always be shown, but we still recommend including bone cement components in the allergological diagnostics of suspected hypersensitivity reactions to arthroplasty. PMID:18227996

  20. Speciality cements with advanced properties

    SciTech Connect

    Scheetz, B.E. ); Landers, A.G. ); Odler, I. ); Jennings, H. )

    1991-01-01

    The subject matter, specialty cements with advanced properties, highlight some of the recent progress in the non-standard cementitious systems. The topic was intended to be broad enough to include MDF and DSP cement, as well as phosphate-based and other binders. The response to this broad request resulted in a wide variational sampling of potential binder systems, which included calcium phosphates, magnesium phosphates, silica systems derived from sodium fluosilicates, stratlingite glasses, alkali-activated blended cements, and aluminophosphates. Presentations also addressed in depth, the underlying processing and fundamental insight into macro defect cements and DSP.

  1. Femoroacetabular impingement with chronic acetabular rim fracture - 3D computed tomography, 3D magnetic resonance imaging and arthroscopic correlation

    PubMed Central

    Chhabra, Avneesh; Nordeck, Shaun; Wadhwa, Vibhor; Madhavapeddi, Sai; Robertson, William J

    2015-01-01

    Femoroacetabular impingement is uncommonly associated with a large rim fragment of bone along the superolateral acetabulum. We report an unusual case of femoroacetabular impingement (FAI) with chronic acetabular rim fracture. Radiographic, 3D computed tomography, 3D magnetic resonance imaging and arthroscopy correlation is presented with discussion of relative advantages and disadvantages of various modalities in the context of FAI. PMID:26191497

  2. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hip joint metal/metal semi-constrained, with an... Devices § 888.3330 Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented...

  3. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hip joint metal/metal semi-constrained, with an... Devices § 888.3330 Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented...

  4. 21 CFR 888.3330 - Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hip joint metal/metal semi-constrained, with an... Devices § 888.3330 Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis. (a) Identification. A hip joint metal/metal semi-constrained, with an uncemented...

  5. Retrieval analysis of Harris-Galante I and II acetabular liners in situ for more than 10 years

    PubMed Central

    2012-01-01

    Background and purpose There have been few reports documenting the wear and oxidation performance of the polyethylene bearing surface of HGPI and HGPII THA devices. We evaluated retrieved HGPI and HGPII acetabular liners that had been in situ for more than 10 years and determined whether there was a relationship between clinical and radiographic factors, surface damage, wear, and oxidation. Materials and methods 129 HGPI and II acetabular liners with implantation times of > 10 years were retrieved at 4 institutions between 1997 and 2010. The liners were made from a single resin and were gamma radiation-sterilized in air. Surface damage, linear wear, and oxidation index (OI) were assessed. Differences in clinical and radiographic factors, surface damage, linear wear, and OI for the 2 designs were statistically evaluated separately and together. Results Articular surface damage and backside damage was similar in the 2 designs. The linear penetration rate was 0.14 (SD 0.07) mm/year for the HGPI liners and 0.12 (SD 0.08) mm/year for the HGPII liners. For both cohorts, the rim had a higher OI than the articular surface. 74% of the liners had subsurface cracking and 24% had a complete fracture through the acetabular rim. Interpretation Despite modification of the HGP locking mechanism in the HGPII design, dissociation of the liner from the acetabular shell can still occur if fracture of the rim of the liner develops due to oxidative degradation. PMID:22880709

  6. Improved coiled-tubing squeeze-cementing techniques at Prudhoe Bay

    SciTech Connect

    Hornbrook, P.R.; Mason, C.M. )

    1991-04-01

    This paper presents major changes in coiled-tubing squeeze-cementing techniques used in the Prudhoe Bay Unit Western Operating Area (PBUWOA). Changes include introduction of a polymer diluent to replace borax contamination, increased differential pressures placed on squeeze and coil, reduced cement volumes, and incorporation of an inflow test and resqueeze procedure. These changes resulted in increased squeeze effectiveness by reducing equipment and engineering time requirements and by shortening well shut-in time after the workover.

  7. Long-term outcome of a cementless, hemispherical, press-fit acetabular component: survivorship analysis and dose-response relationship to linear polyethylene wear.

    PubMed

    Emms, N W; Stockley, I; Hamer, A J; Wilkinson, J M

    2010-06-01

    Between 1988 and 1998 we implanted 318 total hip replacements (THRs) in 287 patients using the Plasmacup (B. Braun Ltd, Sheffield, United Kingdom) and a conventional metal-on-polyethylene articulation. The main indications for THR were primary or secondary osteoarthritis. At follow-up after a mean 11.6 years (7.6 to 18.4) 17 patients had died and 20 could not be traced leaving a final series of 280 THRs in 250 patients. There were 62 revisions (22.1%) in 59 patients. A total of 43 acetabular shells (15.4%) had been revised and 13 (4.6%) had undergone exchange of the liner. The most frequent indications for revision were osteolysis and aseptic loosening, followed by polyethylene wear. The mean Kaplan-Meier survival of the Plasmacup was 91% at ten years and 58% at 14 years. Osteolysis was found around 36 (17.1%) of the 211 surviving shells. The median annual rate of linear wear in the surviving shells was 0.12 mm/year and 0.25 mm/year in those which had been revised (p < 0.001). Polyethylene wear was a strong independent risk factor for osteolysis and aseptic loosening. The percentage of patients with osteolysis increased proportionately with each quintile of wear-rate. There is a high late rate of failure of the Plasmacup. Patients with the combination of this prosthesis and bearing should be closely monitored after ten years. PMID:20513885

  8. Influence of slag blended cement concrete on chloride diffusion rate

    SciTech Connect

    Dehghanian, C.; Arjemandi, M.

    1997-06-01

    This research was conducted to investigate the effect of 0 to 30% partial replacement of cement by slag on chloride diffusion rate in concrete. Concretes with 0 to 30% slag were used and exposed to 2 to 5% NaCl solutions. The effect of different external salt concentration solutions and the influence of water-cement ratios ranging from 0.45 to 0.75 was also studied. In this research, different curing methods such as 9 to 18 days exposure to 100% humidity and 9 to 18 days submersion in distilled water were selected. The results indicated that after 90 days of exposure to salt solutions an/d 108 days of concrete age, chloride diffusivity for concretes containing slag almost remained the same. This effect was more pronounced for water-cement ratio of 0.45 and curing condition of 18 days submersion in water. An increase in water-cement ratio beyond 0.55 indicated a higher chloride diffusion rate. Curing condition for slag blended cement concrete also indicated a different behavior in chloride diffusivity. The best curing method obtained for this type of concrete was 18 days submersion in water.

  9. The effect of composition on mechanical properties of brushite cements.

    PubMed

    Engstrand, Johanna; Persson, Cecilia; Engqvist, Håkan

    2014-01-01

    Due to a fast setting reaction, good biological properties, and easily available starting materials, there has been extensive research within the field of brushite cements as bone replacing material. However, the fast setting of brushite cement gives them intrinsically low mechanical properties due to the poor crystal compaction during setting. To improve this, many additives such as citric acid, pyrophosphates, and glycolic acid have been added to the cement paste to retard the crystal growth. Furthermore, the incorporation of a filler material could improve the mechanical properties when used in the correct amounts. In this study, the effect of the addition of the two retardants, disodium dihydrogen pyrophosphate and citric acid, together with the addition of β-TCP filler particles, on the mechanical properties of a brushite cement was investigated. The results showed that the addition of low amounts of a filler (up to 10%) can have large effects on the mechanical properties. Furthermore, the addition of citric acid to the liquid phase makes it possible to use lower liquid-to-powder ratios (L/P), which strongly affects the strength of the cements. The maximal compressive strength (41.8MPa) was found for a composition with a molar ratio of 45:55 between monocalcium phosphate monohydrate and beta-tricalcium phosphate, an L/P of 0.25ml/g and a citric acid concentration of 0.5M in the liquid phase. PMID:24064324

  10. Coagulated silica - a-SiO2 admixture in cement paste

    NASA Astrophysics Data System (ADS)

    Pokorný, Jaroslav; Pavlíková, Milena; Záleská, Martina; Rovnaníková, Pavla; Pavlík, Zbyšek

    2016-07-01

    Amorphous silica (a-SiO2) in fine-grained form possesses a high pozzolanic activity which makes it a valuable component of blended binders in concrete production. The origin of a-SiO2 applied in cement-based composites is very diverse. SiO2 in amorphous form is present in various amounts in quite a few supplementary cementing materials (SCMs) being used as partial replacement of Portland cement. In this work, the applicability of a commercially produced coagulated silica powder as a partial replacement of Portland cement in cement paste mix design is investigated. Portland cement CEM I 42.5R produced according to the EU standard EN 197-1 is used as a reference binder. Coagulated silica is applied in dosages of 5 and 10 % by mass of cement. The water/binder ratio is kept constant in all the studied pastes. For the applied silica, specific surface area, density, loss on ignition, pozzolanic activity, chemical composition, and SiO2 amorphous phase content are determined. For the developed pastes on the basis of cement-silica blended binder, basic physical properties as bulk density, matrix density, and total open porosity are accessed. Pore size distribution is determined using MIP analysis. Initial and final setting times of fresh mixtures are measured by automatic Vicat apparatus. Effect of silica admixture on mechanical resistivity is evaluated using compressive strength, bending strength, and dynamic Young's modulus measurement. The obtained data gives evidence of a decreased workability of paste mixtures with silica, whereas the setting process is accelerated. On the other hand, reaction activity of silica with Portland cement minerals results in a slight decrease of porosity and improvement of mechanical resistivity of cement pastes containing a-SiO2.

  11. Total Hip Arthroplasty around the Inception of the Interface Bioactive Bone Cement Technique

    PubMed Central

    Oonishi, Hiroyuki; Kawahara, Ikuo

    2016-01-01

    Background To augment cement-bone fixation, Dr. Hironobu Oonishi attempted additional physicochemical bonding through interposition of osteoconductive crystal hydroxyapatite (HA) granules at the cement-bone interface in 1982. He first used the interface bioactive bone cement (IBBC) technique in 12 selected patients (12 hips) in 1982 (first stage) and followed them for 2 years. In 1985, the technique was applied in 25 total hip arthroplasty (THA) patients (second stage) and the effects were investigated by comparing the side with the IBBC technique and the other side without the IBBC technique. He has employed this technique in all THA patients since 1987 (third stage). Methods In the IBBC technique, HA granules (2 to 3 g) were smeared on the bone surface just before the acetabular and femoral components were cemented. In the first stage, 12 hips were operated using the IBBC technique in 1982. In the second stage, THA was performed without the IBBC technique on one side and with the IBBC technique on the other side within 1 year in 25 patients. In the third stage, THA was performed with the IBBC technique in 285 hips in 1987. Results In the first stage patients, implant loosening was not detected at 30 years after operation. In the second stage patients, revision was required in 7 hips without the IBBC technique due to cup loosening (5 hips) and stem loosening (2 hips), whereas no hip was revised after THA with the IBBC technique at 26 years after operation. In the third stage patients, the incidence of radiolucent lines and osteolysis was very few at 25 years after operation. Conclusions The long-term follow-up of THA performed around the inception of the IBBC technique has revealed low incidences of radiolucent lines, osteolysis, and revision surgery. PMID:27583104

  12. Loss in mechanical contact of cementless acetabular prostheses due to post-operative weight bearing: a biomechanical model.

    PubMed

    Bellini, Chiara Maria; Galbusera, Fabio; Ceroni, Roberto Giacometti; Raimondi, Manuela Teresa

    2007-03-01

    The primary stability of cementless acetabular components is a prerequisite for their clinical success. The target of the present study was to analyse possible effects of post-operative joint loading on the initial mechanical stability of a press-fitted acetabular prosthesis. For this purpose, a three-dimensional finite element model of the pelvic bone with acetabular reconstruction was set-up. The analysis included two steps: (1) simulation of the prosthesis press-fit implantation and (2) simulation of the instant of peak resultant hip loading during the one-legged stance. The difference between the contact pressures at the bone/implant interface, at the end of the second step and those at the end of the first step was calculated and assumed as an index of variation in mechanical contact due to post-operative weight bearing. The results show that, due to hip loading, contact pressures given by press-fit increase in the postero-superior acetabular region but decrease in the antero-inferior acetabular region. The calculated area in which the contact pressures decrease extend to about 30% of the total contact surface. These results imply that post-operative joint loading significantly reduces the mechanical stability given by press-fit. The decrease in contact pressures at the bone/implant interface may result in a lack of osteointegration, possibly hindering the implant secondary stability. It may also create a route for wear debris, possibly favouring periprosthetic osteolysis, which may lead to further loss in contact and clinical failure of the implant due to loosening. PMID:16569508

  13. Monitoring the press-fit insertion of an acetabular cup by impact measurements: influence of bone abrasion.

    PubMed

    Michel, Adrien; Bosc, Romain; Mathieu, Vincent; Hernigou, Philippe; Haiat, Guillaume

    2014-10-01

    Press-fit procedures used for the insertion of cementless hip prostheses aim at obtaining optimal implant primary stability. We have previously used the measurement of impact duration to follow the insertion of the acetabular cup implant within bone tissue. The aim of this study was to investigate the variation of the value of the impact momentum due to successive insertions of the acetabular cup into bone tissue. The results obtained with impact momentum and contact duration measurements were compared. A total of 10 bovine bone samples were subjected to three successive procedures consisting of 10 reproducible impacts (3.5 kg falling 40 mm). Each procedure aimed at inserting the acetabular cup implant into the same bone cavity. The time variation of force during each impact was recorded by a force sensor, allowing the measurement of the impact duration (I 1) and momentum (I 2). The value of I 2 increased as a function of the impact number and reached a constant value after N 2 = 5.07 ± 1.31 impacts. Moreover, statistical analyses show that N 2 decreased significantly as a function of the number of experiments, which may be due to abrasion phenomena at the bone-implant interface. Abrasion phenomena led to a faster insertion of the acetabular cup when the implant had been previously inserted into the same bone cavity. An empirical analytical model considering a flat punch configuration to model the bone-implant contact conditions was used to understand the trend of the variation of I 2 during the insertion of the acetabular cup. The measurement of the force during impacts is useful to assess the bone-implant interface properties, but needs to be validated in the clinic to be useful for orthopaedic surgeons intra-operatively. PMID:25258009

  14. Thermal Shock-resistant Cement

    SciTech Connect

    Sugama T.; Pyatina, T.; Gill, S.

    2012-02-01

    We studied the effectiveness of sodium silicate-activated Class F fly ash in improving the thermal shock resistance and in extending the onset of hydration of Secar #80 refractory cement. When the dry mix cement, consisting of Secar #80, Class F fly ash, and sodium silicate, came in contact with water, NaOH derived from the dissolution of sodium silicate preferentially reacted with Class F fly ash, rather than the #80, to dissociate silicate anions from Class F fly ash. Then, these dissociated silicate ions delayed significantly the hydration of #80 possessing a rapid setting behavior. We undertook a multiple heating -water cooling quenching-cycle test to evaluate the cement’s resistance to thermal shock. In one cycle, we heated the 200 and #61616;C-autoclaved cement at 500 and #61616;C for 24 hours, and then the heated cement was rapidly immersed in water at 25 and #61616;C. This cycle was repeated five times. The phase composition of the autoclaved #80/Class F fly ash blend cements comprised four crystalline hydration products, boehmite, katoite, hydrogrossular, and hydroxysodalite, responsible for strengthening cement. After a test of 5-cycle heat-water quenching, we observed three crystalline phase-transformations in this autoclaved cement: boehmite and #61614; and #61543;-Al2O3, katoite and #61614; calcite, and hydroxysodalite and #61614; carbonated sodalite. Among those, the hydroxysodalite and #61614; carbonated sodalite transformation not only played a pivotal role in densifying the cementitious structure and in sustaining the original compressive strength developed after autoclaving, but also offered an improved resistance of the #80 cement to thermal shock. In contrast, autoclaved Class G well cement with and without Class F fly ash and quartz flour failed this cycle test, generating multiple cracks in the cement. The major reason for such impairment was the hydration of lime derived from the dehydroxylation of portlandite formed in the autoclaved

  15. Retention of alkali ions by hydrated low-pH cements: Mechanism and Na{sup +}/K{sup +} selectivity

    SciTech Connect

    Bach, T.T.H.; Chabas, E.; Cau Dit Coumes, C.; Frizon, F.

    2013-09-15

    Low-pH cements, also referred to as low-alkalinity cements, can be designed by replacing significant amounts of Portland cement by pozzolanic materials. Their pore solution is characterized by a pH near 11, and an alkali concentration much lower than that of Portland cement. This work investigates the retention of sodium and potassium by a hydrated low-pH cement comprising 60% Portland cement and 40% silica fume. It is shown that sorption of potassium is higher than that of sodium and mainly results from counterion charge balancing of the C-S-H negative surface charge. To explain the greater retention of potassium compared to sodium, it is postulated that potassium, unlike sodium, may enter the interlayer of C-S-H to compensate the negative charges in the interlayer, in addition to the external surfaces. This assumption is supported by structural characterization of C-S-H using X-ray diffraction.

  16. Effects of mechanical properties of adhesive resin cements on stress distribution in fiber-reinforced composite adhesive fixed partial dentures.

    PubMed

    Yokoyama, Daiichiro; Shinya, Akikazu; Gomi, Harunori; Vallittu, Pekka K; Shinya, Akiyoshi

    2012-01-01

    Using finite element analysis (FEA), this study investigated the effects of the mechanical properties of adhesive resin cements on stress distributions in fiber-reinforced resin composite (FRC) adhesive fixed partial dentures (AFPDs). Two adhesive resin cements were compared: Super-Bond C&B and Panavia Fluoro Cement. The AFPD consisted of a pontic to replace a maxillary right lateral incisor and retainers on a maxillary central incisor and canine. FRC framework was made of isotropic, continuous, unidirectional E-glass fibers. Maximum principal stresses were calculated using finite element method (FEM). Test results revealed that differences in the mechanical properties of adhesive resin cements led to different stress distributions at the cement interfaces between AFPD and abutment teeth. Clinical implication of these findings suggested that the safety and longevity of an AFPD depended on choosing an adhesive resin cement with the appropriate mechanical properties. PMID:22447051

  17. Diagenesis and cement fabric of gas reservoirs in the Oligocene Vicksburg Formation, McAllen Ranch Field, Hidalgo County, Texas

    SciTech Connect

    Langford, R.P.; Lynch, F.L. )

    1990-09-01

    McAllen Ranch field produces natural gas from 12 deep, overpressured sandstone packages, each interpreted to be the deposit of a prograding shelf-edge delta. One hundred and sixty thin sections from 350 ft of core were petrographically described. The sandstones are feldspathic litharenites containing subequal proportions of volcanic rock fragments (VRF), feldspar, and quartz grains. Grain size ranges from very fine to coarse sand. Porosity is mostly secondary, having formed through dissolution of VRF and feldspar grains. There are four major diagenetic facies (portions of core that can be grouped by the predominance of one diagenetic cement and similar appearance in hand specimen): (1) calcite cemented; (2) chlorite cemented, tight; (3) chlorite cemented, porous; and (4) quartz overgrowths, porous. The calcite-cemented facies predominates in very fine grained sandstones and siltstones and encroaches into adjoining sandstones irrespective of grain size. Sparry calcite filled all available pores and replaced some feldspar. Core permeabilities are generally less than 0.01 md, and porosities range from 7 to 15%. Authigenic clay (predominantly chlorite) generally cements sands intermediate in grain size between those cemented by calcite and those cemented by quartz. Two types of diagenetic clay fabric are interbedded, forming distinct alternating bands 0.1 in. to 3 ft thick. Gray, tightly chlorite-cemented bands are macroscopically and microscopically distinct from green, porous chlorite-cemented bands. In the tightly chlorite-cemented facies, permeabilities are less than 0.3 md, and porosities range from 8 to 16%. Small plates of chlorite fill interparticle pores, and secondary pores are rare. In the porous chlorite-cemented facies, dissolution of framework grains and chlorite cement increased porosity, and a second chlorite cement was precipitated. Core permeability ranges from 0.1 to 1 md, and porosities range from 15 to 20%.

  18. The Use of Micro and Nano Particulate Fillers to Modify the Mechanical and Material Properties of Acrylic Bone Cement

    NASA Astrophysics Data System (ADS)

    Slane, Joshua A.

    Acrylic bone cement (polymethyl methacrylate) is widely used in total joint replacements to provide long-term fixation of implants. In essence, bone cement acts as a grout by filling in the voids left between the implant and the patient's bone, forming a mechanical interlock. While bone cement is considered the `gold standard' for implant fixation, issues such as mechanical failure of the cement mantle (aseptic loosening) and the development of prosthetic joint infection (PJI) still plague joint replacement procedures and often necessitate revision arthroplasty. In an effort to address these failures, various modifications are commonly made to bone cement such as mechanical reinforcement with particles/fibers and the addition of antibiotics to mitigate PJI. Despite these attempts, issues such as poor particle interfacial adhesion, inadequate drug release, and the development of multidrug resistant bacteria limit the effectiveness of bone cement modifications. Therefore, the overall goal of this work was to use micro and nanoparticles to enhance the properties of acrylic bone cement, with particular emphasis placed on improving the mechanical properties, cumulative antibiotic release, and antimicrobial properties. An acrylic bone cement (Palacos R) was modified with three types of particles in various loading ratios: mesoporous silica nanoparticles (for mechanical reinforcement), xylitol microparticles (for increased antibiotic release), and silver nanoparticles (as an antimicrobial agent). These particles were used as sole modifications, not in tandem with one another. The resulting cement composites were characterized using a variety of mechanical (macro to nano, fatigue, fracture, and dynamic), imaging, chemical, thermal, biological, and antimicrobial testing techniques. The primary outcomes of this dissertation demonstrate that: (1) mesoporous silica, as used in this work, is a poor reinforcement phase for acrylic bone cement, (2) xylitol can significantly

  19. Usefulness of Arthroscopic Treatment of Painful Hip after Acetabular Fracture or Hip Dislocation

    PubMed Central

    Hwang, Jung-Taek; Lee, Woo-Yong; Kang, Chan; Kim, Dong-Yeol; Zheng, Long

    2015-01-01

    Background Painful hip following hip dislocation or acetabular fracture can be an important signal for early degeneration and progression to osteoarthritis due to intraarticular pathology. However, there is limited literature discussing the use of arthroscopy for the treatment of painful hip. The purpose of this retrospective study was to analyze the effectiveness and benefit of arthroscopic treatment for patients with a painful hip after major trauma. Methods From July 2003 to February 2013, we reviewed 13 patients who underwent arthroscopic treatment after acetabular fracture or hip dislocation and were followed up for a minimum of 2 postoperative years. The degree of osteoarthritis based on the Tonnis classification pre- and postoperatively at final follow-up was determined. Clinical outcomes were evaluated using visual analogue scale for pain (VAS) and modified Harris hip score (MHHS), and range of motion (ROM) of the hip pre- and postoperatively at final follow-up. Results There were nine male and four female patients with a mean age at surgery of 28 years (range, 20 to 50 years). The mean follow-up period of the patients was 59.8 months (range, 24 to 115 months), and the mean interval between initial trauma and arthroscopic treatment was 40.8 months (range, 1 to 144 months). At the final follow-up, VAS and MHHS improved significantly from 6.3 and 53.4 to 3.0 and 88.3, respectively (p = 0.002 and p < 0.001, respectively). However, there were no significant differences in hip flexion, abduction, adduction, external rotation, and internal rotation as minor improvements from 113.1°, 38.5°, 28.5°, 36.5°, and 22.7° to 118.5°, 39.0°, 29.2°, 38.9°, and 26.5° were observed, respectively (p = 0.070, p = 0.414, p = 0.317, p = 0.084, and p = 0.136, respectively). None of the patients exhibited progression of osteoarthritis of the hip at the final follow-up. Conclusions Arthroscopic treatment after acetabular fracture or hip dislocation is effective and delays

  20. Elbow replacement - discharge

    MedlinePlus

    Total elbow arthroplasty - discharge; Endoprosthetic elbow replacement - discharge ... You had surgery to replace your elbow joint with artificial joint parts (prosthetics). The surgeon made a cut (incision) in the back of your upper or lower arm and ...

  1. Partial knee replacement - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series To use the sharing features on ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  2. Nicotine replacement therapy

    MedlinePlus

    ... If wearing the patch at night causes odd dreams, try sleeping without the patch. People who smoke ... cessation - nicotine replacement; Tobacco - nicotine replacement therapy References American Cancer Society. Guide to quitting smoking. Last revised ...

  3. Partial knee replacement

    MedlinePlus

    Most people recover quickly and have much less pain than they did before surgery. People who have a partial knee replacement recover faster than those who have a total knee replacement. Many people are able to walk ...

  4. Investigation of an effervescent additive as porogenic agent for bone cement macroporosity.

    PubMed

    Hesaraki, Saeed; Sharifi, Davood

    2007-01-01

    Calcium phosphate cements (CPCs) are biocompatible and osteoconductive materials used in dental, craniofacial and orthopaedic applications. One of the most important advantages of these materials is their replacement with bone followed by resorption. Already several attempts have been made to improve the resorption behaviour of calcium phosphate cements by increasing the porosity of the material. In this investigation a mixture of NaHCO(3) and citric acid monohydrate was added to the apatite cement component as an effervescent additive for producing interconnected macropores into the cement matrix. Mercury intrusion porosimetry was employed to determine pore volume and pore size distribution in the calcium phosphate cement (CPC) samples. Results showed that addition of only 10 wt % of the effervescent additive (based on the cement powder) to the CPC components lead to producing about 20 V % macropores (with the size of 10 to 1000 mum) into the cement structure. The setting time was measured in an incubator at 37 degrees C and decreased from 40 min for additive-free CPC to about 14 min for CPC containing effervescent additive. Other properties of the CPCs such as compressive strength, phase composition, microstructure morphology and dissolution behavior were evaluated after immersing them in a simulated body fluid solution. The results showed that the rate of formation of poor crystalline apatite phase have been improved by production of macroporosity into the cement matrix. PMID:17264385

  5. Microdamage assessment of bone-cement interfaces under monotonic and cyclic compression.

    PubMed

    Tozzi, Gianluca; Zhang, Qing-Hang; Tong, Jie

    2014-11-01

    Bone-cement interface has been investigated under selected loading conditions, utilising experimental techniques such as in situ mechanical testing and digital image correlation (DIC). However, the role of bone type in the overall load transfer and mechanical behaviour of the bone-cement construct is yet to be fully quantified. Moreover, microdamage accumulation at the interface and in the cement mantle has only been assessed on the exterior surfaces of the samples, where no volumetric information could be obtained. In this study, some typical bone-cement interfaces, representative of different fixation scenarios for both hip and knee replacements, were constructed using mainly trabecular bone, a mixture of trabecular and cortical bone and mainly cortical bone, and tested under static and cyclic compression. Axial displacement and strain fields were obtained by means of digital volume correlation (DVC) and microdamage due to static compression was assessed using DVC and finite element (FE) analysis, where yielded volumes and strains (εzz) were evaluated. A significantly higher load was transferred into the cement region when mainly cortical bone was used to interdigitate with the cement, compared with the other two cases. In the former, progressive damage accumulation under cyclic loading was observed within both the bone-cement interdigitated and the cement regions, as evidenced by the initiation of microcracks associated with high residual strains (εzz_res). PMID:25283468

  6. Hydration of blended cement pastes containing waste ceramic powder as a function of age

    NASA Astrophysics Data System (ADS)

    Scheinherrová, Lenka; Trník, Anton; Kulovaná, Tereza; Pavlík, Zbyšek; Rahhal, Viviana; Irassar, Edgardo F.; Černý, Robert

    2016-07-01

    The production of a cement binder generates a high amount of CO2 and has high energy consumption, resulting in a very adverse impact on the environment. Therefore, use of pozzolana active materials in the concrete production leads to a decrease of the consumption of cement binder and costs, especially when some type of industrial waste is used. In this paper, the hydration of blended cement pastes containing waste ceramic powder from the Czech Republic and Portland cement produced in Argentina is studied. A cement binder is partially replaced by 8 and 40 mass% of a ceramic powder. These materials are compared with an ordinary cement paste. All mixtures are prepared with a water/cement ratio of 0.5. Thermal characterization of the hydrated blended pastes is carried out in the time period from 2 to 360 days. Simultaneous DSC/TG analysis is performed in the temperature range from 25 °C to 1000 °C in an argon atmosphere. Using this thermal analysis, we identify the temperature, enthalpy and mass changes related to the liberation of physically bound water, calcium-silicate-hydrates gels dehydration, portlandite, vaterite and calcite decomposition and their changes during the curing time. Based on thermogravimetry results, we found out that the portlandite content slightly decreases with time for all blended cement pastes.

  7. Self-cleaning and mechanical properties of modified white cement with nanostructured TiO2.

    PubMed

    Khataee, R; Heydari, V; Moradkhannejhad, L; Safarpour, M; Joo, S W

    2013-07-01

    In the present study, self-cleaning and mechanical properties of white Portland cement by addition of commercial available TiO2 nanoparticles with the average particle size of 80 nm were investigated. X-ray diffraction (XRD), transmission electron microscopy (TEM) and BET were used to characterize TiO2 nanoparticles. For determination of self-cleaning properties of TiO2-modified white cement, colorimetric tests in decolorization of C.I. Basic Red 46 (BR46) in comparison to unmodified cement samples was applied. The results indicated that with increasing the amount of TiO2 nanoparticles in modified cement, self-cleaning property of the samples increased. The mechanical properties of TiO2-modified and unmodified cement samples, such as time of setting of hydraulic cement, compressive strength of hydraulic cement mortar and flexural strength of hydraulic cement mortar were examined. The results indicated that addition of TiO2 nanoparticles up to maximum replacement level of 1.0% improved compressive and flexural strength and decreased its setting time. PMID:23901537

  8. Cement fabrics of the Bahamian platform and its margin near Lee Stocking Island

    SciTech Connect

    Whittle, G.; Rouche, L.; Dill, R.F.; Kendall, C.G.S.C. )

    1991-03-01

    Consolidated to firable carbonate rock samples were collected on and around Lee Stocking Island to determine the distribution, fabric, and mineralogy of their cements. The rocks include: (1) beachrock rimming the islands, (2) shallow-water hardgrounds, (3) reef rock, (4) channel stromatolites, and (5) Pleistocene bedrock. Analyses by SEM, microprobe, X-ray diffraction, and petrographic microscope have revealed ten different cement fabrics. Five of these cements are varieties of fibers, all of which are aragonitic except the whisker' fibers that form coarse networks of intertwining high-Mg calcite in a Pleistocene cave sample. Acicular fan-druse and square-tipped coarse fibers cement the beachrock, while an isopachous, needle-fiber rim is found only in the hardgrounds. A radial fibrous cement occurs in several ooids and biogenic grains, representing a replacement fabric of aragonite that has inverted to high-Mg calcite. Two types of blades are present: a stubby variety with a length:width ratio of 2:1 and an elongated 5:1 variety, both of which are high-Mg calcite. While the 2:1 variety is rather common, the 5:1 variety only occurred in one sample. Aragonitic micrite envelopes often surround grains in beachrock and hardgrounds, but only in association with fibrous cement. An aragonitic lime mud matrix cements the crusted mud beds and low-Mg calcite equant spar cements the Pleistocene samples and occurs as void-fill in beachrock and hardgrounds. The most common marine cementation is associated with the aragonitic fibers found in the discontinuous hardgrounds and beachrocks. The more widespread cements are the low Mg-calcite spar associated with meteoric diagenesis and cementation of the Pleistocene surface.

  9. Advanced cement solidification system

    SciTech Connect

    Nakashima, T.; Kuribayashi, H.; Todo, F.

    1993-12-31

    In order to easily and economically store and transport radioactive waste generated at nuclear power stations, it is essential to reduce the waste volume to the maximum extent. It is also necessary to transform the waste into a stable form for final disposal which will maintain its chemical and physical stability over a long period of time. For this purpose, the Advanced Cement Solidification Process (AC-process) was developed. The AC-process, which utilizes portland cement, can be applied to several kinds of waste such as boric acid waste, laboratory drain waste, incineration ash and spent ion exchange resin. In this paper, the key point of the AC-process, the pretreatment concept for each waste, is described. The AC-process has been adopted for two Japanese PWR stations: the Genkai Nuclear Power Station (Kyushu Electric Power Co.) and the Ikata Nuclear Power Station (Shikoku Electric Power Co.). Construction work has almost finished and commissioning tests are under way at both power stations.

  10. Hip replacement by a minimal anterior approach.

    PubMed

    Paillard, P

    2007-08-01

    The mini-incision anterior approach in total hip replacement is not new, but uses a shorter incision than the traditional Hueter approach, typically only 6-8 cm in length. Despite its size, the single anterior incision allows good exposure. It is very atraumatic, preserves muscles and tendons, and allows the patient early mobilisation and fast postoperative recovery. Although, a special table (e.g., a Judet table) and specific tools (e.g., a curved reamer) are needed to perform hip replacement via the mini-anterior approach, any kind of hip prosthesis (cemented or uncemented) can be implanted. As there is a significant learning curve in mastering the mini-incision anterior approach, surgeons are advised to start with a longer incision and then to decrease its length with increasing experience. PMID:17657491

  11. Durability of Cement Composites Reinforced with Sisal Fiber

    NASA Astrophysics Data System (ADS)

    Wei, Jianqiang

    This dissertation focuses mainly on investigating the aging mechanisms and degradation kinetics of sisal fiber, as well as the approaches to mitigate its degradation in the matrix of cement composites. In contrast to previous works reported in the literature, a novel approach is proposed in this study to directly determine the fiber's degradation rate by separately studying the composition changes, mechanical and physical properties of the embedded sisal fibers. Cement hydration is presented to be a crucial factor in understanding fiber degradation behavior. The degradation mechanisms of natural fiber consist of mineralization of cell walls, alkali hydrolysis of lignin and hemicellulose, as well as the cellulose decomposition which includes stripping of cellulose microfibrils and alkaline hydrolysis of amorphous regions in cellulose chains. Two mineralization mechanisms, CH-mineralization and self-mineralization, are proposed. The degradation kinetics of sisal fiber in the cement matrix are also analyzed and a model to predict the degradation rate of cellulose for natural fiber embedded in cement is outlined. The results indicate that the time needed to completely degrade the cellulose in the matrix with cement replacement by 30wt.% metakaolin is 13 times longer than that in pure cement. A novel and scientific method is presented to determine accelerated aging conditions, and to evaluating sisal fiber's degradation rate and durability of natural fiber-reinforced cement composites. Among the static aggressive environments, the most effective approach for accelerating the degradation of natural fiber in cement composites is to soak the samples or change the humidity at 70 °C and higher temperature. However, the dynamic wetting and drying cycling treatment has a more accelerating effect on the alkali hydrolysis of fiber's amorphous components evidenced by the highest crystallinity indices, minimum content of holocellulose, and lowest tensile strength. Based on the

  12. Stabilization of high and low solids Consolidated Incinerator Facility (CIF) waste with super cement

    SciTech Connect

    Walker, B.W.

    2000-01-11

    This report details solidification activities using selected Mixed Waste Focus Area technologies with the High and Low Solid waste streams. Ceramicrete and Super Cement technologies were chosen as the best possible replacement solidification candidates for the waste streams generated by the SRS incinerator from a list of several suggested Mixed Waste Focus Area technologies. These technologies were tested, evaluated, and compared to the current Portland cement technology being employed. Recommendation of a technology for replacement depends on waste form performance, process flexibility, process complexity, and cost of equipment and/or raw materials.

  13. Precooling an acetabular liner makes its insertion into a metal shell easier.

    PubMed

    Kyle, Richard F; Bourgeault, Craig A; Lew, William D; Bechtold, Joan E

    2006-02-01

    Temporary shrinkage of an acetabular polyethylene liner due to precooling could reduce the force required to snap the liner into its metal shell. This study documented cooling and heating rates of liners with a particular locking mechanism design, determined forces required to seat liners in their shells as a function of temperature, and quantified the force surgeons can exert with their thumbs when seating a liner. It took up to 8 minutes to cool 58- and 70-mm liners in an ice-water bath from room temperature to near 0 degrees C, and up to 24 minutes to subsequently warm these liners to near body temperature. Forces required to seat liners were greater at room and body temperatures than at 0 degrees C. Liners precooled to 0 degrees C required insertion forces that could be generated manually by surgeons. PMID:16520215

  14. A Feasibility Study into the Use of Three-Dimensional Printer Modelling in Acetabular Fracture Surgery

    PubMed Central

    Yu, A. W.; Duncan, J. M.; Daurka, J. S.; Lewis, A.; Cobb, J.

    2015-01-01

    There are a number of challenges associated with the operative treatment of acetabular fractures. The approach used is often extensive, while operative time and perioperative blood loss can also be significant. With the proliferation of 3D printer technology, we present a fast and economical way to aid the operative planning of complex fractures. We used augmented stereoscopic 3D CT reconstructions to allow for an appreciation of the normal 3D anatomy of the pelvis on the fractured side and to use the models for subsequent intraoperative contouring of pelvic reconstruction plates. This leads to a reduction in the associated soft tissue trauma, reduced intraoperative time and blood loss, minimal handling of the plate, and reduced fluoroscopic screening times. We feel that the use of this technology to customize implants, plates, and the operative procedure to a patient's unique anatomy can only lead to improved outcomes. PMID:25709843

  15. Does the ingrowth surface make a difference? A retrieval study of 423 cementless acetabular components.

    PubMed

    Swarts, Eric; Bucher, Thomas A; Phillips, Michael; Yap, Francis H X

    2015-04-01

    The effect of factors such as design, alloy and coating type on bony or fibrous tissue ingrowth was evaluated in a study of 423 retrieved cementless acetabular shells representing 16 shell designs. Small-beaded (250μm) porous coatings, either with or without hydroxyapatite (HA) coatings, proved to be the superior porous surface for bone ingrowth. Small-beaded shells that were Duofix coated had predominantly fibrous tissue ingrowth. In addition to bead size, alloy type and surface type have significant effect on bone ingrowth. In contrast, there is no significant association between bone ingrowth and time in situ, with most bone ingrowth occurring early. Although roughened, press-fit shells have acceptable clinical and Registry data, they showed some of the lowest ingrowth/ongrowth scores of all the shells tested. PMID:25515944

  16. The Harris-Galante porous acetabular component press-fit without screw fixation. Five-year radiographic analysis of primary cases.

    PubMed

    Schmalzried, T P; Wessinger, S J; Hill, G E; Harris, W H

    1994-06-01

    One hundred twenty-two primary total hip arthroplasties were followed for an average of 56 months (range, 48-66 months) in which the Harris-Galante (Zimmer, Warsaw, IN) porous ingrowth acetabular component had been press-fit into the innominate bone without screw fixation. There were no acetabular fractures. No socket was revised for loosening and none were radiographically loose. There was no evidence of disruption of the titanium porous mesh. There was no acetabular osteolysis. Compared to the authors' series of primary hip reconstructions using this same prosthesis inserted with line-to-line reaming and screw fixation, the data indicate that the tight peripheral fit associated with the press-fit technique is effective in reducing both the incidence and extent of bone-implant radiolucencies. However, the increased incidence of radiolucencies near the apex of the acetabulum also suggest that initial contact of the porous surface with live acetabular bone at this location is desirable in order to obtain and maintain an optimal bone-implant interface. Additional studies are necessary to further establish the relationship between the initial fit and long-term fixation of cementless acetabular components. Based on the data and other considerations for eliminating both vascular risk and the potential for fretting wear between the screws and shell, the authors recommend press-fitting without screw fixation for this acetabular component in primary cases when anatomy and bone stock permit. Full seating of the component is recommended in order to obtain dome contact. PMID:8077971

  17. Measurement of lateral acetabular coverage: a comparison between CT and plain radiography

    PubMed Central

    Chadayammuri, Vivek; Garabekyan, Tigran; Jesse, Mary-Kristen; Pascual-Garrido, Cecilia; Strickland, Colin; Milligan, Kenneth; Mei-Dan, Omer

    2015-01-01

    We prospectively evaluated the degree of absolute agreement between measurements of lateral center-edge angle (LCEA) on plain radiography (XR) and computed tomography (CT) in a consecutive cohort of 205 patients (410 hips) undergoing hip arthroscopy. Preoperative measurements of the LCEA were performed bilaterally utilizing standardized anteroposterior radiographs and coronal reformatted CT scans. Demographic variables including age, gender, height, weight, BMI and clinical diagnosis were recorded for all patients. Overall, measured values of the LCEA were 2.1° larger on CT compared with XR (32.9° versus 30.8°, P < 0.001). Subgroup analysis revealed the highest mean difference in hips with acetabular dysplasia and concomitant cam-type femoroacetabular impingement (FAI) [mean difference (CT–XR) 5.5°, 95% confidence interval (CI) 3.7°–7.3°, P = 0.011], followed by hips with isolated acetabular dysplasia (mean difference [CT–XR] 4.9°, 95% CI 2.7°–7.0°, P < 0.001). In contrast, 119 (29.0%) of the hips demonstrated larger measurements of the LCEA on 25 XR relative to CT. Of these hips, 20 (16.8%) had pincer-FAI and 25 had cam-FAI (21.0%), representing a significantly higher proportion compared with all other clinical subgroups (P = 0.045 and 0.036, respectively). Our study demonstrates measured values of the LCEA are consistently inflated on CT relative to XR for a wide variety of hip pathologies, highlighting the need for standardization and validation of CT-based measurements to improve the quality of clinical decision making. Level of Evidence: Diagnostic Level II. PMID:27011864

  18. Wear of gamma-crosslinked polyethylene acetabular cups against roughened femoral balls.

    PubMed

    McKellop, H; Shen, F W; DiMaio, W; Lancaster, J G

    1999-12-01

    Crosslinking of ultrahigh molecular weight polyethylene has been shown to markedly improve its wear resistance in clinical studies and laboratory tests using hip joint simulators. However, because most of the laboratory studies have been done under clean conditions using prosthesis-quality, highly polished counterfaces, there is concern regarding how well an intentionally crosslinked polyethylene acetabular cup will resist abrasion by a femoral ball that has been damaged by third-body abrasion in vivo. To investigate this, conventional and radiation crosslinked-remelted acetabular cups of ultra-high molecular weight polyethylene were tested in a hip joint simulator bearing against smooth femoral balls and against balls with moderate and severe roughening. Cups were tested with and without aging to accelerate any oxidative degradation. The crosslinked cups were produced by exposing extruded GUR 4150 bar stock of ultrahigh molecular weight polyethylene to 5 Mrad gamma radiation under a partial vacuum and then the bars were remelted to extinguish residual free radicals. Artificial aging at 70 degrees C under 5 atm oxygen for 14 days induced negligible oxidation in the crosslinked and remelted material. Against smooth balls, the wear of the crosslinked cups, with or without aging, averaged approximately 15% of that of the conventional cups. Against the moderately rough balls, the wear rate of the conventional cups was unchanged, whereas the wear rate increased slightly for the nonaged and aged crosslinked cups, but was still only 26% and 20% of that of the conventional cups, respectively. Against extremely rough balls, the mean wear rates increased markedly for each material such that during the final 1 million cycle interval, the average wear rates of the nonaged and the aged crosslinked cups were 72% and 47% of that of the conventional cups, respectively. That is, the crosslinked polyethylene showed substantially better wear resistance than conventional polyethylene

  19. Patient-specific Analysis of Cartilage and Labrum Mechanics in Human Hips with Acetabular Dysplasia

    PubMed Central

    Henak, Corinne R; Abraham, Christine L; Anderson, Andrew E; Maas, Steve A; Ellis, Benjamin J; Peters, Christopher L; Weiss, Jeffrey A

    2014-01-01

    BACKGROUND Acetabular dysplasia is a major predisposing factor for development of hip osteoarthritis, and may result from alterations to chondrolabral loading. Subject-specific finite element (FE) modeling can be used to evaluate chondrolabral mechanics in the dysplastic hip, thereby providing insight into mechanics that precede osteoarthritis. OBJECTIVE To evaluate chondrolabral contact mechanics and congruency in dysplastic hips and normal hips using a validated approach to subject-specific FE modeling. METHODS FE models of ten subjects with normal acetabula and ten subjects with dysplasia were constructed using a previously validated protocol. Labrum load support, and labrum and acetabular cartilage contact stress and contact area were compared between groups. Local congruency was determined at the articular surface for two simulated activities. RESULTS The labrum in dysplastic hips supported 2.8 to 4.0 times more of the load transferred across the joint than in normal hips. Dysplastic hips did not have significantly different congruency in the primary load-bearing regions than normal hips, but were less congruent in some unloaded regions. Normal hips had larger cartilage contact stress than dysplastic hips in the few regions that had significant differences. CONCLUSIONS The labrum in dysplastic hips has a far more significant role in hip mechanics than it does in normal hips. The dysplastic hip is neither less congruent than the normal hip, nor subjected to elevated cartilage contact stresses. This study supports the concept of an outside-in pathogenesis of osteoarthritis in dysplastic hips and that the labrum in dysplastic hips should be preserved during surgery. PMID:24269633

  20. Prophylactic radiotherapy against heterotopic ossification following internal fixation of acetabular fractures: a comparative estimate of risk

    PubMed Central

    Nasr, P; Yip, G; Scaife, J E; House, T; Thomas, S J; Harris, F; Owen, P J; Hull, P

    2014-01-01

    Objective: Radiotherapy (RT) is effective in preventing heterotopic ossification (HO) around acetabular fractures requiring surgical reconstruction. We audited outcomes and estimated risks from RT prophylaxis, and alternatives of indometacin or no prophylaxis. Methods: 34 patients underwent reconstruction of acetabular fractures through a posterior approach, followed by a 8-Gy single fraction. The mean age was 44 years. The mean time from surgery to RT was 1.1 days. The major RT risk is radiation-induced fatal cancer. The International Commission on Radiological Protection (ICRP) method was used to estimate risk, and compared with a method (Trott and Kemprad) specifically for estimating RT risk for benign disease. These were compared with risks associated with indometacin and no prophylaxis. Results: 28 patients (82%) developed no HO; 6 developed Brooker Class I; and none developed Class II–IV HO. The ICRP method suggests a risk of fatal cancer in the range of 1 in 1000 to 1 in 10,000; the Trott and Kemprad method suggests 1 in 3000. For younger patients, this may rise to 1 in 2000; and for elderly patients, it may fall to 1 in 6000. The risk of death from gastric bleeding or perforation from indometacin is 1 in 180 to 1 in 900 in older patients. Without prophylaxis risk of death from reoperation to remove HO is 1 in 4000 to 1 in 30,000. Conclusion: These results are encouraging, consistent with much larger series and endorse our multidisciplinary management. Risk estimates can be used in discussion with patients. Advances in knowledge: The risk from RT prophylaxis is small, it is safer than indometacin and substantially overlaps with the range for no prophylaxis. PMID:25089852

  1. The Incidence of Acetabular Osteolysis in Young Patients With Conventional versus Highly Crosslinked Polyethylene

    PubMed Central

    Mall, Nathan A.; Nunley, Ryan M.; Zhu, Jin Jun; Maloney, William J.; Barrack, Robert L.

    2010-01-01

    Background Osteolysis is a major mode of hip implant failure. Previous literature has focused on the amount of polyethylene wear comparing highly crosslinked polyethylene (HXPLE) with conventional liners but has not clarified the relative incidence of osteolysis with these two liners. Questions/purposes We determined (1) the incidence of osteolysis in HXLPE versus conventional polyethylene (CPE), (2) the ability to detect and evaluate the size of lytic lesions using radiographs compared with CT scans, (3) head penetration in hips without and with lysis, and (4) determined whether acetabular position, head size, and UCLA activity score contributed to lysis. Methods We compared head penetration and osteolysis on plain radiographs and presence and volume of osteolysis on CT scans in 48 patients with HXLPE (mean, 46.5 years) and 50 patients with CPE (mean, 43.2 years). The minimum followup was 5 years (average, 7.2 years; range, 5.1–10.9 years), Results Osteolysis was apparent on CT in a larger number of patients with CPE liners than HXLPE liners: 12 of 50 (24%) versus one of 48 (2%), respectively. We found no correlation between head penetration and volume of osteolytic lesions. Head penetration was greater in patients with osteolysis. Smaller head sizes were associated with greater wear and those with osteolysis had smaller head sizes; however, there was no difference in acetabular component position or UCLA activity in those with lysis compared with those without. Conclusions HXLPE diminished the incidence of osteolysis, but the lack of correlation between penetration and volume of osteolysis suggests other factors other than wear contribute to the development of osteolysis. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID:20824407

  2. Characterization of vapor phase mercury released from concrete processing with baghouse filter dust added cement.

    PubMed

    Wang, Jun; Hayes, Josh; Wu, Chang-Yu; Townsend, Timothy; Schert, John; Vinson, Tim; Deliz, Katherine; Bonzongo, Jean-Claude

    2014-02-18

    The fate of mercury (Hg) in cement processing and products has drawn intense attention due to its contribution to the ambient emission inventory. Feeding Hg-loaded coal fly ash to the cement kiln introduces additional Hg into the kiln's baghouse filter dust (BFD), and the practice of replacing 5% of cement with the Hg-loaded BFD by cement plants has recently raised environmental and occupational health concerns. The objective of this study was to determine Hg concentration and speciation in BFD as well as to investigate the release of vapor phase Hg from storing and processing BFD-added cement. The results showed that Hg content in the BFD from different seasons ranged from 0.91-1.44 mg/kg (ppm), with 62-73% as soluble inorganic Hg, while Hg in the other concrete constituents were 1-3 orders of magnitude lower than the BFD. Up to 21% of Hg loss was observed in the time-series study while storing the BFD in the open environment by the end of the seventh day. Real-time monitoring in the bench system indicated that high temperature and moisture can facilitate Hg release at the early stage. Ontario Hydro (OH) traps showed that total Hg emission from BFD is dictated by the air exchange surface area. In the bench simulation of concrete processing, only 0.4-0.5% of Hg escaped from mixing and curing BFD-added cement. A follow-up headspace study did not detect Hg release in the following 7 days. In summary, replacing 5% of cement with the BFD investigated in this study has minimal occupational health concerns for concrete workers, and proper storing and mixing of BFD with cement can minimize Hg emission burden for the cement plant. PMID:24444016

  3. 21 CFR 888.4200 - Cement dispenser.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cement dispenser. 888.4200 Section 888.4200 Food... DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4200 Cement dispenser. (a) Identification. A cement dispenser is a nonpowered syringe-like device intended for use in placing bone cement (§ 888.3027)...

  4. 21 CFR 888.4200 - Cement dispenser.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cement dispenser. 888.4200 Section 888.4200 Food... DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4200 Cement dispenser. (a) Identification. A cement dispenser is a nonpowered syringe-like device intended for use in placing bone cement (§ 888.3027)...

  5. 21 CFR 888.4200 - Cement dispenser.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cement dispenser. 888.4200 Section 888.4200 Food... DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4200 Cement dispenser. (a) Identification. A cement dispenser is a nonpowered syringe-like device intended for use in placing bone cement (§ 888.3027)...

  6. 21 CFR 888.4200 - Cement dispenser.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cement dispenser. 888.4200 Section 888.4200 Food... DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4200 Cement dispenser. (a) Identification. A cement dispenser is a nonpowered syringe-like device intended for use in placing bone cement (§ 888.3027)...

  7. 21 CFR 888.4200 - Cement dispenser.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cement dispenser. 888.4200 Section 888.4200 Food... DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4200 Cement dispenser. (a) Identification. A cement dispenser is a nonpowered syringe-like device intended for use in placing bone cement (§ 888.3027)...

  8. Osteolytic changes around biodegradable cement restrictors in hip surgery.

    PubMed

    Erschbamer, Matthias; Zdravkovic, Vilijam; Erhardt, Johannes; Öhlschlegel, Christian; Grob, Karl

    2016-06-01

    Background and purpose - Biodegradable cement restrictors are widely used in hip arthroplasty. Like others, we observed osteolytic reactions associated with a specific cement restrictor (SynPlug; made of PolyActive) and reviewed our patients. Patients and methods - We identified 703 patients with suitable radiographs from our database (2007 to 2012) who underwent cemented hip arthroplasty and received a SynPlug biodegradable cement restrictor. We reviewed all available radiographs to determine the incidence, severity, and progression of osteolysis. Mean postoperative follow-up was 1.8 (1-7) years Results - 1 year after implantation, the femoral cortex showed thinning by 12% in the anterior-posterior view and by 8% in the axial view. This had increased to 14% and 12%, respectively, at the latest available follow-up postoperatively (at a mean of 4 years). Cortical thinning of less than 10% was found in 37% of patients, but cortical thinning of 10-30% was found in 56% of patients. In the remaining 7%, a reduction of more than 30% of the original cortical thickness was observed. Interpretation - Osteolytic changes associated with the SynPlug biodegradable bone restrictors are inconsistent and highly variable. While some patients showed increased weakening of the femoral cortex with the potential risk of periprosthetic fracture, in others the degree of osteolysis only increased slightly or stabilized after 2 or more years. Any cortical bone loss after total hip replacement should be avoided, so the use of PolyActive biodegradable cement restrictors should be discontinued. Patients with a PolyActive cement restrictor in place should be followed up closely after surgery. PMID:26905752

  9. Osteolytic changes around biodegradable cement restrictors in hip surgery

    PubMed Central

    Erschbamer, Matthias; Zdravkovic, Vilijam; Erhardt, Johannes; Öhlschlegel, Christian; Grob, Karl

    2016-01-01

    Background and purpose Biodegradable cement restrictors are widely used in hip arthroplasty. Like others, we observed osteolytic reactions associated with a specific cement restrictor (SynPlug; made of PolyActive) and reviewed our patients. Patients and methods We identified 703 patients with suitable radiographs from our database (2007 to 2012) who underwent cemented hip arthroplasty and received a SynPlug biodegradable cement restrictor. We reviewed all available radiographs to determine the incidence, severity, and progression of osteolysis. Mean postoperative follow-up was 1.8 (1–7) years Results 1 year after implantation, the femoral cortex showed thinning by 12% in the anterior-posterior view and by 8% in the axial view. This had increased to 14% and 12%, respectively, at the latest available follow-up postoperatively (at a mean of 4 years). Cortical thinning of less than 10% was found in 37% of patients, but cortical thinning of 10–30% was found in 56% of patients. In the remaining 7%, a reduction of more than 30% of the original cortical thickness was observed. Interpretation Osteolytic changes associated with the SynPlug biodegradable bone restrictors are inconsistent and highly variable. While some patients showed increased weakening of the femoral cortex with the potential risk of periprosthetic fracture, in others the degree of osteolysis only increased slightly or stabilized after 2 or more years. Any cortical bone loss after total hip replacement should be avoided, so the use of PolyActive biodegradable cement restrictors should be discontinued. Patients with a PolyActive cement restrictor in place should be followed up closely after surgery. PMID:26905752

  10. Reusing fly ash in glass fibre reinforced cement: a new generation of high-quality GRC composites.

    PubMed

    Payá, J; Bonilla, M; Borrachero, M V; Monzó, J; Peris-Mora, E; Lalinde, L F

    2007-01-01

    New composite materials based on an alkali-resistant glass-fibre reinforced cement (AR-GRC) system are being developed by using fly ash (FA) produced at coal thermoelectric power plants, and fluid catalytic cracking catalyst residue (FC3R) from the petrol industry as cement replacement materials. These wastes are reactive from the pozzolanic viewpoint, and modify the nature and the microstructure of the cement matrix when a part of the Portland cement is replaced in the formulation of GRC. Several microstructural and mechanical aspects are being studied for AR-GRC systems. The behaviour of composites exposed to ageing shows that the pozzolanic activity of the ground FA added in high amounts and its mixture with the FC3R increase the flexural strength and no evidences of strength decay are observed. Additionally, the fibres due to the high alkalinity of the cementing matrix can be deteriorated. Fibres in the control (only Portland cement) and FC3R containing composites were attacked, whereas composites with FA and their mixture with FC3R show that the fibres have not been attacked, due to the pozzolanic activity of replacing materials that reduce the calcium hydroxide content in the cementing matrix. PMID:17512718

  11. Normalization of chromium and cobalt values after femoral head replacement

    PubMed Central

    Iacobellis, Claudio; Berizzi, Antonio; Pozzuoli, Assunta; Biz, Carlo

    2015-01-01

    Introduction Adverse reaction to metal debris (ARMD) can be caused by metal-on-metal total hip arthoplasty. We treated a case of ARMD in a 61-year-old patient by limited prosthetic revision, replacing the metal head with a polyethylene one. Presentation of case Two years after metal-on-metal total arthoplasty of the left hip, radiographic control showed osteolysis of the patient’s greater trochanter. He underwent surgical curettage and the application of demineralized bone matrix. After a few months, blood Co and Cr increased, and at clinical evaluation, the patient had worsening paresthesias. He agreed to prosthetic revision after 14 months. Discussion During surgery, the acetabular cup and femoral stem appeared correctly osteointegrated; therefore, the cup was maintained, while the prosthetic femoral head was removed and replaced with a 50 mm polyethylene head. Conclusion Blood Cr and urinary Cr and Co decreased and normalized 3 months after surgery, and the patient no longer suffered paresthesias. Blood Co normalized 7 months after revision. Radiographic follow-up showed no change after 30 months post-operatively. We believe this case report could be a starting point for a future randomized clinical trial to test the efficacy of the procedure used compared with complete implant revision. PMID:25841157

  12. Influence of acetabular cup rim design on the contact stress during edge loading in ceramic-on-ceramic hip prostheses.

    PubMed

    Mak, Mathew; Jin, Zhongmin; Fisher, John; Stewart, Todd D

    2011-01-01

    The purpose of the study was to investigate the contact stresses in 3 different acetabular cup rim designs (new, worn, chamfer) during edge loading, after microseparation of ceramic on ceramic hip prostheses. A 3-dimensional finite element analysis was conducted for a 28-mm diameter alumina ceramic bearing with a radial clearance of 40 μm using a normal load of 2500 N under edge loading. At a separation distance of 250 μm, the maximum tensile stress in the "new" design was of similar magnitude to the flexural strength of the alumina material that supports the localized breakdown (stripe wear) of the acetabular cup surface observed clinically. Introducing a 2.5-mm radius chamfer should reduce the maximum tensile stress in the region of 60%. PMID:20149581

  13. A hierarchy of computationally derived surgical and patient influences on metal on metal press-fit acetabular cup failure.

    PubMed

    Clarke, S G; Phillips, A T M; Bull, A M J; Cobb, J P

    2012-06-01

    The impact of anatomical variation and surgical error on excessive wear and loosening of the acetabular component of large diameter metal-on-metal hip arthroplasties was measured using a multi-factorial analysis through 112 different simulations. Each surgical scenario was subject to eight different daily loading activities using finite element analysis. Excessive wear appears to be predominantly dependent on cup orientation, with inclination error having a higher influence than version error, according to the study findings. Acetabular cup loosening, as inferred from initial implant stability, appears to depend predominantly on factors concerning the area of cup-bone contact, specifically the level of cup seating achieved and the individual patient's anatomy. The extent of press fit obtained at time of surgery did not appear to influence either mechanism of failure in this study. PMID:22513086

  14. Changes in the treatment of acetabular fractures over 15 years: Analysis of 1266 cases treated by the German Pelvic Multicentre Study Group (DAO/DGU).

    PubMed

    Ochs, Björn Gunnar; Marintschev, Ivan; Hoyer, Heike; Rolauffs, Bernd; Culemann, Ulf; Pohlemann, Tim; Stuby, Fabian Maria

    2010-08-01

    Epidemiological, clinical and radiological data of 1266 patients with a unilateral acetabular fracture of up to 29 hospitals was reviewed. Three time periods, 1991-1993 (Registry I; n=359), 1998-2000 (Registry II; n=503), and 2005-2006 (Registry III; n=404) were compared with regard to injury pattern and severity, fracture type, and chosen nonoperative vs. operative treatment to elucidate changes over time in the treatment of acetabular fractures. In the operatively treated group, time to operation, surgical approach, fracture fixation implants and fracture reduction quality were examined. 641 (50.6%) patients with isolated acetabular fractures, 410 (32.4%) multiple injured and 215 (17.0%) polytrauma patients with 642 (50.7%) simple and 624 (49.3%) associated acetabular fractures were evaluated. In the time period from 1991 to 2006, the rate of operative treatments increased nationwide to 77% (rho<0.001). The distribution of fracture types involving the anterior and posterior wall changed with age (rho<0.001). Across all registries, 583 (68.0%) operations were performed within 7 days, 212 (24.7%) operations between 7 and 14 days and 54 (6.3%) operations were performed later than 14 days after injury. An anatomical reduction (0-1mm displacement) was achieved in 551 (64%) acetabular fractures. The obtained reduction quality did not correlate with time to operation, was lower in associated than in simple fracture types, and also lower in patients with isolated acetabular fractures than in polytrauma patients. Most importantly, the fracture reduction quality did not improve over time despite a higher frequency of surgical interventions. The Kocher-Langenbeck approach was preferred in the nineties in nearly three quarters of all operative procedures. Currently, the Kocher-Langenbeck and the ilioinguinal approaches are used equally often. The fracture fixation did not change over time and is achieved in 51% with plates in combination with single screws. This multisurgeon

  15. Cementing porcelain-fused-to-metal crowns.

    PubMed

    Vadachkoria, D

    2009-12-01

    The clinical success of fixed prosthodontic restorations can be complex and involve multifaceted procedures. Preparation design, oral hygiene/micro flora, mechanical forces, and restorative materials are only a few of the factors which contribute to overall success. One key factor to success is choosing the proper cement. Popular use of cements for PFM crowns has shifted from zinc phosphate and glass ionomer cements to resin-reinforced glass ionomer, or RRGI, cements. This change has been rapid and profound. Dental cements have always been less than ideal materials, but this is shift to the relatively new RRGI category justified. Resin-reinforced glass ionomer (RRGI) cements appear to be better than zinc phosphate and glass ionomer cements when placing porcelain-to-metal crowns. RRGI cements, such as RelyX Luting, Fuji Plus and Vitremer Luting Cement, satisfy more of the ideal characteristics of PFM cementation than any other previous cement. Expansion of all three cements has not caused any apparent problems with the cements when used with PFM or metal crowns, but these cements, however, should be avoided when cementing all-ceramic crowns. PMID:20090144

  16. Graphite-reinforced bone cement

    NASA Technical Reports Server (NTRS)

    Knoell, A. C.

    1976-01-01

    Chopped graphite fibers added to surgical bone cement form bonding agent with mechanical properties closely matched to those of bone. Curing reaction produces less heat, resulting in reduced traumatization of body tissues. Stiffness is increased without affecting flexural strength.

  17. The dermal toxicity of cement.

    PubMed

    Winder, Chris; Carmody, Martin

    2002-08-01

    Cement and concrete are products used widely in the construction sector, with a traditional perception that any hazards that they have are limited to dermatitis in a small number of workers. In some cases, employers and builders do not think that concrete is a chemical. However, contact dermatitis is one of the most frequently reported health problems among construction workers. A review of the available literature suggests that cement has constituents that produce both irritant contact dermatitis and corrosive effects (from alkaline ingredients such as lime) and sensitization, leading to allergic contact dermatitis (from ingredients such as chromium). These findings indicate that cement and concrete should be treated as hazardous materials, and that workers handling such products should reduce exposure wherever possible. Initiatives to reduce the chromium content of cement have been shown to be successful in reducing the incidence of allergic dermatitis, although the irritant form remains. PMID:15068132

  18. Process for cementing geothermal wells

    SciTech Connect

    Eilers, L. H.

    1985-12-03

    A pumpable slurry of coal-filled furfuryl alcohol, furfural, and/or a low molecular weight monoor copolymer thereof containing, preferably, a catalytic amount of a soluble acid catalyst is used to cement a casing in a geothermal well.

  19. Magnesium substitution in brushite cements.

    PubMed

    Alkhraisat, Mohammad Hamdan; Cabrejos-Azama, Jatsue; Rodríguez, Carmen Rueda; Jerez, Luis Blanco; Cabarcos, Enrique López

    2013-01-01

    The use of magnesium-doped ceramics has been described to modify brushite cements and improve their biological behavior. However, few studies have analyzed the efficiency of this approach to induce magnesium substitution in brushite crystals. Mg-doped ceramics composed of Mg-substituted β-TCP, stanfieldite and/or farringtonite were reacted with primary monocalcium phosphate (MCP) in the presence of water. The cement setting reaction has resulted in the formation of brushite and newberyite within the cement matrix. Interestingly, the combination of SAED and EDX analyses of single crystal has indicated the occurrence of magnesium substitution within brushite crystals. Moreover, the effect of magnesium ions on the structure, and mechanical and setting properties of the new cements was characterized as well as the release of Ca(2+) and Mg(2+) ions. Further research would enhance the efficiency of the system to incorporate larger amounts of magnesium ions within brushite crystals. PMID:25428098

  20. Effect of acetabular cup abduction angle on wear of ultrahigh-molecular-weight polyethylene in hip simulator testing.

    PubMed

    Korduba, Laryssa A; Essner, Aaron; Pivec, Robert; Lancin, Perry; Mont, Michael A; Wang, Aiguo; Delanois, Ronald E

    2014-10-01

    The effect of acetabular component positioning on the wear rates of metal-on-polyethylene articulations has not been extensively studied. Placement of acetabular cups at abduction angles of more than 40° has been noted as a possible reason for early failure caused by increased wear. We conducted a study to evaluate the effects of different acetabular cup abduction angles on polyethylene wear rate, wear area, contact pressure, and contact area. Our in vitro study used a hip joint simulator and finite element analysis to assess the effects of cup orientation at 4 angles (0°, 40°, 50°, 70°) on wear and contact properties. Polyethylene bearings with 28-mm cobalt-chrome femoral heads were cycled in an environment mimicking in vivo joint fluid to determine the volumetric wear rate after 10 million cycles. Contact pressure and contact area for each cup abduction angle were assessed using finite element analysis. Results were correlated with cup abduction angles to determine if there were any differences among the 4 groups. The inverse relationship between volumetric wear rate and acetabular cup inclination angle demonstrated less wear with steeper cup angles. The largest abduction angle (70°) had the lowest contact area, largest contact pressure, and smallest head coverage. Conversely, the smallest abduction angle (0°) had the most wear and most head coverage. Polyethylene wear after total hip arthroplasty is a major cause of osteolysis and aseptic loosening, which may lead to premature implant failure. Several studies have found that high wear rates for cups oriented at steep angles contributed to their failure. Our data demonstrated that larger cup abduction angles were associated with lower, not higher, wear. However, this potentially "protective" effect is likely counteracted by other complications of steep cup angles, including impingement, instability, and edge loading. These factors may be more relevant in explaining why implants fail at a higher rate if

  1. An Effective and Feasible Method, “Hammering Technique,” for Percutaneous Fixation of Anterior Column Acetabular Fracture

    PubMed Central

    Zhang, Lihai; Zhang, Wei; Li, Tongtong; Li, Jiantao; Chen, Hua

    2016-01-01

    Objective. The objective of this study was to evaluate the effectiveness and advantages of percutaneous fixation of anterior column acetabular fracture with “hammering technique.” Materials and Methods. We retrospectively reviewed 16 patients with percutaneous fixation of anterior column acetabular fracture with “hammering technique.” There were 11 males and 5 females with an average age of 38.88 years (range: 24–54 years) in our study. Our study included 7 nondisplaced fractures, 6 mild displaced fractures (<2 mm), and 5 displaced fractures (>2 mm). The mean time from injury to surgery was 4.5 days (range: 2–7 days). Results. The average of operation time was 27.56 minutes (range: 15–45 minutes), and the mean blood loss was 55.28 mL (range: 15–100 mL). The mean fluoroscopic time was 54.78 seconds (range: 40–77 seconds). The first pass of the guide wire was acceptable without cortical perforation or intra-articular perforation in 88.89% (16/18) of the procedures, and the second attempt was in 11.11% (2/18). Conclusion. Our study suggested that percutaneous fixation of anterior column acetabular fracture with “hammering technique” acquired satisfying surgical and clinical outcomes. It may be an alternative satisfying treatment for percutaneous fixation of anterior column acetabular fracture by 2D fluoroscopy using a C-arm with less fluoroscopic time. PMID:27493962

  2. Study of the three-dimensional orientation of the labrum: its relations with the osseous acetabular rim

    PubMed Central

    Bonneau, Noémie; Bouhallier, July; Baylac, Michel; Tardieu, Christine; Gagey, Olivier

    2012-01-01

    Understanding the three-dimensional orientation of the coxo-femoral joint remains a challenge as an accurate three-dimensional orientation ensure an efficient bipedal gait and posture. The quantification of the orientation of the acetabulum can be performed using the three-dimensional axis perpendicular to the plane that passes along the edge of the acetabular rim. However, the acetabular rim is not regular as an important indentation in the anterior rim was observed. An innovative cadaver study of the labrum was developed to shed light on the proper quantification of the three-dimensional orientation of the acetabulum. Dissections on 17 non-embalmed corpses were performed. Our results suggest that the acetabular rim is better represented by an anterior plane and a posterior plane rather than a single plane along the entire rim as it is currently assumed. The development of the socket from the Y-shaped cartilage was suggested to explain the different orientations in these anterior and posterior planes. The labrum forms a plane that takes an orientation in between the anterior and posterior parts of the acetabular rim, filling up inequalities of the bony rim. The vectors VL, VA2 and VP, representing the three-dimensional orientation of the labrum, the anterior rim and the posterior rim, are situated in a unique plane that appears biomechanically dependent. The three-dimensional orientation of the acetabulum is a fundamental parameter to understand the hip joint mechanism. Important applications for hip surgery and rehabilitation, as well as for physical anthropology, were discussed. PMID:22360458

  3. Ion replacement electrorefining

    SciTech Connect

    Willit, J.L.; Tomczuk, Z.; Miller, W.E.; Laidler, J.J.

    1994-04-01

    We are developing a two-step electrochemical process for purifying and separating metals called ion replacement electrorefining. In each step, metal cations formed by oxidation at an electrode replace other metal cations that are reduced at another elecmae. Using this approach, we have separated or purified uranium, dysprosium, and lanthanum on a laboratory scale. This paper explains the ion replacement concept and presents results of these demonstration experiments.

  4. Using of borosilicate glass waste as a cement additive

    NASA Astrophysics Data System (ADS)

    Han, Weiwei; Sun, Tao; Li, Xinping; Sun, Mian; Lu, Yani

    2016-08-01

    Borosilicate glass waste is investigated as a cement additive in this paper to improve the properties of cement and concrete, such as setting time, compressive strength and radiation shielding. The results demonstrate that borosilicate glass is an effective additive, which not only improves the radiation shielding properties of cement paste, but also shows the irradiation effect on the mechanical and optical properties: borosilicate glass can increase the compressive strength and at the same time it makes a minor impact on the setting time and main mineralogical compositions of hydrated cement mixtures; and when the natural river sand in the mortar is replaced by borosilicate glass sand (in amounts from 0% to 22.2%), the compressive strength and the linear attenuation coefficient firstly increase and then decrease. When the glass waste content is 14.8%, the compressive strength is 43.2 MPa after 28 d and the linear attenuation coefficient is 0.2457 cm-1 after 28 d, which is beneficial for the preparation of radiation shielding concrete with high performances.

  5. Solubility of cobalt in cement.

    PubMed

    Fregert, S; Gruvberger, B

    1978-02-01

    Unlike chromate, cobalt occurring as cobalt oxides in cement is not water-soluble in a detectable amount. Cobalt oxides are to some extent soluble in the presence of amino acids with which cobalt forms complexes. Such complexes can elicit patch test reactions. It is postulated that cobalt is more readily dissolved by forming complexes in eczematous skin than in normal skin. This may explain why cobalt sensitization in cement eczemas is secondary to chromate sensitivity. PMID:657784

  6. Requirements for successful total knee replacements. Design considerations.

    PubMed

    Walker, P S

    1989-01-01

    Historical review up to 1969 showed the emergence of conservative hemiarthroplasty resurfacings and rigid all-metal hinges. The first cemented metal-on-plastic design, introduced in 1969, began a decade in which a large number of different condylar designs were introduced. Variations of these condylar replacements in terms of femoral-tibial surface conformity, the fixation elements, and the provision for the patellofemoral joint produced wide variations of clinical results. In parallel with these condylar replacement designs, unicompartmental and both lax and fixed hinges were still used for particular indications. A review of all of the different design types showed that the most successful results were obtained with partially conforming condylar replacements with provision for the patellofemoral joint. Although cemented condylar replacement components composed the majority of the clinical reports, press-fit uncemented designs also had significant promise. The results of unicompartmental designs depended dramatically upon the indications. Present hinged replacements, whether lax or fixed-axis, produced problems that were sufficiently serious to restrict their use to cases in which condylar replacements were distinctly inadequate. Despite the success of condylar replacements at up to 10 years follow-up, a number of problems remain. These include optimizing the femoral-tibial geometry for maximum range of motion, minimum loosening, and minimum wear. Longer-term problems include improved design for long-term fixation and reduction of wear of polyethylene by optimum surface geometry, by better material quality control, or by improved materials. Whichever instrumentation system was used, surgical parameters such as component placement and sizing were shown to affect the potential range of motion. Considerations of design were given for revision cases in which condylar replacements were inadequate. Certain design suggestions were made for minimizing the serious problems

  7. A new design of cemented stem using functionally graded materials (FGM).

    PubMed

    Hedia, H S; Aldousari, S M; Abdellatif, A K; Fouda, N

    2014-01-01

    One of the most frequent complications of total hip replacement (THR) is aseptic loosening of femoral component which is primarily due to changes of post-operative stress distribution pattern with respect to intact femur. Stress shielding of the femur is known to be a principal factor in aseptic loosening of hip replacements. Many designers show that a stiff stem shields the surrounding bone from mechanical loading causing stress shielding. Others show that reducing stem stiffness promotes higher proximal interface shear stress which increases the risk of proximal interface failure. Therefore, the task of this investigation is to solve these conflicting problems appeared in the cemented total hip replacement. The finite element method and optimization technique are used in order to find the optimal stem material which gives the optimal available stress distribution between the proximal medial femoral bone and the cement mantle interfaces. The stem is designed using the concept of functionally graded material (FGM) instead of using the conventional most common used stem material. The results showed that there are four feasible solutions from the optimization runs. The best of these designs is to use a cemented stem graded from titanium at the upper stem layer to collagen at the lower stem layer. This new cemented stem design completely eliminates the stress shielding problem at the proximal medial femoral region. The stress shielding using the cemented functionally graded stem is reduced by 98% compared to titanium stem. PMID:24840196

  8. Upward and inward displacements of the acetabular component increase stress on femoral head in single endoprothesis models

    PubMed Central

    Zhang, Zhiqi; Kang, Yan; Chen, Yi; Liao, Weiming

    2009-01-01

    The centre of rotation of the hip can be displaced in hip dysplasia and revision arthroplasty. This study examined the effect of artificial femoral head load after acetabular component displacement in total hip arthroplasty. Sixteen total hip arthroplasty models of human cadaver specimens were reconstructed, and under different acetabular component position, the load around the femoral head was evaluated by strain gages. The results showed that the load was higher in the same specimens when the cup was moved 2 mm inward or upward, especially after the cup was moved more than 6 mm, and the load had an increasing effect in the inward group. In the upward group, an increasing effect happened at 8 mm upward displacement, but the stress value decreased from 4 mm to 6 mm upward displacement. In the same moving distance, the stress of inward displacement is obviously higher than upward displacement. Altogether, the results suggested that for both inward displacement and upward displacement of the acetabular cup, the load around the femoral head increased gradually, while the distance of the inward displacement and the superior displacement was increased. The greater the displacement, the bigger the loading contact stress. The upward displacement caused less stress change on the femoral head. The stress of the 6 mm upward position was lower than nearby positions; perhaps this site represented a stress buffering zone. PMID:19424694

  9. Acetabular Reconstruction with the Burch-Schneider Antiprotrusio Cage and Bulk Allografts: Minimum 10-Year Follow-Up Results

    PubMed Central

    Sandri, Andrea

    2014-01-01

    Reconstruction of severe pelvic bone loss is a challenging problem in hip revision surgery. Between January 1992 and December 2000, 97 hips with periprosthetic osteolysis underwent acetabular revision using bulk allografts and the Burch-Schneider antiprotrusio cage (APC). Twenty-nine patients (32 implants) died for unrelated causes without additional surgery. Sixty-five hips were available for clinical and radiographic assessment at an average follow-up of 14.6 years (range, 10.0 to 18.9 years). There were 16 male and 49 female patients, aged from 29 to 83 (median, 60 years), with Paprosky IIIA (27 cases) and IIIB (38 cases) acetabular bone defects. Nine cages required rerevision because of infection (3), aseptic loosening (5), and flange breakage (1). The average Harris hip score improved from 33.1 points preoperatively to 75.6 points at follow-up (P < 0.001). Radiographically, graft incorporation and cage stability were detected in 48 and 52 hips, respectively. The cumulative survival rates at 18.9 years with removal for any reason or X-ray migration of the cage and aseptic or radiographic loosening as the end points were 80.0% and 84.6%, respectively. The use of the Burch-Schneider APC and massive allografts is an effective technique for the reconstructive treatment of extensive acetabular bone loss with long-lasting survival. PMID:24967339

  10. Assessment of Physical and Mechanical Properties of Cement Panel Influenced by Treated and Untreated Coconut Fiber Addition

    NASA Astrophysics Data System (ADS)

    Abdullah, Alida; Jamaludin, Shamsul Baharin; Anwar, Mohamed Iylia; Noor, Mazlee Mohd; Hussin, Kamarudin

    This project was conducted to produce a cement panel with the addition of treated and untreated coconut fiber in cement panel. Coconut fiber was added to replace coarse aggregate (sand) in this cement panel. In this project, the ratios used to design the mixture were 1:1:0, 1:0.97:0.03, 1:0.94:0.06, 1:0.91:0.09 (cement: sand: coconut fiber). The water cement ratio was constant at 0.55. The sizes of sample tested were, 160 mm x 40 mm x 40 mm for compression test, and 100 mm x 100 mm x 40 mm for density, moisture content and water absorption tests. After curing samples for 28 days, it was found that the addition of coconut fiber, further increase in compressive strength of cement panel with untreated coconut fiber. Moisture content of cement panel with treated coconut fiber increased with increasing content of coconut fiber whereas water absorption of cement panel with untreated coconut fiber increased with increasing content of coconut fiber. The density of cement panel decreased with the addition of untreated and treated coconut fiber.

  11. Celestite replacements of evaporites in the Salina Group

    NASA Astrophysics Data System (ADS)

    Carlson, Ernest H.

    1987-09-01

    Replacements of evaporites by celestite were discovered recently at three sites in northwestern Ohio. These replacements are more durable than the original evaporites and provide new paleoenvironmental data for the upper Silurian rocks of the region. The occurrences are situated along the western margin of the Ohio (Cayugan) Basin and appear in the Greenfield Dolomite and in undifferentiated Salina dolostones. The replacements include: lenticular and prismatic crystals of gypsum, nodules of anhydrite and laminar evaporites. The lenticular crystals contain inclusions of carbonate and anhydrite, and are believed to have altered to anhydrite prior to replacement. The prismatic crystals are exceptionally well-preserved, with euhedral, deeply embayed outlines and internally zoned growth bands containing large numbers of inclusions of dolostone and anhydrite. Optical data for the latter crystals indicate that they are oriented replacements of gypsum, and suggest that the original gypsum was unchanged prior to replacement. The nodular and laminar occurrences display features such as chicken-wire and enterolithic structures, and were comprised of anhydrite prior to replacement. Replacement postdates the dolomitization and cementation of the Salina sediments enclosing the evaporites, but occurred prior to deep burial. The rocks hosting the replacements, therefore, did not provide the strontium. The strontium may have been released from dolomitization of the underlying Lockport (Niagaran) beds or from dissolution of subaerially exposed Salina gypsum prior to the middle Devonian.

  12. Evaluation of lignite combustion residues as cement additives

    SciTech Connect

    Demirbas, A.; Aslan, A.

    1999-07-01

    In this study the physical and chemical properties of lignite fly ashes obtained from electrostatic precipitator and cyclone, lignite bottom ash, cement + lignite ash mixtures, and their effects on mechanical properties of concrete were investigated. The ashes were classified into two general types based on total silica, alumina, and iron-III oxide: class A and class B. When 25% of the cement was replaced by class A lignite bottom ash (the combined three oxide contents were 30.2%), the 28-day compressive strength increased by 18.9% compared to the control mix, and when 25% of the cement was replaced by class B lignite ash (the combined three oxide contents were 78.1%), the compressive strength decreased by 3.5% compared to the control mix. The results obtained were compared with the Turkish Standards and, in general, were found to be within the limits. As a result, the lignite fly ash and bottom ash samples may be used as cementitious materials.

  13. Processing of Sugarcane Bagasse ash and Reactivity of Ash-blended Cement Mortar

    NASA Astrophysics Data System (ADS)

    Ajay, Goyal; Hattori, Kunio; Ogata, Hidehiko; Ashraf, Muhammad

    Sugarcane bagasse ash (SCBA), a sugar-mill waste, has the potential of a partial cement replacement material if processed and obtained under controlled conditions. This paper discusses the reactivity of SCBA obtained by control burning of sugarcane bagasse procured from Punjab province of India. X-ray diffraction (XRD) and scanning electron microscopy (SEM) techniques were employed to ascertain the amorphousness and morphology of the minerals ash particles. Destructive and non-destructive tests were conducted on SCBA-blended mortar specimens. Ash-blended cement paste specimens were analyzed by XRD, thermal analysis, and SEM methods to evaluate the hydration reaction of SCBA with cement. Results showed that the SCBA processed at 600°C for 5 hours was reactive as ash-blended mortar specimens with up to 15% substitution of cement gave better strength than control specimens.

  14. Characterisation of a metallic foam-cement composite under selected loading conditions.

    PubMed

    Tozzi, Gianluca; Zhang, Qing-Hang; Lupton, Colin; Tong, Jie; Guillen, Teodolito; Ohrndorf, Arne; Christ, Hans-Jurgen

    2013-11-01

    An open-cell metallic foam was employed as an analogue material for human trabecular bone to interface with polymethyl methacrylate (PMMA) bone cement to produce composite foam-cement interface specimens. The stress-displacement curves of the specimens were obtained experimentally under tension, shear, mixed tension and shear (mixed-mode), and step-wise compression loadings. In addition, under step-wise compression, an image-guided failure assessment (IGFA) was used to monitor the evolution of micro-damage of the interface. Microcomputed tomography (µCT) images were used to build a subject-specific model, which was then used to perform finite element (FE) analysis under tension, shear and compression. For tension-shear loading conditions, the strengths of the interface specimens were found to increase with the increase of the loading angle reaching the maximum under shear loading condition, and the results compare reasonably well with those from bone-cement interface. Under compression, however, the mechanical strength measured from the foam-cement interface is much lower than that from bone-cement interface. Furthermore, load transfer between the foam and the cement appears to be poor under both tension and compression, hence the use of the foam should be discouraged as a bone analogue material for cement fixation studies in joint replacements. PMID:23846838

  15. Influence of various amount of diatomaceous earth used as cement substitute on mechanical properties of cement paste

    NASA Astrophysics Data System (ADS)

    Pokorný, Jaroslav; Pavlíková, Milena; Medved, Igor; Pavlík, Zbyšek; Zahálková, Jana; Rovnaníková, Pavla; Černý, Robert

    2016-06-01

    Active silica containing materials in the sub-micrometer size range are commonly used for modification of strength parameters and durability of cement based composites. In addition, these materials also assist to accelerate cement hydration. In this paper, two types of diatomaceous earths are used as partial cement replacement in composition of cement paste mixtures. For raw binders, basic physical and chemical properties are studied. The chemical composition of tested materials is determined using classical chemical analysis combined with XRD method that allowed assessment of SiO2 amorphous phase content. For all tested mixtures, initial and final setting times are measured. Basic physical and mechanical properties are measured on hardened paste samples cured 28 days in water. Here, bulk density, matrix density, total open porosity, compressive and flexural strength, are measured. Relationship between compressive strength and total open porosity is studied using several empirical models. The obtained results give evidence of high pozzolanic activity of tested diatomite earths. Their application leads to the increase of both initial and final setting times, decrease of compressive strength, and increase of flexural strength.

  16. Cemented femoral fixation: the North Atlantic divide.

    PubMed

    Murray, David W

    2011-09-01

    In the United Kingdom, more cemented than cementless stems are implanted, whereas in North America, few cemented stems are implanted. This is primarily because cemented stems have not performed well in North America, whereas they have in the United Kingdom, as different designs have been used. The majority of cemented stems used in the United Kingdom are polished, collarless, and tapered. These are forgiving, as they subside within the cement mantle and compress the cement and stabilize the interface. They perform well in both young and active patients and elderly patients. They also do well in osteoporotic bone, with deformity, or with suboptimal cementing techniques. As the position of the stem can be varied, it is simple to achieve appropriate leg length, offset, and version. Cement can be used to deliver antibiotics locally. If revision is necessary, it is relatively straightforward. Cement has numerous advantages that outweigh the main disadvantage of an extended operating time. PMID:21902131

  17. Manufacture and properties of fluoride cement

    NASA Astrophysics Data System (ADS)

    Malata-Chirwa, Charles David

    This research work aimed at characterising composition, hydration and physical properties of fluoride cement, by studying samples of the cement obtained from Malawi, and comparing them to ordinary Portland cement. By confirming the suitable characteristics of fluoride cement through this work, the results of the research work provide a good basis for the wider adoption of fluoride cement as an alternative to ordinary Portland cement, especially in developing economies. Numerous accounts have been cited regarding the production and use of fluoride cement. Since there have not been conclusive agreement as to its properties, this study was limited to the theories of successful incorporation of fluoride compounds in the manufacture of fluoride cement. Hence, the properties and characteristics reported in this study relate to the cement currently manufactured in Malawi, and, on a comparative basis only, to that manufactured in other parts of the world. Samples of the fluoride cement used in the study were obtained by synthetic manufacture of the cement using common raw materials for the manufacture of fluoride cement that is limestone, silica sand, and fluorspar. These samples were subjected to several comparative tests used to characterise cements including examination under x-ray diffractometer, scanning electron microscopy and tests for setting time and compressive strength. Under similar laboratory conditions, it was possible to prove that fluoride cement hardens more rapidly than ordinary Portland cement. Also observed during the experimental work is that fluoride cement develops higher compressive strengths than ordinary Portland cement. The hardening and setting times are significantly different between the two cements. Also the nature of the hydration products, that is the microstructural development is significantly different in the two cements. The differences brought about between the two cements are because of the presence of fluorine during the clinkering

  18. Effects of densified silica fume on microstructure and compressive strength of blended cement pastes

    SciTech Connect

    Ji Yajun; Cahyadi, Jong Herman

    2003-10-01

    Some experimental investigations on the microstructure and compressive strength development of silica fume blended cement pastes are presented in this paper. The silica fume replacement varies from 0% to 20% by weight and the water/binder ratio (w/b) is 0.4. The pore structure by mercury intrusion porosimetry (MIP), the micromorphology by scanning electron microscopy (SEM) and the compressive strength at 3, 7, 14, 28, 56 and 90 days have been studied. The test results indicate that the improvements on both microstructure and mechanical properties of hardened cement pastes by silica fume replacement are not effective due to the agglomeration of silica fume particles. The unreacted silica fume remained in cement pastes, the threshold diameter was not reduced and the increase in compressive strength was insignificant up to 28 days. It is suggested that the proper measures should be taken to disperse silica fume agglomeration to make it more effective on improving the properties of materials.

  19. Effects of fly ash particle size on strength of Portland cement fly ash mortars

    SciTech Connect

    Erdogdu, K.; Tuerker, P.

    1998-09-01

    Fly ashes do not have the same properties for different size fractions. It can be accepted that the effect of a fly ash on mortar strength is a combined effect of its size fractions. Therefore, it was concluded that by separating the size fractions and replacing cement with them, the combined bulk effect of a fly ash on strength can be better analyzed. In this study, different size fractions of fly ash were used to replace cement partially in standard compressive strength mortars. The authors attempted to interpret the strength of Portland cement-fly ash mortars in terms of the chemical, mineralogical, morphological, and physical properties of different fly ash size fractions used. Strengths of the mortars were compared at 2, 7, 28, and 90 days. Also strength of mortars with all-in ash (original ash containing all the fractions) were estimated by using strength of mortars with size fractions and the suitability of this estimation was discussed.

  20. Radiation Source Replacement Workshop

    SciTech Connect

    Griffin, Jeffrey W.; Moran, Traci L.; Bond, Leonard J.

    2010-12-01

    This report summarizes a Radiation Source Replacement Workshop in Houston Texas on October 27-28, 2010, which provided a forum for industry and researchers to exchange information and to discuss the issues relating to replacement of AmBe, and potentially other isotope sources used in well logging.

  1. The effect of cement creep and cement fatigue damage on the micromechanics of the cement-bone interface.

    PubMed

    Waanders, Daan; Janssen, Dennis; Mann, Kenneth A; Verdonschot, Nico

    2010-11-16

    The cement-bone interface provides fixation for the cement mantle within the bone. The cement-bone interface is affected by fatigue loading in terms of fatigue damage or microcracks and creep, both mostly in the cement. This study investigates how fatigue damage and cement creep separately affect the mechanical response of the cement-bone interface at various load levels in terms of plastic displacement and crack formation. Two FEA models were created, which were based on micro-computed tomography data of two physical cement-bone interface specimens. These models were subjected to tensile fatigue loads with four different magnitudes. Three deformation modes of the cement were considered: 'only creep', 'only damage' or 'creep and damage'. The interfacial plastic deformation, the crack reduction as a result of creep and the interfacial stresses in the bone were monitored. The results demonstrate that, although some models failed early, the majority of plastic displacement was caused by fatigue damage, rather than cement creep. However, cement creep does decrease the crack formation in the cement up to 20%. Finally, while cement creep hardly influences the stress levels in the bone, fatigue damage of the cement considerably increases the stress levels in the bone. We conclude that at low load levels the plastic displacement is mainly caused by creep. At moderate to high load levels, however, the plastic displacement is dominated by fatigue damage and is hardly affected by creep, although creep reduced the number of cracks in moderate to high load region. PMID:20692663

  2. Quantum Mechanical Metric for Internal Cohesion in Cement Crystals

    PubMed Central

    Dharmawardhana, C. C.; Misra, A.; Ching, Wai-Yim

    2014-01-01

    Calcium silicate hydrate (CSH) is the main binding phase of Portland cement, the single most important structural material in use worldwide. Due to the complex structure and chemistry of CSH at various length scales, the focus has progressively turned towards its atomic level comprehension. We study electronic structure and bonding of a large subset of the known CSH minerals. Our results reveal a wide range of contributions from each type of bonding, especially hydrogen bonding, which should enable critical analysis of spectroscopic measurements and construction of realistic C-S-H models. We find the total bond order density (TBOD) as the ideal overall metric for assessing crystal cohesion of these complex materials and should replace conventional measures such as Ca:Si ratio. A rarely known orthorhombic phase Suolunite is found to have higher cohesion (TBOD) in comparison to Jennite and Tobermorite, which are considered the backbone of hydrated Portland cement. PMID:25476741

  3. Dilemmas in imaging for peri-acetabular osteotomy: the influence of patient position and imaging technique on the radiological features of hip dysplasia.

    PubMed

    Kosuge, D; Cordier, T; Solomon, L B; Howie, D W

    2014-09-01

    Peri-acetabular osteotomy is an established surgical treatment for symptomatic acetabular dysplasia in young adults. An anteroposterior radiograph of the pelvis is commonly used to assess the extent of dysplasia as well as to assess post-operative correction. Radiological prognostic factors include the lateral centre-edge angle, acetabular index, extrusion index and the acetabular version. Standing causes a change in the pelvis tilt which can alter certain radiological measurements relative to the supine position. This article discusses the radiological indices used to assess dysplasia and reviews the effects of patient positioning on these indices with a focus on assessment for a peri-acetabular osteotomy. Intra-operatively, fluoroscopy is commonly used and the implications of using fluoroscopy as a modality to assess the various radiological indices along with the effects of using an anteroposterior or posteroanterior fluoroscopic view are examined. Each of these techniques gives rise to a slightly different image of the pelvis as the final image is sensitive to the position of the pelvis and the projection of the x-ray beam. PMID:25183583

  4. Cement applicator use for hip resurfacing arthroplasty.

    PubMed

    Jaeger, Sebastian; Rieger, Johannes S; Obermeyer, Beate; Klotz, Matthias C; Kretzer, J Philippe; Bitsch, Rudi G

    2015-05-01

    We compared the manufacturer recommended cementing technique for a femoral hip resurfacing implant (BHR, S&N) to a newly designed cement applicator on 20 porous carbon foam specimens. Substantial design changes and improvements of the cement applicator were necessary: The diameter and number of the cement escaping holes at the top of the applicator were optimized for medium viscosity cement. It was necessary to add four separate air inlet holes with large diameters. The inner shape of the applicator had to be adapted to the BHR design with a circular extending chamfer in the proximal region, a parallel inner wall and a second chamfer distally. The interface temperatures showed no risk for heat necrosis using both techniques. The cement penetration depth was more uniform and significantly reduced for the applicator cementing technique (4.34 ± 1.42 mm, 6.42 ± 0.43 mm, p = 0.001). The cement-applicator showed no cement defects compared to a large defect length (0.0 ± 0.0 mm, 10.36 ± 1.10 mm, p < 0.001) with the manufacturer recommended cementing technique. The cement applicator technique appears to be effective for a homogenous cement distribution without cement defects and safe with a lower risk of polar over-penetration. PMID:25772262

  5. Degradable borate glass polyalkenoate cements.

    PubMed

    Shen, L; Coughlan, A; Towler, M; Hall, M

    2014-04-01

    Glass polyalkenoate cements (GPCs) containing aluminum-free borate glasses having the general composition Ag2O-Na2O-CaO-SrO-ZnO-TiO2-B2O3 were evaluated in this work. An initial screening study of sixteen compositions was used to identify regions of glass formation and cement compositions with promising rheological properties. The results of the screening study were used to develop four model borate glass compositions for further study. A second round of rheological experiments was used to identify a preferred GPC formulation for each model glass composition. The model borate glasses containing higher levels of TiO2 (7.5 mol %) tended to have longer working times and shorter setting times. Dissolution behavior of the four model GPC formulations was evaluated by measuring ion release profiles as a function of time. All four GPC formulations showed evidence of incongruent dissolution behavior when considering the relative release profiles of sodium and boron, although the exact dissolution profile of the glass was presumably obscured by the polymeric cement matrix. Compression testing was undertaken to evaluate cement strength over time during immersion in water. The cements containing the borate glass with 7.5 mol % TiO2 had the highest initial compressive strength, ranging between 20 and 30 MPa. No beneficial aging effect was observed-instead, the strength of all four model GPC formulations was found to degrade with time. PMID:24435528

  6. Calcium phosphate cement - gelatin powder composite testing in canine models: Clinical implications for treatment of bone defects.

    PubMed

    Yomoda, Mitsuhiro; Sobajima, Satoshi; Kasuya, Akihiro; Neo, Masashi

    2015-05-01

    Previous studies have reported the excellent biocompatibility of calcium phosphate cement. However, calcium phosphate cement needs further improvement in order for it to promote bone replacement and eventual bone substitution, as it exhibits slow biodegradability and thus remains in the body over an extended period of time. In this study, we mixed calcium phosphate cement with gelatin powder in order to create a composite containing macropores with interconnectivity, and we then implanted it into canine femurs from the diaphysis to the distal metaphysis. Eight dogs were divided into the sham group, the control (C0) group with 100 wt% calcium phosphate cement, the C10 group with 90 wt% calcium phosphate cement and 10 wt% gelatin powder, and the C15 group with 85 wt% calcium phosphate cement and 15 wt% gelatin powder. Bone replaceability in C10 and C15 at 3 and 6 months was evaluated by radiography, micro-CT, histomorphometry, and mineral apposition rate. New bone formation was seen in C10 and C15 although that was not seen in C0 at six months. The mineral apposition rate was significantly higher in C15 than in C10 in both the diaphysis and metaphysis, and the composite was found to have excellent biodegradability and bone replaceability in canine subjects. As the composite is easily and rapidly prepared, it is likely to become a new bone substitute for use in clinical settings. PMID:25550332

  7. Accuracy of navigation-assisted acetabular component positioning studied by computed tomography measurements: methods and results.

    PubMed

    Ybinger, Thomas; Kumpan, W; Hoffart, H E; Muschalik, B; Bullmann, W; Zweymüller, K

    2007-09-01

    The postoperative position of the acetabular component is key for the outcome of total hip arthroplasty. Various aids have been developed to support the surgeon during implant placement. In a prospective study involving 4 centers, the computer-recorded cup alignment of 37 hip systems at the end of navigation-assisted surgery was compared with the cup angles measured on postoperative computerized tomograms. This comparison showed an average difference of 3.5 degrees (SD, 4.4 degrees ) for inclination and 6.5 degrees (SD, 7.3 degrees ) for anteversion angles. The differences in inclination correlated with the thickness of the soft tissue overlying the anterior superior iliac spine (r = 0.44; P = .007), whereas the differences in anteversion showed a correlation with the thickness of the soft tissue overlying the pubic tubercles (r = 0.52; P = .001). In centers experienced in the use of navigational tools, deviations were smaller than in units with little experience in their use. PMID:17826270

  8. Arthroscopic Bone Grafting of Deep Acetabular Cysts Using a Curved Delivery Device

    PubMed Central

    Garabekyan, Tigran; Chadayammuri, Vivek; Pascual-Garrido, Cecilia; Mei-Dan, Omer

    2016-01-01

    Acetabular intraosseous cysts are frequently encountered in patients with dysplasia or femoroacetabular impingement. Small cysts are typically addressed by removing the cyst lining and stimulating healing via microfracture or abrasion chondroplasty. In contrast, larger cysts involving 1-3 cm3 frequently require additional fortification with bone graft material to facilitate osseous ingrowth and cyst healing. Previous arthroscopic reports have described the use of rim trimming to access the extra-articular side of the cyst, with subsequent use of straight metal cannulas for delivery of bone graft material. The downsides of this technique include the requirement for rim trimming, which may be ill advised in patients with normal coverage or dysplasia, as well as the creation of a second breach in the cyst wall, precluding pressurization of the bone graft material. We describe an arthroscopic technique using a curved delivery device allowing for deeper penetration into the cyst cavity through the articular side and greater delivery of bone graft material. PMID:27073770

  9. Retrieved Highly Crosslinked UHMWPE Acetabular Liners Have Similar Wear Damage as Conventional UHMWPE

    PubMed Central

    Schroder, David T.; Kelly, Natalie H.; Parks, Michael L.

    2010-01-01

    Background Highly crosslinked UHMWPE is associated with increased wear resistance in hip simulator and clinical studies. Laboratory and case studies, however, have described rim fracture in crosslinked acetabular liners. Controversy exists, therefore, on the relative merits of crosslinked liners over conventional liners in terms of wear performance versus resistance to fatigue cracking. Questions/purposes We asked whether crosslinked liners would show less surface damage than conventional liners but would be more susceptible to fatigue damage. Methods We examined 36 conventional UHMWPE and 39 crosslinked UHMWPE retrieved implants with similar patient demographics and identical design for evidence of wear damage, including articular surface damage, impingement, screw-hole creep, and rim cracks. Results We observed no difference in wear damage scores for the two liners. Conventional liners more frequently impinged but were more often elevated with smaller head sizes. We observed creep in approximately 70% of both types of liners. Incipient rim cracks were found in five crosslinked liners, and one liner had a rim fracture. Only one conventional liner had an incipient rim crack. Conclusions Contrary to our expectation, damage was similar between crosslinked and conventional UHMWPE liners. Moreover, the 15% occurrence (six of 39) of incipient or complete fractures in crosslinked liners as compared with a 3% occurrence (one of 36) in conventional liners may have implications for the long-term performance of crosslinked liners. Longer-term studies will be necessary to establish the fate of rim cracks and thus the overall clinical fatigue performance of crosslinked liners. PMID:20844998

  10. Retrieval analysis of a failed TriboFit polycarbonate urethane acetabular buffer.

    PubMed

    Biant, Leela C; Gascoyne, Trevor C; Bohm, Eric R; Moran, Matthew

    2016-03-01

    The purpose of this research was to determine the failure mechanisms and damage features of a TriboFit acetabular buffer implanted directly against a native, prepared acetabulum which was revised after 11months. Retrieval analyses were carried out via light microscopy, gravimetric wear assessment, and observer scoring of visible damage features on the buffer. The volume of material abraded from the backside of the buffer was estimated via three-dimensional reconstruction using a laser scanner. Scanning electron microscopy was used to confirm damage features and mechanisms. Severe abrasion to the backside of the buffer was the primary damage feature, while stippling damage was seen on the articular surface of the buffer. Material loss due to backside abrasion was approximated to be between 0.13360.085 g (gravimetric analyses) and 0.19360.053 g (three-dimensional reconstruction). Implantation of the TriboFit buffer against the patient's native acetabulum without a metal backing allowed for significant movement of the buffer against the bone, resulting in the abrasion seen on this implant. The stippling damage on the articular surface indicates an adhesive wear mechanism which exacerbates movement of the buffer against the acetabulum, thereby increasing backside abrasion. PMID:26833696

  11. The effect of femoro-acetabular impingement on the kinematics and kinetics of the hip joint.

    PubMed

    Alshameeri, Zeiad; Khanduja, Vikas

    2014-08-01

    Gait analysis is an objective tool that has been used to assess and monitor treatment for many musculoskeletal conditions. Recently, it has been used to assess the impact of femoro-acetabular impingement (FAI) on the hip and lower limb movements. There have been a fairly limited number of studies published so far reporting unexpected and inconsistent results, which calls for more research to be conducted in this arena. In the light of the limited data available, it has been challenging to reconcile the contradictions in some of these results, and therefore no coherent conclusions could be drawn. In this short article, we attempt to explain some of the abnormal kinematic and kinetic patterns associated with FAI by highlighting similarities between the gait seen in early osteoarthritis (OA) and that of FAI. We also propose an approach for future research in this field and emphasise the importance of quantifying early OA in FAI based on magnetic resonance imaging (MRI) scans and the amount of chondral damage seen during open or arthroscopic surgery. PMID:24687267

  12. Does surface roughness influence the primary stability of acetabular cups? A numerical and experimental biomechanical evaluation.

    PubMed

    Le Cann, Sophie; Galland, Alexandre; Rosa, Benoît; Le Corroller, Thomas; Pithioux, Martine; Argenson, Jean-Noël; Chabrand, Patrick; Parratte, Sébastien

    2014-09-01

    Most acetabular cups implanted today are press-fit impacted cementless. Anchorage begins with the primary stability given by insertion of a slightly oversized cup. This primary stability is key to obtaining bone ingrowth and secondary stability. We tested the hypothesis that primary stability of the cup is related to surface roughness of the implant, using both an experimental and a numerical models to analyze how three levels of surface roughness (micro, macro and combined) affect the primary stability of the cup. We also investigated the effect of differences in diameter between the cup and its substrate, and of insertion force, on the cups' primary stability. The results of our study show that primary stability depends on the surface roughness of the cup. The presence of macro-roughness on the peripheral ring is found to decrease primary stability; there was excessive abrasion of the substrate, damaging it and leading to poor primary stability. Numerical modeling indicates that oversizing the cup compared to its substrate has an impact on primary stability, as has insertion force. PMID:25080896

  13. The Relationship of Acetabular Dysplasia and Femoroacetabular Impingement to Hip Osteoarthritis: A Focused Review

    PubMed Central

    Royer, Nathaniel K.

    2012-01-01

    Hip osteoarthritis (OA) leads to significant functional limitations and economic burden. If modifiable risk factors for hip OA are identified, it may be possible to implement preventative measures. Bony abnormalities associated with acetabular dysplasia (AD) and femoroacetabular impingement (FAI) have been recently implicated as risk factors for hip osteoarthritis (OA). The purpose of this focused review is to summarize the available evidence describing the relationship between bony abnormalities and hip OA. A librarian-assisted database search using PubMed, Embase and Central was performed. Relevant articles were identified and assessed for inclusion criteria. The authors reviewed cohort and case control studies that reported on the association between abnormal hip morphology and hip OA. The available literature suggests that an association exists between bony abnormalities found in AD and FAI and hip OA and preliminary evidence suggests that AD is a risk factor for OA, however these conclusions are based on limited evidence. Prospective, longitudinal studies are needed to confirm the causal relationship between abnormal hip morphology and the future development of hip OA. PMID:22108232

  14. Computed Tomography-Based Software Safely Guides Anterograde Percutaneous Anterior and Posterior Column Acetabular Screws.

    PubMed

    Banerjee, Soham; Starr, Adam J; Banerjee, Rahul

    2016-01-01

    The objective of this study was to develop three-dimensional (3-D) modeling software to generate the optimal individualized starting points and pathways for anterior and posterior column screws. In this cross-sectional study, 95 consecutive patients from a level I trauma center with noncontrast pelvis computed tomography (CT) images without displaced acetabular fractures were studied. A Java-based program was designed that generated a 3-D graph of pelvic bones and a list was compiled of every potential anterograde anterior and posterior column screw that exited distal to the acetabulum, eliminating screws that did not safely remain within the cortex. The longest safe screw pathway for each patient was determined for both 6.5-mm and 7.3-mm diameter screws. The program was able to identify safe screw pathways for the vast majority of patients (>96%). The study also found that males tolerated significantly longer screws in the anterior column (p < .05), but there was no posterior column difference regarding sex. PMID:27518290

  15. Effects of acetabular resurfacing component material and fixation on the strain distribution in the pelvis.

    PubMed

    Thompson, M S; Northmore-Ball, M D; Tanner, K E

    2002-01-01

    A 3D finite element (FE) model of an implanted pelvis was developed as part of a project investigating an all-polymer hip resurfacing design. The model was used to compare this novel design with a metal-on-metal design in current use and a metal-on-polymer design typical of early resurfacing implants. The model included forces representing the actions of 22 muscles as well as variable cancellous bone stiffness and variable cortical shell thickness. The hip joint reaction force was applied via contact modelled between the femoral and acetabular components of the resurfacing prosthesis. Five load cases representing time points through the gait cycle were analysed. The effect of varying fixation conditions was also investigated. The highest cancellous bone strain levels were found at mid-stance, not heel-strike. Remote from the acetabulum there was little effect of prosthesis material and fixation upon the von Mises stresses and maximum principal strains. Implant material appeared to have little effect upon cancellous bone strain failure with both bended and unbonded bone-implant interfaces. The unbonded implants increased stresses in the subchondral bone at the centre of the acetabulum and increased cancellous bone loading, resembling behaviour obtained previously for the intact acetabulum. PMID:12206520

  16. The capsular ligaments provide more hip rotational restraint than the acetabular labrum and the ligamentum teres

    PubMed Central

    van Arkel, R. J.; Amis, A. A.; Cobb, J. P.; Jeffers, J. R. T.

    2015-01-01

    In this in vitro study of the hip joint we examined which soft tissues act as primary and secondary passive rotational restraints when the hip joint is functionally loaded. A total of nine cadaveric left hips were mounted in a testing rig that allowed the application of forces, torques and rotations in all six degrees of freedom. The hip was rotated throughout a complete range of movement (ROM) and the contributions of the iliofemoral (medial and lateral arms), pubofemoral and ischiofemoral ligaments and the ligamentum teres to rotational restraint was determined by resecting a ligament and measuring the reduced torque required to achieve the same angular position as before resection. The contribution from the acetabular labrum was also measured. Each of the capsular ligaments acted as the primary hip rotation restraint somewhere within the complete ROM, and the ligamentum teres acted as a secondary restraint in high flexion, adduction and external rotation. The iliofemoral lateral arm and the ischiofemoral ligaments were primary restraints in two-thirds of the positions tested. Appreciation of the importance of these structures in preventing excessive hip rotation and subsequent impingement/instability may be relevant for surgeons undertaking both hip joint preserving surgery and hip arthroplasty. Cite this article: Bone Joint J 2015; 97-B:484–91. PMID:25820886

  17. Tranexamic acid reduces the blood loss and blood transfusion requirements following peri-acetabular osteotomy.

    PubMed

    Wassilew, G I; Perka, C; Janz, V; Krämer, M; Renner, L

    2015-12-01

    We have investigated the effect of using tranexamic acid (TXA) during peri-acetabular osteotomy (PAO) on peri-operative blood loss and blood transfusion requirements. In addition we analysed whether the use of TXA was associated with an increased risk of venous thromboembolism (VTE) following this procedure. A consecutive series of 96 PAOs, performed by a single surgeon, were reviewed. A total of 48 patients received TXA and 48 did not. The TXA group received a continuous infusion of TXA at a rate of 10 mg/kg/h. The primary outcome measure was the requirement for blood transfusion. Secondary outcomes included total blood loss, the decrease in the level of haemoglobin in the blood, the length of hospital stay, and the complications of this treatment. The mean rate of transfusion was significantly lower in the TXA group (62.5% vs 12.5%, p < 0.001). The mean blood loss was also significantly reduced in the TXA group (1.9 L (standard deviation (SD) 0.9) vs 1.5 L (SD 0.7), p < 0.01). No post-operative episodes of VTE were identified in either group. The use of TXA reduced the blood loss and the rate of transfusion after PAO significantly, without adverse effects such as an increased rate of VTE. PMID:26637672

  18. Ex vivo estimation of cementless acetabular cup stability using an impact hammer.

    PubMed

    Michel, Adrien; Bosc, Romain; Sailhan, Frédéric; Vayron, Romain; Haiat, Guillaume

    2016-02-01

    Obtaining primary stability of acetabular cup (AC) implants is one of the main objectives of press-fit procedures used for cementless hip arthroplasty. The aim of this study is to investigate whether the AC implant primary stability can be evaluated using the signals obtained with an impact hammer. A hammer equipped with a force sensor was used to impact the AC implant in 20 bovine bone samples. For each sample, different stability conditions were obtained by changing the cavity diameter. For each configuration, the inserted AC implant was impacted four times with a maximum force comprised between 2500 and 4500 N. An indicator I was determined based on the partial impulse estimation and the pull-out force was measured. The implant stability and the value of the indicator I reached a maximum value for an interference fit equal to 1 mm for 18 out of 20 samples. When pooling all samples and all configurations, the implant stability and I were significantly correlated (R(2) = 0.83). The AC implant primary stability can be assessed through the analysis of the impact force signals obtained using an impact hammer. Based on these ex vivo results, a medical device could be developed to provide a decision support system to the orthopedic surgeons. PMID:26671784

  19. Mechanical properties of α-tricalcium phosphate-based bone cements incorporating regenerative biomaterials for filling bone defects exposed to low mechanical loads.

    PubMed

    Harrison, Reed; Criss, Zachary K; Feller, Lacie; Modi, Shan P; Hardy, John G; Schmidt, Christine E; Suggs, Laura J; Murphy, Matthew B

    2016-01-01

    Calcium phosphate-based cements with enhanced regenerative potential are promising biomaterials for the healing of bone defects in procedures such as percutaneous vertebroplasty. With a view to the use of such cements for low load bearing applications such as sinus augmentation or filling extraction sites. However, the inclusion of certain species into bone cement formulations has the potential to diminish the mechanical properties of the formulations and thereby reduce their prospects for clinical translation. Consequently, we have prepared α-tricalcium phosphate (α-TCP)-based bone cements including materials that we would expect to improve their regenerative potential, and describe the mechanical properties of the resulting formulations herein. Formulations incorporated α-TCP, hydroxyapatite, biopolymer-thickened wetting agents, sutures, and platelet poor plasma. The mechanical properties of the composites were composition dependent, and optimized formulations had clinically relevant mechanical properties. Such calcium phosphate-based cements have potential as replacements for cements such as those based on polymethylmethacrylate. PMID:25677680

  20. A modified PMMA cement (Sub-cement) for accelerated fatigue testing of cemented implant constructs using cadaveric bone.

    PubMed

    Race, Amos; Miller, Mark A; Mann, Kenneth A

    2008-10-20

    Pre-clinical screening of cemented implant systems could be improved by modeling the longer-term response of the implant/cement/bone construct to cyclic loading. We formulated bone cement with degraded fatigue fracture properties (Sub-cement) such that long-term fatigue could be simulated in short-term cadaver tests. Sub-cement was made by adding a chain-transfer agent to standard polymethylmethacrylate (PMMA) cement. This reduced the molecular weight of the inter-bead matrix without changing reaction-rate or handling characteristics. Static mechanical properties were approximately equivalent to normal cement. Over a physiologically reasonable range of stress-intensity factor, fatigue crack propagation rates for Sub-cement were higher by a factor of 25+/-19. When tested in a simplified 2 1/2-D physical model of a stem-cement-bone system, crack growth from the stem was accelerated by a factor of 100. Sub-cement accelerated both crack initiation and growth rate. Sub-cement is now being evaluated in full stem/cement/femur models. PMID:18774136

  1. [Antimicrobial activity of orthodontic band cements].

    PubMed

    Pavic, J; Arriagada, M; Elgueta, J; García, C

    1990-01-01

    The prevalence of enamel decalcification and caries beneath orthodontic bands, has indicated the need for a new enamel binding adhesive orthodontic cement. The purpose of this study was to evaluate the antimicrobial activity, in vitro, on Streptococcus mutans and Lactobacillus, acidophillus, of three materials used to cements the orthodontic bands. The cements studied were: Zinc phosphate cement, Glass-ionomer cement, and Policarboxylate cement. Thirty petri plates were seeded with S. mutans, and thirty with L. acidophillus; on each plate three pellet were placed, one of each cement studied. Petri plates were incubated under microaerophilic conditions at 37 C, and checked at 72 hrs. for Streptococcus, mutans, and four days for Lactobacillus acidophillus to evaluate the inhibition zone. The results were tabulated for each material. It was demonstrated that exists important variations in the antimicrobial properties of the materials studied, as in the microbial sensitivity to these cements. PMID:2135908

  2. Reducing CO2-Emission by using Eco-Cements

    NASA Astrophysics Data System (ADS)

    Voit, K.; Bergmeister, K.; Janotka, I.

    2012-04-01

    CO2 concentration in the air is rising constantly. Globally, cement companies are emitting nearly two billion tonnes/year of CO2 (or around 6 to 7 % of the planet's total CO2 emissions) by producing portland cement clinker. At this pace, by 2025 the cement industry will be emitting CO2 at a rate of 3.5 billion tones/year causing enormous environmental damage (Shi et al., 2011; Janotka et al., 2012). At the dawn of the industrial revolution in the mid-eighteenth century the concentration of CO2 was at a level of ca. 280 ppm. 200 years later at the time of World War II the CO2 level had risen to 310 ppm what results in a rate of increase of 0,15 ppm per year for that period (Shi et al., 2011). In November 2011 the CO2 concentration reached a value of 391 ppm (NOAA Earth System Research Laboratory, 2011), a rise of ca. 81 ppm in 66 years and an increased rate of around 1,2 ppm/year respectively. In the same period cement production in tons of cement has multiplied by a factor of ca. 62 (Kelly & Oss, US Geological Survey, 2010). Thus new CO2-saving eco-cement types are gaining in importance. In these cement types the energy-consuming portland cement clinker is partially replaced by latent hydraulic additives such as blast furnace slag, fly ash or zeolite. These hydraulic additives do not need to be fired in the rotary furnace. They ony need to be pulverized to the required grain size and added to the ground portland cement clinker. Hence energy is saved by skipping the engery-consuming firing process, in addition there is no CO2-degassing as there is in the case of lime burning. Therefore a research project between Austria and Slovakia, funded by the EU (Project ENVIZEO), was initiated in 2010. The main goal of this project is to develop new CEM V eco-types of cements and certificate them for common usage. CEM V is a portland clinker saving cement kind that allows the reduction of clinker to a proportion of 40-64% for CEM V/A and 20-39% for CEM V/B respectively by the

  3. A preliminary study of CO2 sequestration of cement paste

    NASA Astrophysics Data System (ADS)

    Choi, Y.; Lee, H.; Hwang, J.; Oh, J.; Lee, J.

    2013-12-01

    CSH by replacement of Ca by Mg. Almost all portlandites change to calcites in the pulverized cement paste (<0.15mm) within one hour with direct aqueous carbonation method. The carbonation of CSH is slightly progressed. With the addition of NaCl and MgCl2, the carbonation efficiency of CSH is not increased. However, the leaching test result with MgCl2 solution indicates that MgCl2 can be an efficient additive in indirect aqueous carbonation method.

  4. In vivo evaluation of bioactive PMMA-based bone cement with unchanged mechanical properties in a load-bearing model on rabbits.

    PubMed

    Fottner, Andreas; Nies, Berthold; Kitanovic, Denis; Steinbrück, Arnd; Hausdorf, Jörg; Mayer-Wagner, Susanne; Pohl, Ulrich; Jansson, Volkmar

    2015-07-01

    Polymethylmethacrylate-based bone cements are widely used for fixation of joint replacements. To improve the long-term outcome, bioactive bone cements are aspired to advance the bone-cement interface. This study evaluated the in vivo properties of a new polymethylmethacrylate-based bioactive bone cement with addition of amphiphilic phosphorylated 2-hydroxyethylmethacrylate. Previous in vitro studies confirmed bioactive properties in cell culture, as well as unchanged mechanical properties are tests according to ISO 5833:2002.Three different variations of the cement (polymethylmethacrylate + phosphorylated 2-hydroxyethylmethacrylate, polymethylmethacrylate + phosphorylated 2-hydroxyethylmethacrylate + CaCl2 and polymethylmethacrylate + phosphorylated 2-hydroxyethylmethacrylate + CaCl2 + Na2CO3) were compared to conventional polymethylmethacrylate cement. To evaluate the properties under load-bearing conditions, a spacer prosthesis was implanted into the femoral diaphysis of 24 rabbits. Additionally, a cement plug was installed into the proximal tibia. After three months, polished sections with Giemsa surface staining were prepared. The bioactivity was determined using the bone affinity index.The sections showed a good osseointegration of the bioactive bone cement without cement cracks under load-bearing conditions. Regarding the bone affinity index, the bioactive bone cement revealed a significantly higher value in the proximal tibia (25.9-37.7%) and around the spacer prosthesis (36.8-58.9%) compared to the conventional polymethylmethacrylate cement (12.8-17.0%).The results confirm the in vivo bioactivity of this bone cement. The absence of cement cracks indicates a sufficient mechanical stability to fix prostheses with this bioactive cement, but for a final assessment long-term tests are necessary. PMID:25627649

  5. Hormone Replacement Therapy

    MedlinePlus

    ... before and during menopause, the levels of female hormones can go up and down. This can cause ... hot flashes and vaginal dryness. Some women take hormone replacement therapy (HRT), also called menopausal hormone therapy, ...

  6. Hip replacement - discharge

    MedlinePlus

    ... a hip replacement and need antibiotics before any dental work. When to Call Your Doctor Call your health care provider if you have: A sudden increase in pain Chest pain or shortness of breath Frequent urination ...

  7. Replacing Arizona's Roofs.

    ERIC Educational Resources Information Center

    Fickes, Michael

    2000-01-01

    Discusses the Arizona statewide mandate to spend $500 million to repair or replace roofs in its public school system. Data from the state's evaluation process are provided, including how the state will fund the project. (GR)

  8. Knee joint replacement

    MedlinePlus

    The results of a total knee replacement are often excellent. The operation relieves pain for most people. Most people do not need help walking after they fully recover. Most artificial knee joints last 10 ...

  9. Hip joint replacement - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100006.htm Hip joint replacement - series—Normal anatomy To use the sharing ... to slide 5 out of 5 Overview The hip joint is made up of two major parts: the ...

  10. Replacing a Missing Tooth

    MedlinePlus

    ... majority of patients with clefts will require full orthodontic treatment, especially if the cleft has passed through ... later replacement of the missing lateral incisor. During orthodontic treatment, an artificial tooth may be attached to ...

  11. Knee joint replacement - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series—Normal anatomy To use the sharing ... of 4 Overview The knee is a complex joint. It contains the distal end of the femur ( ...

  12. Kidney Replacement Therapy

    MedlinePlus

    ... their function with either dialysis or a transplant. Dialysis Dialysis, the more common form of kidney-replacement ... the result of diabetes, not of hemodialysis. Peritoneal dialysis Another form of dialysis is called peritoneal dialysis. ...

  13. Artificial Disc Replacement

    MedlinePlus

    ... treat this condition, alternatives to disc replacement include fusion, nonoperative care or no treatment. Typically, surgery is ... operative treatment for disc pain has been spinal fusion. This is a surgical procedure in which disc ...

  14. Cementing oil and gas wells

    SciTech Connect

    Bloys, J.B.; Wilson, W.N.; Bradshaw, R.D.

    1991-12-31

    This patent describes a cement composition for cementing in a well penetrating subterranean formations and having an aqueous drilling fluid containing at least one cement retarder. It comprises a major proportion of the drilling fluid from the well as it was drilled the fluid having a density in the range of about 9.0 - 18.0 ppg; water; a lesser proportion of dry cementitious material; about 0.5 to about 10.0 ppb of a dispersant selected from the group consisting of sulfonated styrene maleic anhydride, sulfonated styrene imide, and sulfonate styrene itaconic acid; and a compatible accelerator selected from the group consisting of acetic acid; the first 4 carbon esters thereof; acetamide; monoethanolamine; and diethanolamine.

  15. High temperature well bore cement slurry

    SciTech Connect

    Nahm, J.J.W.; Vinegar, H.J.; Karanikas, J.M.; Wyant, R.E.

    1993-07-13

    A low density well bore cement slurry composition is described suitable for cementing well bores with high reservoir temperatures comprising: (a) a high alumina cement in an amount of about 40 pounds per barrel of slurry or greater: (b) graphite in an amount greater than about one quarter, by volume, of the solids in the cement slurry; and (c) and a carrier fluid comprising drilling mud.

  16. ADVANCED CEMENTS FOR GEOTHERMAL WELLS

    SciTech Connect

    SUGAMA,T.

    2007-01-01

    Using the conventional well cements consisting of the calcium silicate hydrates (CaO-SiO{sub 2}-H{sub 2}O system) and calcium aluminum silicate hydrates (CaO-Al{sub 2}O{sub 3}-SiO{sub 2}-H{sub 2}O system) for the integrity of geothermal wells, the serious concern confronting the cementing industries was their poor performance in mechanically supporting the metallic well casing pipes and in mitigating the pipe's corrosion in very harsh geothermal reservoirs. These difficulties are particularly acute in two geological regions: One is the deep hot downhole area ({approx} 1700 m depth at temperatures of {approx} 320 C) that contains hyper saline water with high concentrations of CO{sub 2} (> 40,000 ppm) in conjunction with {approx} 100 ppm H{sub 2}S at a mild acid of pH {approx} 5.0; the other is the upper well region between the well's surface and {approx} 1000 m depth at temperatures up to 200 C. The specific environment of the latter region is characterized by highly concentrated H{sub 2}SO{sub 4} (pH < 1.5) brine containing at least 5000 ppm CO{sub 2}. When these conventional cements are emplaced in these harsh environments, their major shortcoming is their susceptibility to reactions with hot CO{sub 2} and H{sub 2}SO4, thereby causing their deterioration brought about by CO{sub 2}-catalyzed carbonation and acid-initiated erosion. Such degradation not only reduced rapidly the strength of cements, lowering the mechanical support of casing pipes, but also increased the extent of permeability of the brine through the cement layer, promoting the rate of the pipe's corrosion. Severely carbonated and acid eroded cements often impaired the integrity of a well in less than one year; in the worst cases, casings have collapsed within three months, leading to the need for costly and time-consuming repairs or redrilling operations. These were the reasons why the geothermal well drilling and cementing industries were concerned about using conventional well cements, and further

  17. Skin ulceration due to cement.

    PubMed

    Robinson, S M; Tachakra, S S

    1992-09-01

    Despite legislation that requires manufacturers to inform the public about the dangers of contact with cement, severe ulceration from cement contact still occurs. We present a retrospective study of seven patients presenting to this department over a 2-year period. All were male and employed in the building trade, their injuries being sustained whilst at work. The injuries were to the lower limb, often multiple and required a median of seven visits before healing was complete. One required hospital admission and skin grafting. PMID:1449582

  18. 21 CFR 872.3275 - Dental cement.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Dental cement. 872.3275 Section 872.3275 Food and... DENTAL DEVICES Prosthetic Devices § 872.3275 Dental cement. (a) Zinc oxide-eugenol—(1) Identification... filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns...

  19. 21 CFR 872.3275 - Dental cement.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Dental cement. 872.3275 Section 872.3275 Food and... DENTAL DEVICES Prosthetic Devices § 872.3275 Dental cement. (a) Zinc oxide-eugenol—(1) Identification... filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns...

  20. Ipsilateral Traumatic Posterior Hip Dislocation, Posterior Wall and Transverse Acetabular Fracture with Trochanteric Fracture in an adult: Report of First Case

    PubMed Central

    Sinha, Skand; Naik, Ananta k; Arya, Rajendra K; Jain, Vijay K

    2013-01-01

    Introduction: Posterior dislocation of the hip joint with associated acetabular and intertrochanteric fracture is a complex injury. Early recognition, prompt and stable reduction is needed of successful outcome. Case Report: 45 year old male patient presented with posterior dislocation of the hip with transverse fracture with posterior wall fracture of acetabulam and intertrochanteric fracture on the ipsilateral side. The complex fracture geometry was confirmed by CT scan. The patient was successfully managed by open reduction and internal fixation of intertrochanteric fracture was achieved with dynamic hip screw (DHS) plate fixation followed by fixation of acetabular fracture with reconstruction plate. Conclusion: Hip dislocation combined with acetabular fracture is an uncommon injury; this article presents a unique case of posterior wall and transverse fractures of ipsilateral acetabulum with intertrochanteric fracture in a patient who sustained traumatic posterior hip dislocation. Early surgical intervention is important for satisfactory outcomes of such complex fracture-dislocation injuries. PMID:27298928

  1. The effect of lime-dried sewage sludge on the heat-resistance of eco-cement.

    PubMed

    Li, Wen-Quan; Liu, Wei; Cao, Hai-Hua; Xu, Jing-Cheng; Liu, Jia; Li, Guang-Ming; Huang, Juwen

    2016-01-01

    The treatment and disposal of sewage sludge is a growing problem for sewage treatment plants. One method of disposal is to use sewage sludge as partial replacement for raw material in cement manufacture. Although this process has been well researched, little attention has been given to the thermal properties of cement that has had sewage sludge incorporated in the manufacturing process. This study investigated the fire endurance of eco-cement to which lime-dried sludge (LDS) had been added. LDS was added in proportions of 0%, 3%, 6%, 9%, and 12% (by weight) to the raw material. The eco-cement was exposed to 200, 400, or 600 °C for 3 h. The residual strength and the microstructural properties of eco-cement were then studied. Results showed that the eco-cement samples suffered less damage than conventional cement at 600 °C. The microstructural studies showed that LDS incorporation could reduce Ca(OH)(2) content. It was concluded that LDS has the potential to improve the heat resistance of eco-cement products. PMID:27386999

  2. Finite element analysis of stresses in fixed prosthesis and cement layer using a three-dimensional model

    PubMed Central

    Sangeetha, Arunachalam; Padmanabhan, Thallam Veeravalli; Subramaniam, R.; Ramkumar, Vivekanandan

    2012-01-01

    Context: To understand the effect of masticatory and parafunctional forces on the integrity of the prosthesis and the underlying cement layer. Aims: The purpose of this study was to evaluate the stress pattern in the cement layer and the fixed prosthesis, on subjecting a three-dimensional finite element model to simulated occlusal loading. Materials and Methods: Three-dimensional finite element model was simulated to replace missing mandibular first molar with second premolar and second molar as abutments. The model was subjected to a range of occlusal loads (20, 30, 40 MPa) in two different directions – vertical and 30° to the vertical. The cements (zinc phosphate, polycarboxylate, glass ionomer, and composite) were modeled with two cement thicknesses – 25 and 100 μm. Stresses were determined in certain reference points in fixed prosthesis and the cement layer. Statistical Analysis Used: The stress values are mathematic calculations without variance; hence, statistical analysis is not routinely required. Results: Stress levels were calculated according to Von Mises criteria for each node. Maximum stresses were recorded at the occlusal surface, axio-gingival corners, followed by axial wall. The stresses were greater with lateral load and with 100-μm cement thickness. Results revealed higher stresses for zinc phosphate cement, followed by composites. Conclusions: The thinner cement interfaces favor the success of the prosthesis. The stresses in the prosthesis suggest rounding of axio-gingival corners and a well-established finish line as important factors in maintaining the integrity of the prosthesis. PMID:23066295

  3. Utilization of ground waste seashells in cement mortars for masonry and plastering.

    PubMed

    Lertwattanaruk, Pusit; Makul, Natt; Siripattarapravat, Chalothorn

    2012-11-30

    In this research, four types of waste seashells, including short-necked clam, green mussel, oyster, and cockle, were investigated experimentally to develop a cement product for masonry and plastering. The parameters studied included water demand, setting time, compressive strength, drying shrinkage and thermal conductivity of the mortars. These properties were compared with those of a control mortar that was made of a conventional Portland cement. The main parameter of this study was the proportion of ground seashells used as cement replacement (5%, 10%, 15%, or 20% by weight). Incorporation of ground seashells resulted in reduced water demand and extended setting times of the mortars, which are advantages for rendering and plastering in hot climates. All mortars containing ground seashells yielded adequate strength, less shrinkage with drying and lower thermal conductivity compared to the conventional cement. The results indicate that ground seashells can be applied as a cement replacement in mortar mixes and may improve the workability of rendering and plastering mortar. PMID:22841935

  4. Characterization of composite materials based on cement-ceramic powder blended binder

    NASA Astrophysics Data System (ADS)

    Kulovaná, Tereza; Pavlík, Zbyšek

    2016-06-01

    Characterization of newly developed composite mortars with incorporated ceramic powder coming from precise brick cutting as partial Portland cement replacement up to 40 mass% is presented in the paper. Fine ceramic powder belongs to the pozzolanic materials. Utilization of pozzolanic materials is accompanied by lower request on energy needed for Portland clinker production which generally results in lower production costs of blended binder and lower CO2 emission. In this paper, the ceramic powder is used in cement based mortar composition in amount of 8, 16, 24, 32, and 40 mass% of cement. Chemical composition of ceramic powder is analyzed by X-Ray Fluorescence and X-Ray Diffraction. The particle size distribution of ceramics is accessed on laser diffraction principle. For 28 days cured mortar samples, basic physical and mechanical properties are experimentally determined. The obtained results demonstrate that ceramic powder has potential to replace a part of Portland cement in composition of cement based composites and to reduce negative environmental impact of their production.

  5. Tribological characteristics of a composite total-surface hip replacement

    NASA Technical Reports Server (NTRS)

    Jones, W. R., Jr.; Roberts, J. C.; Ling, F. F.

    1982-01-01

    Continuous fiber, woven E glass composite femoral shells having the same elastic properties as bone were fabricated. The shells were then encrusted with filled epoxy wear resistant coatings and run dry against ultrahigh molecular weight polyethylene acetabular cups in 42,000 and 250,000 cycle wear tests on a total hip simulator. The tribological characteristics of these continuous fiber particulate composite femoral shells articulating with ultrahigh molecular weight polyethylene acetabular cups were comparable to those of a vitallium ball articulating with an ultrahigh molecular weight polyethylene acetabular cup.

  6. Revision Total Hip Arthroplasty Using Tantalum Augment in Patients with Paprosky III or IV Acetabular Bone Defects: A Minimum 2-year Follow Up Study

    PubMed Central

    Jeong, Min; Kim, Hyung-Joo; Lim, Seung-Jae; Moon, Young-Wan

    2016-01-01

    Purpose The purpose of this study is to report the short-term outcomes of revision total hip arthroplasty (THA) using tantalum augments in patients with severe acetabular bone defects. Materials and Methods We retrospectively analyzed 15 revision THAs performed in 15 patients using tantalum augments between June 2010 and December 2013. Acetabular bone defects were Paprosky type IIIA in 7 hips, type IIIB in 7, and type IV in 1. The causes of revision surgery were aseptic loosening in 12 hips and deep infection in 3. Revisions were first in 1 hip, second in 3, and third in 11. Six patients were male and 9 female with a mean age of 59 years (range, 48-75 years). Mean follow-up was 29 months (range, 24-48 months). Results Mean Harris hip score was improved from 34 points (range, 12-54 points) preoperatively to 84 points (range, 38-90 points) at final follow-up. On the final follow-up radiographs, there were 12 hips (80.0%) with stable fixation of the acetabular cup, 2 (13.3%) with secondary stability after mild acetabular protrusion, and 1 (6.7%) with radiolucency around the acetabular cup without mechanical symptoms. Complications included one patient with acute hematogenous infection managed by surgical debridement and long-term antibiotic therapy. There were no cases with nerve palsy or dislocation during the follow-up period. Conclusion The present study showed satisfactory clinical and radiographic outcomes of revision THA using tantalum augments due to severe acetabular bone defects of Paprosky type III or IV at a minimum follow-up of 2 years. PMID:27536651

  7. Hip Abduction Can Prevent Posterior Edge Loading of Hip Replacements

    PubMed Central

    van Arkel, Richard J; Modenese, Luca; Phillips, Andrew TM; Jeffers, Jonathan RT

    2013-01-01

    Edge loading causes clinical problems for hard-on-hard hip replacements, and edge loading wear scars are present on the majority of retrieved components. We asked the question: are the lines of action of hip joint muscles such that edge loading can occur in a well-designed, well-positioned acetabular cup? A musculoskeletal model, based on cadaveric lower limb geometry, was used to calculate for each muscle, in every position within the complete range of motion, whether its contraction would safely pull the femoral head into the cup or contribute to edge loading. The results show that all the muscles that insert into the distal femur, patella, or tibia could cause edge loading of a well-positioned cup when the hip is in deep flexion. Patients frequently use distally inserting muscles for movements requiring deep hip flexion, such as sit-to-stand. Importantly, the results, which are supported by in vivo data and clinical findings, also show that risk of edge loading is dramatically reduced by combining deep hip flexion with hip abduction. Patients, including those with sub-optimally positioned cups, may be able to reduce the prevalence of edge loading by rising from chairs or stooping with the hip abducted. © 2013 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 31:1172–1179, 2013. PMID:23575923

  8. DSC and TG Analysis of a Blended Binder Based on Waste Ceramic Powder and Portland Cement

    NASA Astrophysics Data System (ADS)

    Pavlík, Zbyšek; Trník, Anton; Kulovaná, Tereza; Scheinherrová, Lenka; Rahhal, Viviana; Irassar, Edgardo; Černý, Robert

    2016-03-01

    Cement industry belongs to the business sectors characteristic by high energy consumption and high {CO}2 generation. Therefore, any replacement of cement in concrete by waste materials can lead to immediate environmental benefits. In this paper, a possible use of waste ceramic powder in blended binders is studied. At first, the chemical composition of Portland cement and ceramic powder is analyzed using the X-ray fluorescence method. Then, thermal and mechanical characterization of hydrated blended binders containing up to 24 % ceramic is carried out within the time period of 2 days to 28 days. The differential scanning calorimetry and thermogravimetry measurements are performed in the temperature range of 25°C to 1000°C in an argon atmosphere. The measurement of compressive strength is done according to the European standards for cement mortars. The thermal analysis results in the identification of temperature and quantification of enthalpy and mass changes related to the liberation of physically bound water, calcium-silicate-hydrates dehydration and portlandite, vaterite and calcite decomposition. The portlandite content is found to decrease with time for all blends which provides the evidence of the pozzolanic activity of ceramic powder even within the limited monitoring time of 28 days. Taking into account the favorable results obtained in the measurement of compressive strength, it can be concluded that the applied waste ceramic powder can be successfully used as a supplementary cementing material to Portland cement in an amount of up to 24 mass%.

  9. Formation of aragonite cement by nannobacteria in the Great Salt Lake, Utah

    NASA Astrophysics Data System (ADS)

    Pedone, Vicki A.; Folk, Robert L.

    1996-08-01

    Brine-shrimp egg cases in growth cavities in modern stromatolites in the Great Salt Lake, Utah, are replaced by aragonite and cemented together by aragonite cement. The fabric of the cement changes dramatically as the distance from the egg case increases. The cement within 50 to 70 μm of the egg case exhibits a random fabric of 10 to 20 μm equant crystals. The surface of the cement is covered by bead-like bumps, 0.1 μm in diameter, interpreted as nannobacteria. Overlying the random, “beaded” fabric with a relatively abrupt transition are epitaxial, prismatic aragonite crystals that have smooth crystal surfaces lacking bead-like bodies. The smooth-surfaced prismatic aragonite crystals are interpreted to be “normal” abiotic precipitates, whereas the “beaded” microspar is interpreted to result from biotic processes, where the nannobacteria serve as catalysts for creation of the cement. A population explosion of bacteria occurs as the organic material of egg case rots, which alters the microchemical environment and induces a rapid precipitation of aragonite, enclosing tens of thousands of nannobacteria. As the organic material is destroyed, reproduction of bacteria slows and epitaxial, prismatic aragonite crystals nucleate and grow abiotically on the structureless, “biotic” layer.

  10. Effects of lithium nitrate admixture on early-age cement hydration

    SciTech Connect

    Millard, M.J. Kurtis, K.E.

    2008-04-15

    Although the benefits of lithium admixtures for mitigation of alkali-silica reaction (ASR) have been well documented, the potential ancillary effects of lithium compounds on cement and concrete remain largely uncharacterized. To examine the effects of the most common lithium admixture - lithium nitrate - on early-age behavior, the admixture was introduced at dosages of 0% to 400% of the recommended dosage to six cements of varying composition and to a cement-fly ash blend. Behavior was examined by isothermal calorimetry and measurements of chemical shrinkage, autogenous shrinkage, and setting time. Results indicate that lithium nitrate accelerates the early hydration of most cements but may retard hydration after 24 h. In the lowest alkali cement tested, set times were shortened in the presence of lithium nitrate by 15-22%. Higher dosages appeared to increase autogenous shrinkage after 40 days. The replacement of cement by Class F fly ash at 20% by weight appeared to diminish the early acceleration effects, but later hydration retardation and autogenous shrinkage were still observed.

  11. Wear of the polyethylene liner-metallic shell interface in modular acetabular components. An in vitro analysis.

    PubMed

    Lieberman, J R; Kay, R M; Hamlet, W P; Park, S H; Kabo, J M

    1996-08-01

    The purpose of this study was to determine the effect of compression cycles and wear patterns on the polyethylene liner-metallic shell interface in modular acetabular components. Articular frictional torque was also measured. Modular acetabular components from five manufacturers were tested. The polyethylene liners were sputter coated with gold on the convex surface to enhance the visualization of wear and deformation patterns. Each component was cycled for 10 million cycles in a hydraulic fatigue testing machine. Frictional torque was measured prior to the start of the cyclic loading and in increments of 2 million cycles. Frictional torque was significantly lower in the design with an enhanced polyethylene liner. Abrasion of the gold from the convex surface of polyethylene liners varied from 2 to 23% between designs. Extrusion of the polyethylene into the screw holes in the metallic shells was universal. Three modes of damage (burnishing, punch-out, and gouging) were identified on the convex surface of the polyethylene liner. Abrasion of the gold from the convex surface of the polyethylene varied greatly between designs. This is indicative of relative motion between the polyethylene liner and the metallic shell. This motion must be minimized to limit the generation of wear debris from the convex surface of the polyethylene. Several aspects of modular acetabular component design could be implemented to potentially reduce wear, including limiting the number of holes available for screw placement, smoothing out the edges of the screw holes to avoid punch-out, and avoiding supplemental fixation of the liner unless it is essential to prevent motion between the liner and the metallic shell. PMID:8872582

  12. Computed tomography arthrography with traction in the human hip for three-dimensional reconstruction of cartilage and the acetabular labrum

    PubMed Central

    Henak, C.R.; Abraham, C.L.; Peters, C.L.; Sanders, R.K.; Weiss, J.A.; Anderson, A.E.

    2014-01-01

    AIM To develop and demonstrate the efficacy of a computed tomography arthrography (CTA) protocol for the hip that enables accurate three-dimensional reconstructions of cartilage and excellent visualization of the acetabular labrum. MATERIALS AND METHODS Ninety-three subjects were imaged (104 scans); 68 subjects with abnormal anatomy, 11 patients after periacetabular osteotomy surgery, and 25 subjects with normal anatomy. Fifteen to 25 ml of contrast agent diluted with lidocaine was injected using a lateral oblique approach. A Hare traction splint applied traction during CT. The association between traction force and intra-articular joint space was assessed qualitatively under fluoroscopy. Cartilage geometry was reconstructed from the CTA images for 30 subjects; the maximum joint space under traction was measured. RESULTS Using the Hare traction splint, the intra-articular space and boundaries of cartilage could be clearly delineated throughout the joint; the acetabular labrum was also visible. Dysplastic hips required less traction (~5 kg) than normal and retroverted hips required (>10 kg) to separate the cartilage. An increase in traction force produced a corresponding widening of the intra-articular joint space. Under traction, the maximum width of the intra-articular joint space during CT ranged from 0.98–6.7 mm (2.46 ± 1.16 mm). CONCLUSIONS When applied to subjects with normal and abnormal hip anatomy, the CTA protocol presented yields clear delineation of the cartilage and the acetabular labrum. Use of a Hare traction splint provides a simple, cost-effective method to widen the intra-articular joint space during CT, and provides flexibility to vary the traction as required. PMID:25070373

  13. Post-deformation shape-recovery behavior of vitamin E-diffused, radiation crosslinked polyethylene acetabular components.

    PubMed

    Takahashi, Yasuhito; Tateiwa, Toshiyuki; Shishido, Takaaki; Masaoka, Toshinori; Kubo, Kosuke; Yamamoto, Kengo

    2016-10-01

    The in-vivo progression of creep and wear in ultra-high molecular weight polyethylene (UHMWPE) acetabular liners has been clinically evaluated by measuring radiographic penetration of femoral heads. In such clinical assessments, however, viscoelastic strain relaxation has been rarely considered after a removal of hip joint loading, potentially leading to an underestimation of the penetrated thickness. The objective of this study was to investigate shape-recovery behavior of pre-compressed, radiation crosslinked and antioxidant vitamin E-diffused UHMWPE acetabular liners, and also to characterize the effects of varying their internal diameter (ID) and wall thickness (WT). We applied uniaxial compression to the UHMWPE specimens of various ID (28, 32, 36mm) and WT (4.8, 6.8, 8.9mm) for 4320min under the constant load of 3000N, and subsequently monitored the strain-relaxation behavior as a function of time after unloading. It was observed that there was a considerable shape recovery of the components after removal of the external static load. Reducing ID and WT significantly accelerated the rate of creep strain recovery, and varying WT was more sensitive to the recovery behavior than ID. Creep deformation of the tested liners recovered mostly within the first 300min after unloading. Note that approximately half of the total recovery amount proceeded just within 5min after unloading. These results suggest a remarkably high capability of shape recovery of vitamin E-diffused highly crosslinked UHMWPE. In conclusion, the time-dependent shape recovering and the diameter-thickness effect on its behavior should be carefully considered when the postoperative penetration is quantified in highly crosslinked UHMWPE acetabular liners (especially on the non-weight bearing radiographs). PMID:27454526

  14. Patch testing with cement containing iron sulfate.

    PubMed

    Bruze, M; Fregert, S; Gruvberger, B

    1990-01-01

    Addition of iron sulfate to cement means transformation of water-soluble hexavalent chromium into nonwater-soluble trivalent chromium. This has been the basis for preventive measures concerning sensitization to hexavalent chromium (chromate) in cement. For some years, iron sulfate has been added to cement manufactured in the Scandinavian countries. In the present in vivo study, cements with and without iron sulfate were compared concerning their capacity to elicit allergic patch-test reactions in eight chromate-hypersensitive individuals. No patch-test reactions were obtained from a water extract of cement with iron sulfate when appropriately buffered. PMID:2137395

  15. Process for cementing geothermal wells

    DOEpatents

    Eilers, Louis H.

    1985-01-01

    A pumpable slurry of coal-filled furfuryl alcohol, furfural, and/or a low molecular weight mono- or copolymer thereof containing, preferably, a catalytic amount of a soluble acid catalyst is used to cement a casing in a geothermal well.

  16. The Clinical Performance of Metal-on-Metal as an Articulation Surface in Total Hip Replacement

    PubMed Central

    Long, William T

    2005-01-01

    The metal-on-metal articulations in total hip arthroplasty (THA) were widely used between 1960 and 1975. The McKee-Farrar and other first-generation prostheses failed at a high rate because impingement caused early component loosening. The problem of early component loosening was corrected by improved component design and better manufacturing quality. Second-generation metal-on-metal total hip replacements have experienced short and medium-term success as assessed by Harris Hip Scores and patient selfassessment. The combined annual linear wear of the metal-on-metal femoral head and acetabular insert is less than 10 mm and osteolysis has only rarely been observed in association with well-fixed metal-on-metal total hip replacements. Hypersensitivity is not a common cause of loosening with second-generation hip replacements and remains to be proven as a definitive diagnosis in unusual cases of unexplained pain. More than 40 years of use has demonstrated no increase in the incidence of renal failure or cancer in patients with metal-on-metal total hip replacements. The scientific evidence of the results using the metal-on-metal articulations would recommend its continued use in any patient who does not have compromised renal function. PMID:16089065

  17. CO2-saturated brine reactivity at the Portland cement-shale interface and the integrity of wellbore systems

    NASA Astrophysics Data System (ADS)

    Carey, J. W.; Lichtner, P. C.; Wigand, M. O.

    2006-12-01

    Long-term geologic storage of CO2 requires trapping the buoyant CO2 plume beneath impermeable caprocks such as shale. Given a high-quality caprock, wells that penetrate the caprock represent the most significant potential leak point in the sequestration system. This is particularly so because the Portland cement used to create the primary fluid barrier in the wellbore system is reactive with CO2 and may degrade over time. In this study, we used a combination of field observations obtained at the SACROC Unit in West Texas (the oldest CO2-enhanced oil recovery field in the US), experimental studies of cement-CO2-brine interactions, and numerical modeling to investigate the stability of the primary seal. The field observations and the recognition of the large thickness of Portland cement used in the wellbore annulus shows that the primary concern for potential leakage is not matrix flow due to carbonation of the Portland cement, but is the interfaces between the casing and cement and the cement and caprock. We focused on the dynamics of the cement- caprock interface in this study. Both field observations and experiments show that cement carbonation is accompanied by loss of primary cement phases such as portlandite and their replacement by a combination of carbonate minerals (calcite, aragonite, vaterite, and dolomite) and an amorphous alumino-silica residue. The carbonation reaction is accompanied by a transformation of the cement to a distinctive orange color. We have used the field and laboratory observations to construct a numerical model of carbonation at the cement-shale interface. The initial focus was on obtaining an adequate simulation of the cement alteration mineralogy with a 1-D, diffusion-based model. The primary variables controlling the reaction characteristics were porosity, tortuosity, and mineral reaction rates. By suitable adjustment of these parameters, the model successfully reproduces many of the alteration features of the cement including the

  18. Toxicology of chlorofluorocarbon replacements.

    PubMed Central

    Dekant, W

    1996-01-01

    Chlorofluorocarbons (CFCs) are stable in the atmosphere and may reach the stratosphere. They are cleaved by UV-radiation in the stratosphere to yield chlorine radicals, which are thought to interfere with the catalytic cycle of ozone formation and destruction and deplete stratospheric ozone concentrations. Due to potential adverse health effects of ozone depletion, chlorofluorocarbon replacements with much lower or absent ozone depleting potential are developed. The toxicology of these compounds that represent chlorofluorohydrocarbons (HCFCs) or fluorohydrocarbons (HFCs) has been intensively studied. All compounds investigated (1, 1-dichloro-1-fluoroethane [HCFC-141b], 1,1,1,2-tetrafluoroethane [HFC-134a], pentafluoroethane [HFC-125], 1-chloro- 1,2,2,2-tetrafluoroethane [HCFC-124], and 1,1-dichloro-2,2,2-trifluoroethane [HCFC-123]) show only a low potential for skin and eye irritation. Chronic adverse effects on the liver (HCFC-123) and the testes (HCFC-141b and HCFC-134a), including tumor formation, were observed in long-term inhalation studies in rodents using very high concentrations of these CFC replacements. All CFC replacements are, to varying extents, biotransformed in the organism, mainly by cytochrome P450-catalyzed oxidation of C-H bonds. The formed acyl halides are hydrolyzed to give excretable carboxylic acids; halogenated aldehydes that are formed may be further oxidized to halogenated carboxylic acids or reduced to halogenated alcohols, which are excretory metabolites in urine from rodents exposed experimentally to CFC replacements. The chronic toxicity of the CFC replacements studied is unlikely to be of relevance for humans exposed during production and application of CFC replacements. PMID:8722112

  19. Mesoscale texture of cement hydrates.

    PubMed

    Ioannidou, Katerina; Krakowiak, Konrad J; Bauchy, Mathieu; Hoover, Christian G; Masoero, Enrico; Yip, Sidney; Ulm, Franz-Josef; Levitz, Pierre; Pellenq, Roland J-M; Del Gado, Emanuela

    2016-02-23

    Strength and other mechanical properties of cement and concrete rely upon the formation of calcium-silicate-hydrates (C-S-H) during cement hydration. Controlling structure and properties of the C-S-H phase is a challenge, due to the complexity of this hydration product and of the mechanisms that drive its precipitation from the ionic solution upon dissolution of cement grains in water. Departing from traditional models mostly focused on length scales above the micrometer, recent research addressed the molecular structure of C-S-H. However, small-angle neutron scattering, electron-microscopy imaging, and nanoindentation experiments suggest that its mesoscale organization, extending over hundreds of nanometers, may be more important. Here we unveil the C-S-H mesoscale texture, a crucial step to connect the fundamental scales to the macroscale of engineering properties. We use simulations that combine information of the nanoscale building units of C-S-H and their effective interactions, obtained from atomistic simulations and experiments, into a statistical physics framework for aggregating nanoparticles. We compute small-angle scattering intensities, pore size distributions, specific surface area, local densities, indentation modulus, and hardness of the material, providing quantitative understanding of different experimental investigations. Our results provide insight into how the heterogeneities developed during the early stages of hydration persist in the structure of C-S-H and impact the mechanical performance of the hardened cement paste. Unraveling such links in cement hydrates can be groundbreaking and controlling them can be the key to smarter mix designs of cementitious materials. PMID:26858450

  20. Mesoscale texture of cement hydrates

    PubMed Central

    Ioannidou, Katerina; Krakowiak, Konrad J.; Bauchy, Mathieu; Hoover, Christian G.; Masoero, Enrico; Yip, Sidney; Ulm, Franz-Josef; Levitz, Pierre; Pellenq, Roland J.-M.; Del Gado, Emanuela

    2016-01-01

    Strength and other mechanical properties of cement and concrete rely upon the formation of calcium–silicate–hydrates (C–S–H) during cement hydration. Controlling structure and properties of the C–S–H phase is a challenge, due to the complexity of this hydration product and of the mechanisms that drive its precipitation from the ionic solution upon dissolution of cement grains in water. Departing from traditional models mostly focused on length scales above the micrometer, recent research addressed the molecular structure of C–S–H. However, small-angle neutron scattering, electron-microscopy imaging, and nanoindentation experiments suggest that its mesoscale organization, extending over hundreds of nanometers, may be more important. Here we unveil the C–S–H mesoscale texture, a crucial step to connect the fundamental scales to the macroscale of engineering properties. We use simulations that combine information of the nanoscale building units of C–S–H and their effective interactions, obtained from atomistic simulations and experiments, into a statistical physics framework for aggregating nanoparticles. We compute small-angle scattering intensities, pore size distributions, specific surface area, local densities, indentation modulus, and hardness of the material, providing quantitative understanding of different experimental investigations. Our results provide insight into how the heterogeneities developed during the early stages of hydration persist in the structure of C–S–H and impact the mechanical performance of the hardened cement paste. Unraveling such links in cement hydrates can be groundbreaking and controlling them can be the key to smarter mix designs of cementitious materials. PMID:26858450