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      • Record: found
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      Clinical Outcomes of Tibial Components with Modular Stems Used in Primary TKA

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          Abstract

          Due to the known potential for fretting and corrosion at modular junctions in orthopaedic implants, this retrospective study evaluated radiographic and clinical outcomes of 85 primary TKA patients implanted with modular stemmed tibial components and followed up for an average of 82 months. There was low incidence of tibial radiolucent lines, excellent functional outcomes, and no complications associated with stem modularity. The findings were comparable to the historical control study involving 107 TKA with a nonmodular tibial stem design. When using surface cemented tibial components combined with a constrained polyethylene bearing, modular stems appear to be a viable option for primary TKA when adequate fixation and rotational stability are maintained.

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          A multicenter retrieval study of the taper interfaces of modular hip prostheses.

          Jay Goldberg, Jeremy Gilbert, Joshua Jacobs … (2002)
          A multicenter retrieval analysis of 231 modular hip implants was done to investigate the effects of material combination, metallurgic condition, flexural rigidity, head and neck moment arm, neck length, and implantation time on corrosion and fretting of modular taper surfaces. Scores for corrosion and fretting were assigned to medial, lateral, anterior, and posterior quadrants of the necks, and proximal and distal regions of the heads. Neck and head corrosion and fretting scores were found to be significantly higher for mixed alloy versus similar alloy couples. Moderate to severe corrosion was observed in 28% of the heads of similar alloy couples and 42% of the heads of mixed alloy couples. Differences in corrosion scores were observed between components made from the same base alloy, but of different metallurgic conditions. Corrosion and fretting scores tended to be higher for heads than necks. Implantation time and flexural rigidity of the neck were predictors of head and neck corrosion and head fretting. The results of this study suggest that in vivo corrosion of modular hip taper interfaces is attributable to a mechanically-assisted crevice corrosion process. Larger diameter necks will increase neck stiffness and may reduce fretting and subsequent corrosion of the taper interface regardless of the alloy used. Increasing neck diameter must be balanced, however, with the resulting loss of range of motion and joint stability.
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            Corrosion of metal orthopaedic implants.

            Donald Jacobs, Kimberly R. Urban, J. Gilbert (1998)
            Article 0 comments Cited 59 times – based on 0 reviews     Review now
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              Osteolysis: basic science.

              Kenneth A Roebuck, M Archibeck, N Hallab … (2001)
              Since the recognition of aseptic loosening by Charnley in the early 1960s, much information has been gained on the basic science of periprosthetic bone loss. Initially termed cement disease, it now generally is accepted that, in most instances, osteolysis is a manifestation of an adverse cellular response to phagocytosable particulate wear and corrosion debris, possibly facilitated by local hydrodynamic effects. Tissue explant, animal, and cell culture studies have allowed us to compile an appreciation of the complexity of cellular interactions and chemical mediators involved in osteolysis. Cellular participants have been shown to include the macrophage, osteoblast, fibroblast, and osteoclast. The plethora of chemical mediators that are responsible for the cellular responses and effects on bone include prostaglandin E2, tumor necrosis factor-alpha, interleukin-1, and interleukin 6. However, an increasing number of other proinflammatory and antiinflammatory cytokines, prostenoids, and enzymes have been shown to play important roles in this process. The ultimate goal of basic research is to develop novel strategies for evaluation and treatment of patients with osteolysis. Although initial animal studies are promising for possible pharmacologic treatment and prevention of osteolysis, well-controlled human trials are required before agents such as bisphosphonates can be recommended for general clinical use.
              Article 0 comments Cited 47 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Adv Orthop
                Journal ID (iso-abbrev): Adv Orthop
                Journal ID (publisher-id): AORTH
                Title: Advances in Orthopedics
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-3464
                ISSN (Electronic): 2090-3472
                Publication date (Print): 2014
                Publication date (Electronic): 5 February 2014
                Volume: 2014
                Electronic Location Identifier: 651279
                Affiliations
                1Department of Bioengineering, 301 Rhodes Engineering Research Center, Clemson University, Clemson, SC 29634, USA
                2University of South Carolina, School of Medicine Greenville, 607 Grove Road, Greenville, SC 29605, USA
                3Steadman Hawkins Clinic of the Carolinas, 200 Patewood Drive, Suite C100, Greenville, SC 29615, USA
                Author notes
                *Melinda K. Harman: harman2@ 123456clemson.edu

                Academic Editor: Masato Takao

                Author information
                http://orcid.org/0000-0002-7074-8845
                Article
                DOI: 10.1155/2014/651279
                PMC ID: 3941588
                SO-VID: 26aead89-168a-48b8-8d64-bef89f31d3c6
                Copyright © Copyright © 2014 Nicole Durig et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 6 October 2013
                Date revision received : 14 December 2013
                Date accepted : 16 December 2013
                Categories
                Subject: Clinical Study

                ScienceOpen disciplines: Orthopedics
                Data availability:
                ScienceOpen disciplines: Orthopedics

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