Abstract:
:Cross-linked polyethylene currently is being introduced in knee prostheses. The wear rates, wear debris, and biologic reactivity of non cross-linked, moderately cross-linked, and highly cross-linked polyethylene have been compared in multidirectional wear tests and knee simulators. Multidirectional pin-on-plate wear studies of noncross-linked, moderately cross-linked (5 Mrad), and highly cross-linked (10 Mrad) polyethylene showed a 75% reduction in wear with the highly cross-linked material under kinematics found in the hip, but only a 33% reduction under wear in kinematics representative of the knee. In knee simulator studies, with the fixed-bearing press-fit, condylar Sigma cruciate-retaining knee under high kinematic input conditions, the wear of 5 Mrad moderately cross-linked polyethylene was 13 +/- 4 mm per 1 million cycles, which was lower (p < 0.05) than the wear of clinically used, gamma vacuum foil GUR 1020 polyethylene (23 +/- 6 mm/1 million cycles). For the low-contact stress mobile-bearing knee, the wear of moderately cross-linked polyethylene was 2 +/- 1 mm per 1 million cycles, which was lower (p < 0.05) than GVF GUR 1020 polyethylene (5 +/- 2 mm/1 million cycles). The wear debris isolated from the fixed-bearing knees showed the moderately cross-linked material had a larger percentage volume of particles smaller than 1 mum in size, compared with GVF GUR 1020 polyethylene. Direct cell culture studies of wear debris generated in sterile wear simulators using multidirectional motion showed a increase (p < 0.05) in tumor necrosis factor-alpha levels and reactivity for GUR 1050 cross-linked polyethylene debris compared with an equivalent volume of noncross-linked GUR 1050 polyethylene. The use of cross-linked polyethylene in the knee reduces the volumetric wear rate. However, the clinical significance of reduced fracture toughness, elevated wear in abrasive conditions, and the elevated tumor necrosis factor-alpha release from smaller more reactive particles warrant further investigation.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Fisher J,McEwen HM,Tipper JL,Galvin AL,Ingram J,Kamali A,Stone MH,Ingham Edoi
10.1097/01.blo.0000148783.20469.4csubject
Has Abstractpub_date
2004-11-01 00:00:00pages
114-9issue
428eissn
0009-921Xissn
1528-1132pii
00003086-200411000-00019pub_type
杂志文章abstract::An in vitro study was performed using a singular unibody design CoCr tibial baseplate with fins to test the hypothesis that the addition of cement surrounding the tibial stem decreases micromotion of the tibial tray in cemented total knee arthroplasty. Five configurations were tested. Significant micromotion occurred ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199811000-00012
更新日期:1998-11-01 00:00:00
abstract::Many situations in revision THA require the exchange of a PE liner in the setting of a well-fixed cementless acetabular shell. Unfortunately, a replacement liner is not always available, the locking mechanism of the metal shell may be damaged or incompatible with the desired liner, or the shell is malpositioned. Revis...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000096805.78689.8b
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:The majority of patients with osteosarcoma and Ewing's sarcoma are diagnosed before skeletal maturity. Paley's multiplier is used for height prediction in healthy children, and has been suggested as a method to make growth predictions for children with osteosarcoma and Ewing's sarcoma when considering limb s...
journal_title:Clinical orthopaedics and related research
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doi:10.1007/s11999-014-3636-4
更新日期:2014-08-01 00:00:00
abstract::British surgeons and engineers contributed various types of knee prostheses, including hinged, unconstrained, and semiconstrained prostheses, in the development of total knee arthroplasty. Methods of implant fixation, the place of stems, pegs, the use of special instrumentation, and alignment procedures ensure both in...
journal_title:Clinical orthopaedics and related research
pub_type: 历史文章,杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract:UNLABELLED:Current methods of treating congenital clubfeet provide high rates of functional outcomes. Despite the clinical outcomes, radiographic assessment suggests residual equinus deformity of the hindfoot. It is unclear whether these deformities result in abnormal foot-floor pressures and whether they correlate wit...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0746-5
更新日期:2009-05-01 00:00:00
abstract::Proximal realignment was performed in 75 knees due to patellar pain or instability. With a follow-up period of from two to ten years, the result was excellent or good in 68 knees (91%) and fair or poor in seven knees (9%). Postoperative Merchant views were obtained in 57 knees. In the 52 knees rated good and excellent...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-06-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200101000-00004
更新日期:2001-01-01 00:00:00
abstract::Most studies on shoulder arthroplasty include a diverse group of patients presenting to a tertiary care center. Little information is available regarding outcomes in a community setting. We reviewed 98 residents (110 shoulders) of Olmsted County, Minnesota who had shoulder arthroplasties from 1976 to 2000. There were ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000238870.99980.64
更新日期:2007-02-01 00:00:00
abstract::The techniques used in fixation of the femoral prosthesis in total hip replacement are often based on empiricism and raise questions about: venting the medullary canal with a catheter during the insertion of cement; the inclusion of blood into cement during insertion with possible deleterious effects; recementing a pr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197509000-00018
更新日期:1975-09-01 00:00:00
abstract::In many designs of total knee arthroplasty, the patella with one central peg has been replaced by a patella with three small pegs for cement fixation. There have been recent reports of failure of this design. This is a prospective, consecutive study of two types of patella component fixation in 228 posterior-stabilize...
journal_title:Clinical orthopaedics and related research
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doi:10.1097/00003086-200111000-00012
更新日期:2001-11-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1997-02-01 00:00:00
abstract::The purpose of this investigation was to determine the effects of continuous passive motion (CPM) on the chondrogenic potential of autogenous osteoperiosteal grafts to repair major osteochondral defects. A 3.5-mm-wide circular full-thickness defect was drilled in one medial femoral condyle of 55 adolescent New Zealand...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-07-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,随机对照试验
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更新日期:2011-01-01 00:00:00
abstract::Thirty-seven hips with Ficat Stage II, III, or early IV osteonecrosis were treated with hemiresurfacing. The purpose of this study is to analyze specifically the clinical and radiographic results of patients who had hemiresurfacing to refine the indications for the procedure and identify factors substantially affectin...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200104000-00018
更新日期:2001-04-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1228-5
更新日期:2010-04-01 00:00:00
abstract::Fractures of the femur in two women, ages 17 and 27, were treated with Brooker-Wills nails. While the distal deployment device was inserted into the nail in one patient, the tip of the driver/inserter broke into the proximal end of the distal deployment device. This complicated the extraction of the nail and the dista...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Liposomal amphotericin B is locally delivered to treat fungal orthopaedic infections but little is known about local tissue toxicity, if any, that might be associated with local delivery. QUESTIONS/PURPOSES:(1) Is liposomal amphotericin B cytotoxic in vitro? (2) Is locally delivered liposomal amphotericin B...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4232-y
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Patient-specific CT-based instrumentation may reduce implant malpositioning and improve alignment in TKA. However, it is not known whether this innovation is an advance that benefits patients. QUESTIONS/PURPOSES:We evaluated (1) the precision of patient-specific TKA by comparing the incidence of outliers in...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11999-013-3206-1
更新日期:2013-12-01 00:00:00
abstract::The authors introduce a new functional classification of rheumatoid arthritis of the wrist. Unlike the classifications used today, it includes the aspect of the natural course of rheumatoid arthritis. The goal of this paper is to identify radiologic indicators that will classify rheumatoid arthritis into stable forms ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract::Patients with shoulder arthritis present to the orthopedic surgeon due to joint pain and loss of shoulder motion. A differential diagnosis is established, based on the history and physical examination and selected laboratory tests and roentgenograms. Synovial fluid analysis is often very helpful in the diagnosis of sh...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract::Selection of the suitable treatment method for an infected hip arthroplasty requires careful assessment of patient-related variables and expected treatment goals. The basic treatment options include antibiotic suppression, open debridement, resection arthroplasty, arthrodesis, reimplantation of another prosthesis, and...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-200403000-00010
更新日期:2004-03-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0414-1
更新日期:2008-11-01 00:00:00
abstract::A retrospective clinical review of 100 consecutive patients with extremity sarcomas managed by limb salvage operations was performed to evaluate local tumor control and morbidity. The mean follow-up period was 45.1 months. Overall survival was 86%. There were local recurrences in 3% of patients, and 26 complications i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract::Seven cases of fractures of the humerus from arm wrestling included 2 types of fractures. Two were spiral fractures of the humeral shaft with large butterfly fragments at the junction of the middle and distal one third caused by a violent uncoordinated muscular action. Five were fractures of the medial epicondyle of t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract:BACKGROUND:As in all fields of medicine, animal studies are widely performed in orthopaedics and have increased in number over time. However, it is not clear to what extent these studies provide a basis for future research or advancements in clinical science. Concerns about the reliability and translational ability of ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000001335
更新日期:2020-09-01 00:00:00
abstract::Of 2023 patients treated for acute spinal injuries, 729 sustained acute injuries in thoracic and lumbar regions; 295 surgically treated patients were reviewed for evidence of postoperative neurological complications. Of the 295 patients, 150 were intraoperatively monitored using somatosensory-evoked potentials (SSEP)....
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND:Numerous cementless femoral stem design variations are in clinical use. Because initial implant instability and micromotion are associated with aseptic loosening of the femoral component, migration analysis provides an early assessment of implant survivorship. QUESTIONS/PURPOSES:We determined the (1) migrat...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2160-z
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Small recent case series using CT-based navigation suggest such approaches may aid in surgical planning and improve accuracy of intended resections, but the accuracy and clinical use have not been confirmed. QUESTIONS/PURPOSES:We therefore evaluated (1) the accuracy; (2) recurrences; and (3) function in pat...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2557-3
更新日期:2013-03-01 00:00:00
abstract::Nonconsolidated particles of ultra high molecular weight polyethylene are believed to be defects that adversely can affect the wear performance of total joint prostheses. The present study was done to determine the number, size, and distribution of these particles and to determine if their presence correlated with wea...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1995-10-01 00:00:00