Low-friction arthroplasty of the hip using alumina ceramic and cross-linked polyethylene. A ten-year follow-up report.
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We report the results of our continued review of 14 hip arthroplasties using alumina ceramic femoral heads with cross-linked polyethylene cups. There have been no complications and a very low rate of penetration. This was 0.02 mm per year after an initial 'bedding-in' period of two years. There has been no change in the mean rate between our earlier study at six years and the current results at 10 to 11 years. The use of these bearing surfaces appears to reduce the potential amount of polyethylene debris and may provide the next logical stage in the development of the Charnley low-friction arthroplasty. (+info)
The influence of weight-bearing on the measurement of polyethylene wear in THA.
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We have studied the influence of weight-bearing on the measurement of wear of the polyethylene acetabular component in total hip arthroplasty using two techniques. The measured vertical wear was significantly greater when radiographs were taken weight-bearing rather than with the patient supine (p = 0.001, method 1; p = 0.007, method 2). Calculations of rates of linear wear of the acetabular component were significantly underestimated (p < 0.05) when radiographs were taken supine. There are two reasons for this. First, a change in pelvic orientation when bearing weight ensures that the thinnest polyethylene is brought into relief, and secondly, the head of the femoral component assumes the position of maximal displacement along its wear path. Interpretation of previous studies on both linear and volumetric polyethylene wear in total hip arthroplasty should be reassessed in the light of these findings. (+info)
Polymersomes: tough vesicles made from diblock copolymers.
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Vesicles were made from amphiphilic diblock copolymers and characterized by micromanipulation. The average molecular weight of the specific polymer studied, polyethyleneoxide-polyethylethylene (EO40-EE37), is several times greater than that of typical phospholipids in natural membranes. Both the membrane bending and area expansion moduli of electroformed polymersomes (polymer-based liposomes) fell within the range of lipid membrane measurements, but the giant polymersomes proved to be almost an order of magnitude tougher and sustained far greater areal strain before rupture. The polymersome membrane was also at least 10 times less permeable to water than common phospholipid bilayers. The results suggest a new class of synthetic thin-shelled capsules based on block copolymer chemistry. (+info)
Polyethylene wear, osteolysis and acetabular loosening with an HA-coated hip prosthesis. A follow-up of 94 consecutive arthroplasties.
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We have followed up for a period of seven to nine years 100 consecutive arthroplasties of the hip in which an entirely HA-coated implant had been used. The clinical results were excellent and bony incorporation was extensive in all components. No stem became loose or subsided but five cups were revised because of loosening after 3.8 to 5.5 years, having functioned painlessly and shown radiological ingrowth. Revision procedures because of excessive polyethylene wear have been performed on 18 hips and are planned for six more. Two eroded metal backings with worn-through polyethylene were exchanged; six hips showed metallosis without polyethylene wear-through. There were two cases of granulomatous cysts in the groin and 66 hips had osteolysis located periarticularly, in the greater trochanter or in the acetabulum. (+info)
Characterization of DNA condensates induced by poly(ethylene oxide) and polylysine.
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High-molecular-weight DNA is known to collapse into very compact particles in a salt solution containing polymers like poly(ethylene oxide) [(EO)n] or polyacrylate. The biological relevance of this phenomenon is suggested by our recent finding that high concentrations of the highly acidic internal peptides found in the mature T4 bacteriophage head, as well as poly(glutamic acid) and poly(aspartic acid), can collapse DNA in a similar manner. The structure of DNAs collapsed by various methods has been studied with electron microscope. We find (EO)n collapses T4 or T7 bacteriophage DNA into compact particles only slightly larger than the size of the T4 and T7 head, respectively. In contrast, polylysine collapses DNA into different types of structures. Double-stranded DNA collapsed with (EO)n is cut by the single-strand specific Neurospora crassa endonuclease (EC 3.1.4.21) into small fragments. Extensive digestion only occurs above the critical concentration of polymer required for DNA collapse, demonstrating the (EO)n-collapsed DNA contains enzyme-vulnerable regions (probably at each fold), which are preferentially attacked. The size of the DNA fragments produced by limit-digestion with the nuclease ranges between 200 and 400 base pairs when DNA is collapsed by (EO)n. Only fragments of DNA which are larger than 600 base pairs are cut by the endonuclease in (EO)n-containing solution. (+info)
Effects of TGFbeta on bone ingrowth in the presence of polyethylene particles.
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We implanted bone harvest chambers (BHCs) bilaterally in ten mature male New Zealand white rabbits. Polyethylene particles (0.3+/-0.1 microm in diameter, 6.4 x 10(12) particles/ml) were implanted for two, four or six weeks bilaterally in the BHCs, with subsequent removal of the ingrown tissue after each treatment. In addition to the particles, one side also received 1.5 microg of recombinant transforming growth factor beta1 (TGFbeta1). At two weeks, the bone area as a percentage of total area was less in chambers containing TGFbeta compared with those with particles alone (7.8+/-1.3% v 16.9+/-2.7% respectively; 95% confidence interval (CI) for difference -14.0 to -4.30; p = 0.002). At four weeks, the percentage area of bone was greater in chambers containing TGFbeta compared with those with particles alone (31.2+/-3.4% v 22.5+/-2.0% respectively; 95% CI for difference 1.0 to 16.4; p = 0.03). There were no statistical differences at six weeks, despite a higher mean value with TGFbeta treatment (38.2+/-3.9% v 28.8 +/-3.5%; 95% CI for difference -4.6 to 23.3; p = 0.16). The number of vitronectin-receptor-positive cells (osteoclast-like cells) was greater in the treatment group with TGFbeta compared with that with particles alone; most of these positive cells were located in the interstitium, rather than adjacent to bone. TGFbeta1 is a pleotropic growth factor which can modulate cellular events in the musculoskeletal system in a time- and concentration-dependent manner. Our data suggest that there is an early window at between two and six weeks, in which TGFbeta may favourably affect bone ingrowth in the BHC model. Exogenous growth factors such as TGFbeta may be a useful adjunct in obtaining osseointegration and bone ingrowth, especially in revisions when there is compromised bone stock and residual particulate debris. (+info)
Nasogastric hyperalimentation through a polyethylene catheter: an alternative to central venous hyperalimentation.
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We performed nasogastric hyperalimentation with polyethylene catheters and appropriate feeding solutions in 12 cachectic patients who had been referred as candidates for central venous hyperalimentation. Most patients had primary gastrointestinal disease. The duration of hyperalimentation averaged 31 days. Seven patients obtained rapid weight gain (average 0.3 kg/day) with the nasogastric hyperalimentation alone. An additional two were successfully repleted with the addition of parenteral fluids via peripheral veins. In the nine repleted patients, serum albumin rose by average 19%, 24-hr urine creatinine by average 21%, and triceps skinfold by average 46%. The nature of the weight gain in the nine successful cases was analyzed by the metabolic balance study technique. Average composition of the increment in weight was: 50% protoplasm, 48% extracellular fluid, 19% adipose tissue, and less than 1% bone. We conclude that nasogastric hyperalimentation can replace central venous hyperalimentation in a substantial proportion of patients now receiving the latter type of treatment. (+info)
Strike-through of moist contamination by woven and nonwoven surgical materials.
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A test is described which correlates the stress of stretching surgical gown and drape material with moist bacterial strike-through. By application of this test to a number of woven and nonwoven surgical gown and drape materials, it was found that not all of these materials, either woven or nonwoven, are impermeable to moist contamination for equal periods of time. Nonwoven disposable materials now in use range from those which remain impermeable to moist bacterial permeation through all tests while some remain impermeable for limited periods of time, and others almost immediately permeable to moist bacterial penetration. The same situation holds for woven materials. Under conditions of our test, Quarpel treated Pima tight-woven cotton cloth was impermeable to moist bacterial strike-through, through up to 75 washing and sterilizing cyclings, while ordinary linen and untreated Pima cloth permitted bacterial permeation almost immediately. These results have significance in lengthy wet surgical operations. (+info)