Early aseptic loosening of cemented total hip arthroplasty: the influence of non-steroidal anti-inflammatory drugs and smoking.
(25/386)
The purpose of this study was to investigate whether the clinical variables of non-steroidal anti-inflammatory drugs (NSAID) usage and cigarette smoking are possibly linked to aseptic loosening around total hip arthroplasty (THA). We performed a retrospective review of the records and radiographs of 224 patients attending for follow-up at Wrightington Hospital between August 2002 and 2003 who had undergone THA. The following information was recorded: age, gender, primary and revision surgery details, radiographic parameters, smoking history and NSAID usage history. Logistic regression analysis was used to determine if there is any statistically significant association between NSAID usage or smoking habit and aseptic loosening. No such association was found. (+info)
Failure rates for 4762 revision total hip arthroplasties in the Norwegian Arthroplasty Register.
(26/386)
We present the results for 4762 revision total hip arthroplasties with no previous infection in the hip, which were reported to the Norwegian Arthroplasty Register between 1987 and 2003. The ten-year failure rate for revised prostheses was 26% (95% CI 25 to 26). Cox regression analyses were undertaken separately for acetabular and femoral revision components. Cemented revision components without allograft was the reference category. For acetabular components, we found a significantly reduced risk of failure for uncemented revisions both with (relative risk (RR) = 0.66; 95% CI 0.43 to 0.99) and without (RR = 0.37; 95% CI 0.22 to 0.61) allograft. For femoral components, we found a significantly reduced risk of failure for uncemented revisions, both with (RR = 0.27; 95% CI 0.16 to 0.46) and without (RR = 0.22; 95% CI 0.11 to 0.46) unimpacted allograft. This reduced risk of failure also applied to cemented revision components with allograft (RR = 0.53; 95% CI 0.33 to 0.84) and with impaction bone grafting (RR = 0.34; 95% CI 0.19 to 0.62). Revision prostheses have generally inferior results when compared with primary prostheses. Recementation without allograft, and uncemented revision with bone impaction, were associated with worse results than the other revision techniques which we studied. (+info)
Abutment forms and restorative materials in adhesive prosthesis: a finite element analysis.
(27/386)
This study evaluated experimental abutment forms utilizing adhesion for clinical treatment by the three-dimensional finite element method. Three experimental abutment forms with no axial wall were evaluated: Form 1 was the occlusal surface reduced by 1.5 mm, Forms 2 and 3 were the crown cut perpendicular to the tooth axis 2 mm or 4 mm from the central groove. The restorations were made of 3 types of materials: composite resin, porcelain, and a gold-based alloy. Restorations were bonded to the abutments with an adhesive resin. A vertical load of 500 N was applied to the center of the inner incline of the buccal cusp. The stresses in the adhesives were largest in Form 1 with composite resin and in Form 3. It was indicated that the stresses were greatly affected by the form of the abutment and the restorative materials. (+info)
Bond strength of permanent cements in cementing cast to crown different core build-up materials.
(28/386)
The purpose of this laboratory investigation was to evaluate the bond strength of permanent cement (Duo-cement Kit, Meron, Durelon) to commonly used core build-up materials (President, Dyract AP, Ionofil, Vitremer). Sixty specimens (five of each product) were fabricated as a canine core build- up. Full crown castings were made to fit each core specimen. Full crown castings were cemented to core samples and stored at 37 degrees C and 100% humidity for 10 days. After storage, the bond strength was measured with a Haunsfield tensometer in tensile mode at a crosshead speed of 5 mm/min. Statistical evaluation was performed with univariate analysis of variance (P<0.001). The cement types affected the bond strength of full crown castings to core materials (F: 14.80; P<0.001). The interaction between the cement and core materials was significant (F: 3.69; P<0.01). According to the Duncan's test it was found that the values of Duo-cement were statistically different from the other cements. (+info)
Stability of cemented all-polyethylene keeled glenoid components. A radiostereometric study with a two-year follow-up.
(29/386)
We studied the stability of cemented all-polyethylene keeled glenoid components by radiostereometric analysis (RSA) in 16 shoulders which had received a total shoulder replacement. There were 14 women (one bilateral) and one man with a mean age of 64 years. The diagnosis was osteoarthritis in eight and rheumatoid arthritis in seven. Two of the shoulders were excluded from the RSA study because of loosening of the tantalum markers. Three tantalum markers were inserted in the glenoid socket, two in the coracoid process and two in the acromion. The polyethylene keeled glenoid component was marked with three to five tantalum markers. Conventional radiological and RSA examinations were carried out at five to seven days, at four months and at one and two years after operation. Radiolucent lines were found in all except three shoulders. Migration was most pronounced in the distal direction and exceeded 1 mm in four shoulders. In ten shoulders rotation exceeded 2 degrees in one or more axes with retroversion/anteversion being most common. No correlation was found between migration and the presence of radiolucencies on conventional radiographs. (+info)
A 12 month clinical study of bond failures of recycled versus new stainless steel orthodontic brackets.
(30/386)
The purpose of this prospective longitudinal randomized study was to compare the clinical performance of recycled brackets with that of new stainless steel brackets (Orthos). Twenty patients treated with fixed appliances were included in the investigation. Using a 'split-mouth' design, the dentition of each patient was divided into four quadrants. In 11 randomly selected patients, the maxillary left and mandibular right quadrants were bonded with recycled brackets, and the remaining quadrants with new stainless steel brackets. In the other nine patients the quadrants were inverted. Three hundred and ten stainless steel brackets were examined: 156 were recycled and the remaining 154 were new. All the brackets were bonded with a self-cured resin-modified glass ionomer (GC Fuji Ortho). The number, cause, and date of bracket failures were recorded over 12 months. Statistical analysis was performed by means of a paired t-test, Kaplan-Meier survival estimates, and the log-rank test. No statistically significant differences were found between: (a) the total bond failure rate of recycled and new stainless steel brackets; (b) the upper and lower arches; (c) the anterior and posterior segments. These findings demonstrate that recycling metallic orthodontic brackets can be of benefit to the profession, both economically and ecologically, as long as the orthodontist is aware of the various aspects of the recycling methods, and that patients are informed about the type of bracket that will be used for their treatment. (+info)
Corrosion of cemented titanium femoral stems.
(31/386)
Cemented titanium stems in hip arthroplasty are associated with proximal cement-stem ebonding and early failure. This was well publicised with the 3M Capital hip. However, corrosion in this setting has been reported with only one stem design and is less widely accepted. We present a series of 12 cemented titanium Furlong Straight Stems which required revision at a mean of 78 months for thigh pain. At revision the stems were severely corroded in a pattern which was typical of crevice corrosion. Symptoms were eliminated after revision to an all-stainless steel femoral prosthesis of the same design. We discuss the likely causes for the corrosion. The combination of a titanium stem and cement appears to facilitate crevice corrosion. (+info)
Pre-heating of components in cemented total hip arthroplasty.
(32/386)
Fatigue fractures which originate at stress-concentrating voids located at the implant-cement interface are a potential cause of septic loosening of cemented femoral components. Heating of the component to 44 degrees C is known to reduce the porosity of the cement-prosthesis interface. The temperature of the cement-bone interface was recorded intra-operatively as 32.3 degrees C. A simulated femoral model was devised to study the effect of heating of the component on the implant-cement interface. Heating of the implant and vacuum mixing have a synergistic effect on the porosity of the implant-cement interface, and heating also reverses the gradients of microhardness in the mantle. Heating of the implant also reduces porosity at the interface depending on the temperature. A minimum difference in temperature between the implant and the bone of 3 degrees C was required to produce this effect. The optimal difference was 7 degrees C, representing a balance between maximal reduction of porosity and an increased risk of thermal injury. Using contemporary cementing techniques, heating the implant to 40 degrees C is recommended to produce an optimum effect. (+info)