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W e studied the results of total hip arthroplasty (THA) using AML porous-coated femoral components at a mean follow-up of 11 years in a non-selected, consecutive series of patients with rheumatoid arthritis. We reviewed 64 patients with 82 primary THAs using these components. There were seven men (8 hips) and 57 women (74 hips) with a mean age of 55.1 years (24 to 80) at the time of surgery.Nine patients (11 hips) died before the two-year follow-up. Of the remaining 71 hips, only one stem was revised for aseptic loosening. Survivorship for the stems was 98.1% (95% confidence interval (CI) 94.5 to 100.0) at ten years, using a life-table analysis, with revision for any reason as an endpoint. Of the 70 unrevised stems, 66 (94%) had bony ingrowth, while four (6%) were radiologically loose at the most recent follow-up (mean 11.4 years). Our study shows the excellent long-term results which can be achieved with porous-coated femoral components in patients with rheumatoid arthritis.J Bone Joint Surg [Br] 2001;83-B:686-90.

Life of a metal on ultra‐high molecular weight polyethylene (UHMWPE) total hip replacement is often limited to 10–15 years, due to wear loss and aseptic loosening. Due to its high melt flow index, UHMWPE is typically processed by ram extrusion or compression molding technique, but yet to be processed to the full potential of its mechanical integrity in acetabular shape without any fusion defects or weak bonding. The main objective of the present study is to develop a novel technique to fabricate defect‐free acetabular cups with desired bearing characteristics and surface finish by sintering medical‐grade UHMWPE GUR 1050 powder after its cold isostatic compaction with optimum processing parameters. Sintering kinetics of UHMWPE is studied comprehensively using a thermomechanical analyzer. The influence of compaction pressure, sintering temperature, and sintering duration on sintering kinetics of UHMWPE is explored to realize their optimum. The optimally processed UHMWPE has the relative density of 97% and Vickers hardness of 5.4 with tensile yield strength and elastic modulus of 21.5 and 625 MPa, respectively. The newly developed acetabular cup exhibited inherent plateau‐finished bearing surface with an average surface roughness of <100 nm, having good bearing characteristics and desired dimension.

The development of polymeric nanocomposites for biomedical applications remains a major challenge in terms of tailored addition of nanoparticles to realize the simultaneous enhancement of fracture resistance and cell/blood compatibility. To address this, the present work has been planned to determine whether small addition of surface functionalized multiwalled-carbon-nanotube, MWCNT (<1.5 wt%) and egg-shell derived nanosized hydroxyapatite, nHA (<10 wt%) to ultrahigh-molecular-weight-polyethylene (UHMWPE) can significantly improve the physical properties as well as biocompatibility. The difference in mouse osteoblast and human mesenchymal stem cell (hMSc) proliferation has been validated using both the monolithic composite and a trilayered composite with two different UHMWPE nanocomposites on either face with pure polymer at the middle. The combination of rheology and micro-CT with fractography reveals the homogeneous dispersion of nanofillers, leading to mechanical property enhancement. The quantitative analysis of cell viability and cell spreading by immunocytochemistry method, using vinculin and vimentin expression, establish significant cytocompatibility with hMSc and osteoblast cells onto the trilayer hybrid nanobiocomposite substrates. The hemocompatibility of the investigated composites under the controlled flow of rabbit blood in a microfluidic device reveals the signature of reduced thrombogenesis with reduction of platelet activation on UHMWPE nanocomposite w.r.t. unreinforced UHMWPE. An attempt has been made to discuss the blood compatibility results in the backdrop of the bovine serum albumin adsorption kinetics. Summarizing, the present study establishes that the twin requirement of mechanical property and cyto/hemo-compatibility can be potentially realized in developing trilayer composites in UHMWPE-nHA-MWCNT system.

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