A 68-year-old man with a previous right total hip arthroplasty presented with acute pain in the right hip, and no associated trauma was reported. The previous hybrid arthroplasty consisted of a ceramic femoral head articulating on an ultra-high-molecular-weight polyethylene liner. The unusual diagnosis of fractured ceramic femoral head was made and an urgent revision arthroplasty was performed to remove the ceramic bearing as well as all implants that may have come into contact with the ceramic. This case report highlights the material properties of ceramics in total hip arthroplasties as well as the importance of regular follow-up in these patients.

No abstract

No abstract

Cartilage tissue engineering using bone marrow-derived mesenchymal stem cells (BM-MSCs) is a growing technology for the repair of joint defects. Culturing BM-MSCs to over confluence has historically been avoided due to perceived risk to cell viability, growth inhibition and differentiation potential. Here we show that a simple change in culture practice, based on mimicking the condensation phase during embryonic cartilage development, results in biochemically and histologically superior cartilage tissue engineered constructs. Whole transcriptome analysis of the condensing cells revealed a phenotype associated with early commitment to chondrogenic precursors. This simple adjustment to the common stem cell culture technique would impact the quality of all cartilage tissue engineering modalities utilising these cells.

Introduction Decreased or increased critical shoulder angles (CSA) are associated with osteoarthritis or rotator cuff failure respectively. Secondary cuff failure after shoulder arthroplasty is disabling and often requires additional surgery. The aim of this study was to investigate if the initial CSA correlated with cuff failure in the context of shoulder arthroplasty. Methods Patients from a tertiary referral centre were reviewed from 2011-2017. Those who underwent revision from hemiarthroplasty (HA) or anatomic total shoulder arthroplasty (TSA) to a reverse shoulder arthroplasty (RSA) following rotator cuff failure were compared to an age and sex-matched control group. The CSA was calculated from initial pre-operative radiographs. Results In this study, 16 patients with symptomatic cuff failure after anatomic TSA or HA requiring revision to RSA were compared to a control group of 16 age- and sex-matched patients showing no signs of symptomatic cuff failure. The median CSA in the study group was significantly greater than that of the control group (31.5 o , IQR = 29.8 - 36.1 o vs. 29.5 o , IQR = 27.6 - 30.4 o ; p= 0.026). Conclusion The difference in CSA between those who required revision for secondary cuff failure than those who didn’t suggest that pre-operative measurement of CSA may help guide surgical planning in shoulder arthroplasty.