Fluid flow around model femoral components of differing surface finishes: In vitro investigations

Crawford, Ross; Evans, M.; Ling, R. S. M.; Murray, David

doi:10.3109/17453679908997847

Cited by 38 publications

(23 citation statements)

References 21 publications

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“…In addition, we found through cracks in some mantles of each stem group, presenting conduits to what would, in vivo, have been living bone. Previous workers have suggested that polished double taper stems showed less osteolysis because the subsiding stem cut off the flow of fluid along the stem /cement interface [13, 40]. The current study, and the previous retrieval studies of others [14, 39] indicated that this was probably not the case.…”

Section: Discussionsupporting

confidence: 44%

Using ‘subcement’ to simulate the long-term fatigue response of cemented femoral stems in a cadaver model: Could a novel preclinical screening test have caught the Exeter matt problem?

Race

Miller

Mann

2009

Proc Inst Mech Eng H

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Previously, we formulated cement with degraded fatigue properties (sub-cement) to simulate long-term fatigue in short-term cadaver tests. The present study determined the efficacy of sub-cement in a `pre-clinical' test of a design change with known clinical consequences: the “polished” to “matte” transition of the Exeter stem (revision rates were twice as high for matte stems). Contemporary stems were bead-blasted to give Ra=1micron (matte finish). Matte and polished stems were compared in cadaver pairs under stair-climbing loads (3 pairs size-1, 3 pairs size-3). Stem micromotion was monitored during loading. Post-test, transverse sections were examined for cement damage. Cyclic retroversion decreased for polished stems but increased for matte stems (p<0.0001). Implant size had a substantial effect: retroversion of (larger) size-3 stems was half that of size-1 stems and polished size-3 stems subsided 2½ times more than the others. Cement damage measures were similar and open through-cracks occurred around both stems of two pairs. Stem retroversion within the mantle resulted in stem-cement gaps of 50–150microns. Combining information on cyclic motion, cracks, and gaps, we concluded that this test `predicted' higher revision rates for matte stems (it also implied that polished size-3 stems might be superior to size-1).

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Section: Discussionsupporting

confidence: 44%

Using ‘subcement’ to simulate the long-term fatigue response of cemented femoral stems in a cadaver model: Could a novel preclinical screening test have caught the Exeter matt problem?

Race

Miller

Mann

2009

Proc Inst Mech Eng H

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show abstract

“…In cemented arthroplasty, aseptic loosening is a matter of concern. The implant-cement interface and fatigue cracks in the cemented mantle are believed to provide pathways for wear debris to the bonecement interface leading to localized bone lesions (Anthony et al 1990, Crawford et al 1999. Furthermore, particulate cement originating in the cement mantle is believed to contribute to peri-implant osteolysis (Horowitz and Gonzales 1996).…”

Section: Discussionmentioning

confidence: 99%

Sealing effect of hydroxyapatite coating: A 12-month study in canines

Rahbek¹,

Overgaard²,

Jensen³

et al. 2000

Acta Orthopaedica Scandinavica

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“…in this series is probably due to two factors. First, stems of this geometry and surface finish, given reasonably accurate insertion, are able to seal off the stem-cement interface to the access of fluid from the joint space 34,35 by subsiding within the cement mantle. This prevents the egress of fluid and debris from the stem-cement interface onto the endosteal surface of the femur at the sites of defects in the cement mantle.…”

Section: Discussionmentioning

confidence: 99%