The Pathology of Artificial Joints

Löhrs, U.; Bos, Inge

doi:10.1007/978-3-642-76846-0_1

Cited by 4 publications

(1 citation statement)

References 133 publications

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“…Mikrobewegungen zwischen Implantat und angrenzendem Knochen, verursacht durch mechanische Belastungen, bedingen die Entstehung von Abriebpartikeln der Implantatkomponenten. Diese Abriebpartikel, insbesondere Polyethylen, haben eine entscheidende Bedeutung bei der Initiierung der periprothetischen osteolytischen Prozesse [3,4]. Die durch die Partikel ausgelöste komplexe Fremdkör-perreaktion beginnt mit der Einwanderung leukozytärer Zellen, die durch Produktion von Chemokinen die Rekrutierung zusätz-licher Zelltypen wie Makrophagen, Fibroblasten und Endothelzellen initiieren [5 -7].…”

Section: Aimsunclassified

Immunhistochemische Analyse periprothetischer Osteolysen aseptischer Hüftprothesenlockerungen

Gravius

Mumme²,

Delank³

et al. 2007

Z Orthop Unfall

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Section: Aimsunclassified

Immunhistochemische Analyse periprothetischer Osteolysen aseptischer Hüftprothesenlockerungen

Gravius

Mumme²,

Delank³

et al. 2007

Z Orthop Unfall

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Postarthroplasty histiocytic lymphadenopathy in gynecologic oncology patients: A benign reactive process that clinically may be mistaken for cancer

Zaloudek

Treseler

Powell

1996

Cancer

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Comparison of Diamond‐Like‐Carbon and Alumina‐Oxide articulating with Polyethylene in Total Hip Arthroplasty

Taeger¹,

Podleska

Schmidt

et al. 2003

Materialwissenschaft Werkst

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To reduce wear in joint bearings of total hip arthroplasty (THA) is the most important issue for improving long term results and implant survival. Due to low wear rates and excellent tribological features in simulator tests Diamond-Like-Carbon coating (DLC) of femoral balls is still discussed as an alternative articulation in THA. This clinical prospective study compares survivorship of DLCcoated femoral heads and of Aluminia-Oxide-(Al 2 O 3 ) heads articulating with Polyethylene (PE).Over a period of two years 101 THA with DLC-coated heads and PE cups (DLC-group) and another 101 THA consisting of Al 2 O 3 heads (Al 2 O 3 -group) and PE cups as well were implanted. Both articulations were based on the same type of cementless hip joint prosthesis. All hips were implanted by one surgeon in consecutive series consisting of 51 Al 2 O 3 and 101 DLC-articulations and further 50 Al 2 O 3 . All perioperative and follow-up data was processed with SPSS J . Survival of THA in both groups was evaluated according to Kaplan-Meier survivorship analysis with an intervall of 90 months (range:78-101). Qualitative surface analysis was performed in nineteen retrieved DLC-heads which were revised for aseptic loosening using field scanning electron microscopy (FE-SEM, XL 30 SFEG Philips, Eindoven NL).178 patients (88.2 %) were evaluated for follow-up. Fourteen patients died meantimes (nine DLC, five Al 2 O 3 ) with the implant components not revised. Ten patients (five DLC, five Al 2 O 3 ) were lost to follow-up. Both groups were comparable regarding patient age, weight and indications for THA with a normal distribution. Survivorship analysis for aseptic loosening 8.5 years following implantation resulted in a significant difference between both groups with a 54 % survival for DLC/PE compared to 88 % for Al 2 O 3 /PE bearings (p <0.001). No correlation to variables as age, gender or bodyweight could be detected. Surfaces of nineteen retrieved DLC-heads showed numerous smallest pits of the diamond-carbon layers in different quantity. SEM showed delamination of the carbon layer which caused excessive debris of polyethylene and in some cases even of the metallic substrate of the heads.Despite modern manufacturing technology and excellent experimental results for its tribochemical characteristics and wear, even "new" DLC-coating of femoral heads is to be considered critically due to very high rates of clinical failure. Obwohl moderne Fertigungstechniken mit sehr guten experimentellen Ergebnissen hinsichtlich Tribochemie und Verschleiß verbunden sind, müssen DLC-Beschichtungen zukünftig für diese Anwendung angesichts der immens hohen klinischen Versagensquote mit größter Zurückhaltung betrachtet werden.Schlagworte: Diamond-Like-Carbon,

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The Pathology of Artificial Joints

Cited by 4 publications

References 133 publications

Immunhistochemische Analyse periprothetischer Osteolysen aseptischer Hüftprothesenlockerungen

Immunhistochemische Analyse periprothetischer Osteolysen aseptischer Hüftprothesenlockerungen

Postarthroplasty histiocytic lymphadenopathy in gynecologic oncology patients: A benign reactive process that clinically may be mistaken for cancer

Comparison of Diamond‐Like‐Carbon and Alumina‐Oxide articulating with Polyethylene in Total Hip Arthroplasty

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