The Relative Merits of Cemented and Uncemented Prostheses in Total Hip Arthroplasty

Maggs, Joanna; Wilson, Matthew

doi:10.4103/ortho.ijortho_405_16

Cited by 64 publications

(35 citation statements)

References 83 publications

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“…While regional differences remain significant, the use of cementless THA has been gradually increasing over the last couple of years [25], although the issues, such as bone cement implantation syndrome and potentially a higher mortality, that may have caused surgeons to move away from the use of cemented implants in the past have since been demonstrated to be unfounded. Overall, evidence to date does not clearly support the increasing use of cementless THA [26]. However, even when considering the age structure development, cementless fixation is clearly on the rise in Germany, as evidenced by the fact that during the last decade, the utilization of cemented THA in patients older than 75 years of age was cut in half in favor of cementless implants.…”

Section: Discussionmentioning

confidence: 99%

Trends in Total Hip Arthroplasty in Germany from 2007 to 2016: What Has Changed and Where Are We Now?

et al. 2019

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Background The number of total hip arthroplasties (THA) is rising in many industrialized nations. At the same time, the evidence regarding different types of prostheses and fixation techniques is constantly evolving. Therefore, this study aimed to analyze changes in THA by these advancements during the last decade. Methods A retrospective analysis of data provided by the Federal Statistical Office of Germany from 2007 to 2016 was conducted using codes from the German procedure classification system and associated International Statistical Classification of Diseases and Related Health Problems codes. THA procedures were evaluated according to diagnoses, sex, and age of patients, along with the distribution of different prosthesis types. Additionally, changes in these parameters over time were analyzed. Results From 2007 to 2016 a total of 2 157 041 primary THA procedures were performed in Germany, with an increase of 14.4% over this period. Overall, cementless standard THA (STHA) was used most frequently (50.0%), followed by hybrid variants (18.8%), hemiarthroplasties (15.9%), cemented standard THA (cSTHA; 9.2%), cementless short-stem THA (ssTHA; 4.8%), and hip resurfacing (HR; 0.9%) techniques. During the study period, the number of cSTHA and HR decreased significantly, whereas the use of STHA and ssTHA rose substantially, with a significantly higher application of these procedures in the elderly population. While osteoarthritis of the hip joint was the main indication for THA, several procedure-specific differences were identified. Conclusion The present data clearly demonstrate an increase in the use of cementless fixation for THA in Germany during the last decade and document a rise in ssTHA in recent years with, in contrast, the use of HR decreasing to a minimum.

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Section: Discussionmentioning

confidence: 99%

Trends in Total Hip Arthroplasty in Germany from 2007 to 2016: What Has Changed and Where Are We Now?

et al. 2019

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“…'nın, ciddi bir komplikasyon olan enfeksiyon riskinin azaltılması çalışmaları ve ilerleyen yıllarda enfekte olguların tedavisinde çimento içeriğine antibiyotik eklenmesi, yapısal modifikasyonların en net örneği olarak kabul edilebilir. [13] Enfeksiyon riskinin azaltılması için, çimentonun içerisinde antibiyotiklerden başka gümüş içeren nanopartiküller ve bakteri kaynaklı doğal antimikrobiyal yapıdaki bakteriosinler de kullanılmaktadır. [5] Çimentonun içerisine eklenen Vitamin E ise serbest radikalleri toplayarak çimento yapısının stabilize edilmesinde katkı yapan bir diğer maddedir.…”

Section: Modi̇fi̇kasyonlarunclassified

Artroplastide kemik çimentosunun geçmişi ve geleceği

Altıntaş¹,

Kocadal²

2019

TOTBID

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Türk Ortopedi ve Travmatoloji Birliği Derneği özelliklerini ilk tanımlayan araştırmacıdır. [2] Röhm'ün 1901 yılında "Akrilik Asitin Polimerizasyon Ürünleri" isimli tezi sonrası metilmetakrilat, endüstride cam benzeri sert madde anlamına gelen 'plexiglass' adı ile denizaltı periskoplarında, silah taretlerinde ve havacılık sanayisinde yoğun olarak kullanılmıştır. [1] PMMA'nın klinik olarak ilk kullanımı, 1938 yılında maymunlarda kraniyal defektlerin kapatılması amacıyla gerçekleşmiştir. [3] 1940 yılında Schnebel, metilmetakrilat'ın polimerizasyon prensiplerini tanımlamıştır. 1941'te insanlarda, PMMA kullanılarak kraniyal defektlerin onarılmasına başlanmıştır. [4] 1943 yılında Kulzer ve Degussa metilmetakrilatın oda ısısında tersiyel aromatik aminler yardımı ile polimerizasyonunu ortaya koymuşlardır. [5] PMMA, keşfinin erken dönemlerinde toz polimer ve likit monomerik kısımlarının 100°C'ye kadar ısıtılarak reaksiyona girmesi ile elde ediliyordu. İlerleyen dönemlerde, polimer ve monomerlerin reaksiyona girmesi için aktivatör kullanımı sayesinde, PMMA'nın oda P rotez cerrahisi, ortopedi ve travmatoloji alanında son 50 yılda çarpıcı şekilde gelişme göstermiştir. Hastaların yaşam kalitesini ciddi şekilde arttıran protez cerrahisinin gelişimi; metalurji, triboloji, biyo-teknoloji ve materyal bilimlerindeki gelişmelere paralel seyretmiştir. Akrilik yapıdaki kemik çimentosunun kullanımı, protez cerrahisinin dönüm noktalarından birisidir. Protez cerrahisi, başarılı çimentolama tekniği sayesinde 'uzun süreli sağkalım' hedefine oldukça yaklaşmıştır. KEMİK ÇİMENTOSUNUN TARİHİ'Çimento' kavramı ortopedi ve travmatoloji tarihinde ilk olarak Alman bilim adamı Themistokles Gluck tarafından kullanılmıştır. Gluck, fildişinden imal ettiği diz protezini kemiğe daha iyi tespit edebilmek için alçı, bakır amalgam ve toz macun karışımını kullanmıştır. [1] Günümüzde kemik çimentosu için kullanılan materyal polimetilmetakrilat (PMMA)'dır. Otto Röhm, metilmetakrilatın kimyasal ve fiziksel Artroplastide kemik çimentosunun geçmişi ve geleceği

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“…Cementless fixation requires a shorter time in the operating room, allows greater preservation of bone stock and provides easer revision;2 additionally, uncemented fixation is not affected by any of the possible complications associated with cemented fixation like third body wear and bone cement implantation syndrome 2,3. Despite these benefits, instability of uncemented joint replacements was a major drawback that prevented their diffusion 4. Modern designs have solved this problem and now these two fixation methods are used in a similar proportion of cases worldwide (although their relative popularity varies in different countries) and have similarly good clinical outcomes 4…”

Section: Introductionmentioning

confidence: 99%

“…Despite these benefits, instability of uncemented joint replacements was a major drawback that prevented their diffusion 4. Modern designs have solved this problem and now these two fixation methods are used in a similar proportion of cases worldwide (although their relative popularity varies in different countries) and have similarly good clinical outcomes 4…”

Section: Introductionmentioning

confidence: 99%

<p>Nanoparticle-based model of anti-inflammatory drug releasing LbL coatings for uncemented prosthesis aseptic loosening prevention</p>

Alotaibi¹,

Perni²,

Prokopovich³

2019

IJN

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IntroductionThe only treatment for aseptic loosening is the replacement of the prosthesis through revision surgery. A preventive approach, achieved through anti-inflammatory drugs released from the device, has shown to be a viable strategy; however, the performance of these devices is not yet satisfactory thus further improvements are necessary.MethodsWe used titanium nanoparticles as a model for implant surfaces and developed a coating containing dexamethasone (DEX) using layer-by-layer deposition.ResultsThe amount of deposited drug depended on the number of layers and the release was sustained for months. The efficiency of the released DEX in reducing inflammation markers (tumor necrosis factor alpha and IL-6) produced by human monocytes and macrophages was similar to the pure drug at the same concentration without negative impacts on the viability and morphology of these cells.ConclusionThese coatings were not inferior to medical grade titanium (the standard material used in uncemented devices) regarding their ability to sustain osteoblasts and fibroblasts growth.

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The Relative Merits of Cemented and Uncemented Prostheses in Total Hip Arthroplasty

Cited by 64 publications

References 83 publications

Trends in Total Hip Arthroplasty in Germany from 2007 to 2016: What Has Changed and Where Are We Now?

Trends in Total Hip Arthroplasty in Germany from 2007 to 2016: What Has Changed and Where Are We Now?

Artroplastide kemik çimentosunun geçmişi ve geleceği

<p>Nanoparticle-based model of anti-inflammatory drug releasing LbL coatings for uncemented prosthesis aseptic loosening prevention</p>

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