We investigated whether improvements in design have altered the outcome for patients undergoing endoprosthetic replacement of the distal femur after resection of a tumour. Survival of the implant and 'servicing' procedures have been documented using a prospective database, review of the design of the implant and case records. In total, 335 patients underwent a distal femoral replacement, 162 ha...

Introduction. Metallosis is a phenomenon most commonly associated with hip replacement. However it can occur in any metallic implant subject to wear. Wear creates metal debris, which is deposited in the surrounding soft tissue. This leads to many local adverse reactions including, but not limited to, implant loosening/osteolysis, pain, and effusion. In the deeper joints, for example, the hip, m...

Introduction: A predominant histological feature of periprosthetic tissue surrounding aseptically loose implant components is the presence of a prominent foreign body macrophage response to prosthesis derived wear. A number of potent bone resorbing mediators have been identified in periprosthetic tissue from around loose prostheses and these mediators have been shown to be released from wear pa...

BACKGROUND AND PURPOSE Periprosthetic bone loss after uncemented femoral hip revision is a matter of concern. We have used a proximally porous- and hydroxyapatite-coated prosthesis (Bi-Metric) in revision since 1989 and now we report the bone changes. This prosthesis is intended to distribute the forces more evenly and to avoid proximal femoral unloading. METHODS 22 patients were unilaterally...

The authors have retrospectively studied a series of 32 reverse shoulder prostheses implanted in 30 patients by the same surgeon between 1992 and 2000. The mean age was 71 years; 26 patients were female, 4 were male. Thirteen patients (14 prostheses) were clinically and radiologically examined at follow-up; 9 patients (10 prostheses) were questioned by telephone and their radiological records w...

Hip resurfacing is a popular treatment for osteoarthritis in young, active patients. Previous studies have shown that occasional failures--femoral neck fracture and implant loosening, possibly associated with bone adaptation--are affected by prosthesis sizing and positioning, in addition to patient and surgical factors. With the aim of improving tolerance to surgical variation, finite element m...

AIM The clinical utility of digital linear tomosynthesis in musculoskeletal applications has been validated in only a few reports. Technical performance and utility in hip prosthesis imaging have been discussed in technical reports, but no clinical evaluation has been reported. The purpose of the current study was to assess the added clinical utility of digital linear tomosynthesis compared to ...

PURPOSE To report outcomes of 21 total wrist arthroplasties (TWA) using the Universal 2 prosthesis. METHODS Five men and 14 women aged 44 to 82 (mean, 62) years underwent 21 total wrist arthroplasties for rheumatoid arthritis (n=19) and post-traumatic arthritis (n=2) by a single surgeon using the Universal 2 prosthesis. Pre- and post-operative pain and function were assessed by a single surge...

To date, mesenchymal cells have only been associated with bone resorption indirectly, and it has been hypothesized that the degradation of bone is associated exclusively with specific functions of osteoclasts. Here we show, in aseptic prosthesis loosening, that aggressive fibroblasts at the bone surface actively contribute to bone resorption and that this is independent of osteoclasts. In two s...