Biomechanical and Histological Study of Retrieved LARS Synthetic Ligaments.

Background: Synthetic grafts have been used for a number of years in anterior cruciate ligament (ACL) reconstruction surgery. One of the more recent additions to the stable of synthetic ligaments is the Ligament Augmentation and Reconstruction System (LARS) ligament.

Purpose: To analyze the biomechanics and histology of LARS grafts retrieved due to failure of the device.

Heterotopic ossification, osteolysis and implant failure following cervical total disc replacement with the M6-C™ artificial disc.

Introduction: A recent study reported a 34% mid-term revision rate after M6-C™ cervical total disc replacement (CTDR) for wear-related osteolysis. Here, we aim to investigate the prevalence, risk factors, and radiographic characteristics of periprosthetic bony changes and implant failure of the M6-C™ artificial disc.

Methods: We retrospectively analysed radiographic (conventional X-ray, CT scan) and clinical outcomes (EQ-5D-5L, Neck Disability Index (NDI), and Visual Analog Scale (VAS) for neck and arm pain) data collected during routine follow-up of patients who underwent CTDR with the M6-C™ between 2011 and 2015.

The effect of trunnionosis on the risk of re-revision following femoral head exchange in hip arthroplasty.

Background: Fretting corrosion at modular junctions contributes to arthroplasty failure. Currently, no evidence-based guidelines are available regarding the acceptable level of trunnion corrosion that can occur . We aimed to examine the relationship between trunnion corrosion and risk of re-revision to assist surgeons with intraoperative decision making.

Erratum: Author Correction: The influence of HLA genotype on the development of metal hypersensitivity following joint replacement.

[This corrects the article DOI: 10.1038/s43856-022-00137-0.].

The influence of HLA genotype on the development of metal hypersensitivity following joint replacement.

Background: Over five million joint replacements are performed across the world each year. Cobalt chrome (CoCr) components are used in most of these procedures. Some patients develop delayed-type hypersensitivity (DTH) responses to CoCr implants, resulting in tissue damage and revision surgery.

Loosening of tibia baseplates after total knee arthroplasty: Evaluation of pull-out strength of tibia baseplate-cement Interface.

Background: Aseptic loosening is reported as the leading cause of revision total knee arthroplasty on the Australian National Joint Replacement Registry. Loosening of cemented tibial baseplates has been correlated with type of cement used, cementing technique, and cement contamination with biological material. The aim of this study was to evaluate the effect of cementing application and techniques including surface contamination and cement viscosity on fixation strength of tibia baseplates/cement interface.

Tibial tray debonding from the cement mantle is associated with deformation of the backside of polyethylene tibial inserts.

Aims: The aim of this study was to investigate whether wear and backside deformation of polyethylene (PE) tibial inserts may influence the cement cover of tibial trays of explanted total knee arthroplasties (TKAs).

Methods: At our retrieval centre, we measured changes in the wear and deformation of PE inserts using coordinate measuring machines and light microscopy. The amount of cement cover on the backside of tibial trays was quantified as a percentage of the total surface.

Dissociation of polyethylene liners with the Depuy Pinnacle cup: a report of 26 cases.

Background: Although the Pinnacle Acetabular Hip System (DePuy Synthes) has demonstrated excellent survivorship results since it was first introduced in 2003, there have been a growing number of cases indicating that Pinnacle liners may be subject to a higher-than-expected rate of early dissociation failure. Between 2006 and 2020, our Centre received 212 retrieved Pinnacle liners from Western Australian hospitals. Of these, 26 were removed due to liner dissociation.

Catastrophic failure of the Accolade I hip arthroplasty stem: a retrieval analysis study.

Purpose: Modular Morse tapered femoral arthroplasty stems have been used for many years with great success and minimal complications. 1 stem, the Accolade by Stryker is noted to have increased failure when used in combination with LFIT V40 CoCr or the MITCH CoCr femoral heads. The failure has been in the form of corrosion, metallosis, fretting and trunnion fracture.

The effect of implant modification: the low contact stress experience.

Aims: The aim of this study was to conduct the largest low contact stress (LCS) retrieval study to elucidate the failure mechanisms of the Porocoat and Duofix femoral component. The latter design was voluntarily recalled by the manufacturer.

Materials And Methods: Uncemented LCS explants were divided into three groups: Duofix, Porocoat, and mixed.

Taper Corrosion and Adverse Local Tissue Reactions in Patients with a Modular Knee Prosthesis.

Background: Corrosion has been documented in modular knee implants, but it has not been related to negative patient outcomes. We performed an observational retrieval investigation of 13 Stryker Triathlon TS modular knee implants, 3 of which were revised because of osteolysis and adverse local tissue reactions secondary to fretting corrosion at the modular junctions.

Methods: Modular surfaces were examined for the presence and severity of corrosion, and factors that may influence the development of corrosion were investigated.

Foreign Body Reaction Associated With Artificial LARS Ligaments: A Retrieval Study.

Background: Artificial ligaments have been developed and used in the treatment of ligamentous injuries since the 1970s. The early generation of artificial ligaments showed promising short-term results but resulted in high rates of rupture and inflammatory reaction in the surrounding tissues.

Purpose: To determine whether the use of Ligament Augmentation and Reconstruction System (LARS) ligaments is associated with the development of intra-articular foreign body reaction.

Failure and Fatigue Fracture at the Femoral Stem-Metaphyseal Sleeve Junction in a Modular Knee Prosthesis: A Case Report.

Case: A 66-year-old active man had undergone revision total knee replacement surgery with a femoral metaphyseal sleeve and a cemented stem in 2013 after loosening of the implant following the primary knee arthroplasty. He was overweight and had a high activity level, and there had been progressive osteolysis surrounding the distal aspect of the femoral sleeve. In 2017, the metaphyseal sleeve had loosened, resulting in corrosion of the threaded taper and catastrophic failure of the implant, with a fracture of the stem at the junction of the sleeve.

Oxidation of Second Generation Sequentially Irradiated and Annealed Highly Cross-Linked X3™ Polyethylene Tibial Bearings.

Since the first use of ultra-high-molecular-weight polyethylene as a bearing material, research and development efforts have sought to improve wear resistance, increase longevity and lessen the potential for debris mediated adverse tissue responses. A series of second generation sequentially cross-linked and annealed tibial bearings were analysed after several bearings sent for routine retrieval analysis showed oxidative degradation including subsurface whitening, cracking and gross material loss. Evaluation incorporated visual and white banding assessment, mechanical testing and spectroscopy analysis.

Repair of meniscal cartilage white zone tears using a stem cell/collagen-scaffold implant.

Injuries to the avascular region of knee meniscal cartilage do not heal spontaneously. To address this problem we have developed a new stem cell/collagen-scaffold implant system in which human adult bone marrow mesenchymal stem cells are seeded onto a biodegradable scaffold that allows controlled delivery of actively dividing cells to the meniscus surface. Sandwich constructs of two white zone ovine meniscus discs with stem cell/collagen-scaffold implant in between were cultured in vitro for 40 days.

The synergistic effects of lysophosphatidic acid receptor agonists and calcitriol on MG63 osteoblast maturation at titanium and hydroxyapatite surfaces.

Successful osseointegration stems from the provision of a mechanically competent mineralised matrix at the implant site. Mature osteoblasts are the cells responsible for achieving this and a key factor for ensuring healthy bone tissue is associated with prosthetic materials will be 1 alpha,25 dihydroxy vitamin D3 (calcitriol). However it is known that calcitriol per se does not promote osteoblast maturation, rather the osteoblasts need to be in receipt of calcitriol in combination with selected growth factors in order to undergo a robust maturation response.

Induction of cartilage integration by a chondrocyte/collagen-scaffold implant.

The integration of implanted cartilage is a major challenge for the success of tissue engineering protocols. We hypothesize that in order for effective cartilage integration to take place, matrix-free chondrocytes must be induced to migrate between the two tissue surfaces. A chondrocyte/collagen-scaffold implant system was developed as a method of delivering dividing cells at the interface between two cartilage surfaces.

A comparison of colorimetric and DNA quantification assays for the assessment of meniscal fibrochondrocyte proliferation in microcarrier culture.

We have developed and refined a rapid, reliable method for the evaluation of attachment and proliferation of ovine meniscal chondrocytes in microcarrier culture. Assays measuring both mitochondrial activity, using MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] and MTS [3-(4,5-dimethylthiazol-2-yl)5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium], and DNA synthesis with a PicoGreen assay were compared. The MTT assay was the most sensitive at lower cell concentrations and enabled accurate assessment of cell proliferation over 14 day culture.

Effect of silicon doping on bone formation within alumina porous domains.

The effect of doping a porous bioinert bioceramic with silicon (Si) on tissue ingrowth, differentiation, and osteogenesis was studied using a rat intramedullary model. Alumina tubes (1.3-mm outer diameter, 0.

Bone formation within alumina tubes: effect of calcium, manganese, and chromium dopants.

Alumina tubes (1.3mm outer diameter, 0.6mm inner diameter, 15 mm length) doped with Ca, Mn, or Cr at nominal concentrations of 0.

Use of an intramedullary in vivo model to study bone formation and maintenance in ceramic porous domains.

Tissue ingrowth, differentiation, and osteogenesis in a porous bioinert bioceramic were studied using an intramedullary model. Pure alumina tubes (1.3 mm outer diameter, 0.