A comparative radiographic review of 217 cementless total knee replacements was done 4 years after surgery to look for radiographic change at the screw-bone interface. There were 102 Miller Galante I knee prostheses, 59 Miller Galante II prostheses, and 56 Anatomic Modular Knee prostheses studied. If the appearance of the screw-bone interface had changed, this was classified according to the width of the lucency. Two hundred sixty-five of the 851 screws that were studied showed some evidence of change, with 185 (21.7%) of the screws showing a cavitary appearance change. The AMK prosthesis showed the higher incidence of cystic and cavitary changes. Polyethylene debris is thought to be responsible for generation of osteolysis and the radiographic appearance change. Design of the components and particularly the polyethylene attachment mechanisms may be responsible for the differences in the frequencies of osteolysis.
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J Orthop Surg Res
January 2025
Department for Orthopedics and Traumatology, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020, Linz, Austria.
Background: The occurrence of periprosthetic femoral fractures (PFFs) in cementless total hip arthroplasty (THA) might be associated with the proximal femoral morphology and the pelvis. PFFs in short stem THA are associated with an increased Canal Flare Index. PFFs in straight stem THA show a decreased Canal Flare Index.
View Article and Find Full Text PDFJ Biomech
January 2025
Radboudumc, Orthopaedic Research Lab, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
Aseptic loosening is the primary cause of revision in cementless total knee arthroplasty (TKA), emphasizing the importance of strong initial stability for long-term implant success. Pre-clinical evaluations are crucial for understanding implant fixation mechanics and improving implant designs. Finite element (FE) analysis models often use linear elastic bone material models, which do not accurately reflect bone's mechanical behavior.
View Article and Find Full Text PDFJ Bone Joint Surg Am
January 2025
Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, West Yorkshire, England.
Background: In this study, we estimated the risk of surgically treated postoperative periprosthetic femoral fractures (POPFFs) associated with femoral implants frequently used for total hip arthroplasty (THA).
Methods: In this cohort study of patients who underwent primary THA in England between January 1, 2004, and December 31, 2020, POPFFs were identified from prospectively collected revision records and national hospital records. POPFF incidence rates, adjusting for potential confounders, were estimated for common stems.
J Mech Behav Biomed Mater
January 2025
Division of Orthopaedic Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. Electronic address:
Background: The risk of early revision of total hip arthroplasty (THA) for polyethylene wear is now low, but there remains a need to perform wear measurements in patients for clinical surveillance. The gold standard of wear measurements has been radiostereometric analysis (RSA), which has limited availability. The use of computed tomography (CT) to perform THA wear measurement was described a decade ago and found to have acceptable accuracy and precision, but high radiation dose was a concern.
View Article and Find Full Text PDFBone Joint Res
January 2025
Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
Aims: While cementless fixation offers potential advantages over cemented fixation, such as a shorter operating time, concerns linger over its higher cost and increased risk of periprosthetic fractures. If the risk of fracture can be forecasted, it would aid the shared decision-making process related to cementless stems. Our study aimed to develop and validate predictive models of periprosthetic femoral fracture (PPFF) necessitating revision and reoperation after elective total hip arthroplasty (THA).
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