Total Hip Arthroplasty around the Inception of the Interface Bioactive Bone Cement Technique.

Background: To augment cement-bone fixation, Dr. Hironobu Oonishi attempted additional physicochemical bonding through interposition of osteoconductive crystal hydroxyapatite (HA) granules at the cement-bone interface in 1982. He first used the interface bioactive bone cement (IBBC) technique in 12 selected patients (12 hips) in 1982 (first stage) and followed them for 2 years.

Radiographic and retrieval wear analyses of the first generation highly cross-linked polyethylene cup against a ceramic femoral head.

In this study, the in vivo wear of highly cross-linked polyethylene (CLPE) cups against alumina ceramic femoral heads was evaluated by radiographic and retrieval analysis. The radiographic wear of six ethylene oxide gas-sterilized (i.e.

A long term histological analysis of effect of interposed hydroxyapatite between bone and bone cement in THA and TKA.

The standard cementing technique for total hip and knee arthroplasty (THA, TKA) was modified by interposing osteoconductive porous polycrystalline hydroxyapatite (HA) granules at the cement-bone interface to augment cement-bone bonding. Twenty-one specimens from the acetabulum and two specimens from the femur containing well-fixed bone-cement interface were retrieved five months to twenty-two years after THA and TKA with an interface bioactive bone cement technique. Histological findings were evaluated in terms of the retrieved sites, the interval between index operation and revision, patient age at retrieval and bone pathology.

The long-term in vivo behavior of polymethyl methacrylate bone cement in total hip arthroplasty.

Background And Purpose: The long-term success of cemented total hip arthroplasty (THA) has been well established. Improved outcomes, both radiographically and clinically, have resulted mainly from advances in stem design and improvements in operating techniques. However, there is concern about the durability of bone cement in vivo.

Ceramic versus cobalt-chrome femoral components; wear of polyethylene insert in total knee prosthesis.

The present study aimed to determine the effect of femoral component materials and sterilization methods on wear properties of total knee prostheses by using a knee simulator test and retrieval analysis. The simulator test revealed that ultrahigh molecular weight polyethylene (UHMWPE) inserts had remarkably lower wear against the ceramic femoral component than against the Co-Cr femoral component. However, the retrieval study revealed no significant difference in the linear wear between the former and the latter.

THA with hydroxyapatite granules at cement-bone interface: 15- to 20-year results.

Unlabelled: To augment cement-bone bonding, we interposed hydroxyapatite granules at the cement-bone interface (bioactive bone cement technique). Hydroxyapatite granules (2-3 g) were smeared on the bone surface of the acetabulum and femur just before cementing. We used porous hydroxyapatite granules 300 to 500 microm in diameter from 1986 to 1988 (first generation) and granules 100 to 300 microm in diameter from 1989 to 1991 (second generation).

Oxidation and wear of 100-Mrad cross-linked polyethylene shelf-aged for 30 years.

Some previous studies suggest that aging influences wear and oxidatively degraded nonsterilized ultra-high-molecular-weight polyethylene (UHMWPE) exhibits decreased wear resistance. We therefore asked whether shelf-aging storage conditions influenced degradation and wear resistance of gamma-irradiated UHMWPE. We examined oxidation and wear of 100-Mrad gamma-irradiated UHMWPE (100-Mrad polyethylene) cups shelf-aged for 30 years without (n=2) or with (n=2) packages.

Histologic findings at 14 and 18 years after cemented total hip arthroplasty with interface bioactive bone cement technique.

To augment cement-bone bonding in total hip arthroplasty, we interposed hydroxyapatite (HA) granules at the interface. We report the histologic findings of 2 cases 14 and 18 years after cemented total hip arthroplasty with this technique. We found that a thick bony layer was observed where rich layers of HA granules existed.

Wear of highly cross-linked polyethylene acetabular cup in Japan.

The wear characteristics of ultra-high-molecular-weight polyethylene acetabular cups irradiated with 6.0 to 7.5 Gy of gamma-irradiation were studied in a hip simulator and in vivo in 70 hips for 6 to 39 months.

Change in UHMWPE properties of retrieved ceramic total knee prosthesis in clinical use for 23 years.

The alumina-ceramic total knee prosthesis developed by Kyocera Corp. was implanted in 1979, and was in clinical use for 23 years until total knee arthroplasty revision surgery in January 2002. It is believed that this is the longest clinical period of a ceramic total knee prosthesis reported to date in the world.

Alumina hip joints characterized by run-in wear and steady-state wear to 14 million cycles in hip-simulator model.

The biphasic wear performance (run-in; steady-state phase) of 28-mm alumina-alumina hip implants was studied by hip simulator methods using bovine serum as the lubricant. The Biolox implants were run to 5.7 million cycles and Bioceram implants to 14.

Assessment of wear in extensively irradiated UHMWPE cups in simulator studies.

Higher levels of UHMWPE crosslinking currently are being advocated for improved wear resistance of acetabular cups. Pioneering Japanese studies, begun in 1971, have achieved good clinical results with UHMWPE irradiated to 1000 kGy for use with a cemented-cup design. The objective of our study was to use contemporary simulator techniques to determine the in vitro wear performance of such high-dose irradiated cups.

Study of retrieved acetabular sockets made from high-dose, cross-linked polyethylene.

Although ultra-high molecular weight polyethylene (UHMWPE) has stable chemical properties, chemical degradation, such as oxidation reaction, progresses with long-term clinical use. The purpose of this study was to investigate the change in properties of polyethylene (PE) in vivo by examining retrieved UHMWPE sockets and high-dose, cross-linked PE (100 Mrad PE) sockets. Twenty retrieved sockets (including 2 100 Mrad PE sockets), which were implanted from 1970 to 1996, were used for analysis.