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This book incorporates the experience of numerous experts who explore contemporary opinion of how best to rationalise and optimise the interfaces at total hip replacement to provide the most favourable and durable results. The survival of a total hip replacement depends principally on the enduring integrity of the fixation interfaces and of the articular interface. The design of the stem and the material properties of cement largely determine the state of the component-cement inter face, while the bone-cement interface is significantly influenced by both mechanical and biological factors. The surface finish and shape of cementless implants are designed to preserve the integrity of biological fixation (osseo-integration) at the bone-component interface. Once again, both mechanical and biological factors have to be considered, while bioactive coatings accelerate bone ongrowth. Metal-on-polyethylene is the most widely used articular interface. However, it has been suggested that wear of polyethylene is one of the major factors contributing to failure of total hip replacements. The increasing prevalence of total hip replacement in younger patients has stimulated the investigation of alternative, more durable couples -including ceramic-polyethylene, ceramic-ceramic and metal-on-metal. Modularity provides greater intra-operative flexibility, but each new modular interface introduces new mechanisms of failure. These need to be anticipated and appropriate measures taken to avoid them. Hopefully this book will provide a better understanding of the factors that contribute to stable interfaces and long-term survival of total hip arthroplasty.
Total hip arthroplasty is carried out to relieve pain and restore function and the implant should outlast the patient. However, failure at one of the interfaces represents the commonest cause of failure of total hip replacement. The durability of the fixation interfaces and the articular interface are therefore critical in determining the long-term performance of the implant. This book accesses the opinions of a number of experts in their field on the important issues and factors influencing the component cement and bone cement interface that contribute to durability of fixation in these areas. In addition they explore how this fixation can be influenced both by the design of the implant, the material properties and the cement. The various material combinations that are available at the articular interface are also presented and the wear properties of and generation of debris from the interfaces are revealed.
Cemented Total Hip Arthroplasty (THA) remains one of the most successful procedures in Orthopaedic surgery. It has become very clear that it is the surgical expertise, in particular the quality of the cementing technique, which will affect long-term outcome and success. It is the intention of this book to provide an up-to-date comprehensive assessment of the entire field of cemented THA. Special emphasis has been given to practice-relevant aspects: well-illustrated and detailed operative steps as a practical guideline, a basic science chapter and long-term outcome data are provided. Minimally invasive surgery, modern perioperative management and patient fast tracking are covered. A number of highly respected experts have contributed to this in-depth compilation of the "state of the art" in 2005. This book is written and intended for both, trainees and established arthroplasty surgeons who are dedicated to perform a well-cemented THA.
Total joint arthroplasty is an effective surgical procedure for end-stage osteoarthritis of major joints with satisfactory long term clinical outcome. A large and growing number of arthroplasties are performed annually worldwide and a great number of orthopaedic surgeons are practicing arthroplasty surgery as their main surgical activity. The biological behavior of the bone-implant interface is crucial for the long term survival of the artificial joint. All factors which have a positive or negative effect on the interface are of great interest for those practicing arthroplasty surgery. Basic scientists and the industry are continuously searching for new implant fixation mechanisms and improved materials. There is an accumulation of a great amount of basic science data (both biological, material and mechanical) related to the incorporation or loosening of the bone-implant interface. However, basic science data does not always translate to satisfactory clinical application, and orthopaedic practitioners often wonder which piece of information is clinically useful. A further problem is that basic scientists often speak their own scientific language and may not fully appreciate common clinical practice needs. In this textbook the biological and mechanical mechanisms of implant incorporation and loosening will be presented. All new data concerning materials and methods for incorporation enhancement will be critically analyzed. Data useful for clinical application will be stressed. Orthopaedic Surgeons will find information which will improve their clinical practice and basic scientists will be helped to understand and appreciate clinical needs.
An in-depth understanding of a comprehensive approach to the management of radius fractures and their complications. The authors -- world renowned experts in the field -- present practical, clinical information from their extensive experience in the treatment of these fractures. Topics include the authors' classification as well as decision- making and tactics in the conservative and operative management of all types of radius fractures. Topics covered include: bending fractures of the metaphysis, shearing and compression fractures of the joint surface, avulsion fractures, radio-carpal fracture and dislocation, combined fractures, high velocity injury and malunions. In addition, chapters deal with surgical techniques and approach as well as with complications. With over 500 illustrations, this is the definitive volume on these challenging fractures, their complete treatment, and the management of complications.
The mechanical properties of whole bones, bone tissue, and the bone-implant interfaces are as important as their morphological and structural aspects. Mechanical Testing of Bone and the Bone-Implant Interface helps you assess these properties by explaining how to do mechanical testing of bone and the bone-implant interface for bone-related research