By Hironobu Oonishi, Ian C. Clarke, Victoria Good, Hirokazu Amino, Shingo Masuda (auth.), Nobuo Matsui M.D., Yoichi Taneda M.D., Yukio Yoshida M.D. (eds.)
Joint alternative surgical procedure has visible striking growth and improvement in recent times either in prostheses and in surgical procedure. a main predicament has been more desirable toughness, for which a significant component is aid of the polyethylene put on that results in osteolysis. This booklet offers an replace at the potential in which the issues of wear and tear and loosening are being addressed in overall hip arthroplasty (THA) and overall knee arthroplasty (TKA). integrated are chapters on new surgical innovations for tough circumstances, nonpolyethylene interfaces for THA, customized hip prostheses, and computer-assisted surgical procedure. Arthroplasty 2000 additionally takes up present debatable matters corresponding to posterior cruciate substitution as opposed to retention in TKA. With contributions by way of eminent experts in overall joint substitute in Asia, Europe, and North the United States, this quantity is a useful reference for all orthopedic surgeons.
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Extra resources for Arthroplasty 2000: Recent Advances in Total Joint Replacement
Perhaps we have to consider that HA proximate coated stems may provide an optimal transfer of force at the proximal aspect of the femur without any change in more than 60% of cases. Conversely, we had no hypertrophy and certainly no distal fixation with this stem, which should confirm the success of proximal fixation. We certainly must pay attention to the neck angle of the femur: a valgus in this neck may lead to more important forces being transmitted to this calcar zone. 2. Lines onto the HA-coated aspect of femur: We had no lines in 43% of cases.
A Stable pedestal at the tip of a noncemented non-HA-coated stem, indicating a distal fixation. b Temporary unstable pedestal at 1 year in a very active young woman, having undergone a HA Omnifit stem. Thanks to a secondary stable proximal HA fixation, this pedestal surprisingly disappears at 2 years, with a satisfactory result at 6 years. 5. Endosteal bony formation as a "healing" of the reaming procedure. This specific pattern is not to be confused with a pedestal The presence of a pedestal always explains an accepted (stable pedestal) or insufficient (unstable pedestal) distal fixation.
8. Endosteal ossification filling down the medullary canal over years and reaching the tip of the stem at 12 years. This bone remodeling often replaces the preexisting reactive line FIG. 9. Severe proximal osteolysis at 10 years that may make the stem become loose with time. We expect that ceramic! ceramic bearing surfaces will decrease the rate of these lytic lesions bony formation, and we could confirm the seal provided by an intimate contact between bone and metal resulting from the bioactive interface.