An investigation was started aimed at a better understanding of the complex phenomena leading to chemical degradation and morphological deterioration of UHMW polyethylene cups in total hip prostheses. Analysis was performed on retrieved implants which needed revision due to inflammation and pain problems. Preliminary results obtained by parallel XPS and SEM/EDX experiments gave evidence, for the first time, that silicon traces are involved in the process of particle formation and segregation onto the surface of the cups. The extent of modification of the surface chemical composition of cups and the process of particle segregation seem to be correlated to both the implant time and to some particular features of patient (age, activity, style of life, etc.). Investigation on a large number of samples is in progress in order to test this hypothesis. The results obtained so far confirmed the potential of surface spectroscopies (XPS) in biomaterial investigations.
Introduction: Chronic elbow instability is a disable complication. This prospective study reports our experience with the box-loop reconstruction technique, compared with traditional Lateral Collateral Ligament (LCL) and eventual Medial Collateral Ligament (MCL) reconstruction, showing its functional outcome at 12-month follow-up. Methods: From January 2013 to February 2017, 27 patients with complex elbow instability were recruited. Group-A patients were managed using box-loop technique; in Group-B patients LCL reconstruction was performed and MCL lesions were always intraoperatively tested, under fluoroscopy, and eventually treated. Clinical evaluations were performed at baseline (T0) and at 1month (T1), 6-month (T2) and 12-month (T3) follow-up. X-rays were performed at T0 and T3. Intergroup and intragroup variability was assessed. Results: In all the patients, an improvement of both the range of movement and the joint stability was observed after surgery. The mean increase in flexion-extension arch was 52° in Group-A patients at 12-month follow-up. A significant improvement (p<0.05) of Mayo Elbow Performance Score, Oxford Elbow Scores and Visual Analogue Scale was observed at 12-month follow-up in both groups. Conclusion: Box-loop technique revealed safe and effective in the management of multidirectional elbow instability. Level of evidence: IV, Cases Series.
A retrospective study was conducted on 60 patients (53 females, seven males with a mean age of 68 years and 5 months) who underwent a total knee replacement using a mobile bearing. The diagnosis was primary osteoarthritis in 57 cases and rheumatoid arthritis in three cases. None of the patients underwent a bilateral procedure, thus 60 implants (33 all cementless, three all cemented, 24 with only the tibial component cemented) were considered. Three different groups were identified: Group 1: first 20 total knee arthroplasties with menisci. Group 2: first 20 total knee arthroplasties with rotating platform. Group 3: first 20 total knee arthroplasties with AP glide platform. Clinical and radiological results at the final follow up, although different in time among the three groups, have shown no revision due to mechanical or septic reasons, and no signs of impending failure.
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