Our aim was to determine if the detection rate of infection of total hip replacements could be improved by examining the removed prostheses. Immediate transfer of prostheses to an anaerobic atmosphere, followed by mild ultrasonication to dislodge adherent bacteria, resulted in the culture of quantifiable numbers of bacteria, from 26 of the 120 implants examined. The same bacterial species were cultured by routine microbiological techniques from only five corresponding tissue samples. Tissue removed from 18 of the culture-positive implants was suitable for quantitative tissue pathology and inflammatory cells were present in all samples. Furthermore, inflammatory cells were present in 87% of tissue samples taken from patients whose implants were culture-negative. This suggests that these implants may have been infected by bacteria which were not isolated by the techniques of culture used. The increased detection of bacteria from prostheses by culture has improved postoperative antibiotic therapy and should reduce the need for further revision.

In this study the detection rates of bacterial infection of hip prostheses by culture and nonculture methods were compared for 120 patients with total hip revision surgery. By use of strict anaerobic bacteriological practice during the processing of samples and without enrichment, the incidence of infection by culture of material dislodged from retrieved prostheses after ultrasonication (sonicate) was 22%. Bacteria were observed by immunofluorescence microscopy in 63% of sonicate samples with a monoclonal antibody specific forPropionibacterium acnes and polyclonal antiserum specific for Staphylococcus spp. The bacteria were present either as single cells or in aggregates of up to 300 bacterial cells. These aggregates were not observed without sonication to dislodge the biofilm. Bacteria were observed in all of the culture-positive samples, and in some cases in which only one type of bacterium was identified by culture, both coccoid and coryneform bacteria were observed by immunofluorescence microscopy. Bacteria from skin-flake contamination were readily distinguishable from infecting bacteria by immunofluorescence microscopy. Examination of skin scrapings did not reveal large aggregates of bacteria but did reveal skin cells. These were not observed in the sonicates. Bacterial DNA was detected in 72% of sonicate samples by PCR amplification of a region of the bacterial 16S rRNA gene with universal primers. All of the culture-positive samples were also positive for bacterial DNA. Evidence of high-level infiltration either of neutrophils or of lymphocytes or macrophages into associated tissue was observed in 73% of patients. Our results indicate that the incidence of prosthetic joint infection is grossly underestimated by current culture detection methods. It is therefore imperative that current clinical practice with regard to the detection and subsequent treatment of prosthetic joint infection be reassessed in the light of these results.

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The susceptibilities of 49 isolates recovered from orthopedic implants to seven antimicrobial agents were evaluated by the broth microdilution method. Ciprofloxacin and vancomycin were more active than gentamicin, representing aminoglycosides which are routinely incorporated into bone cement, and also more active than the peroperative antimicrobial agents cefamandole and erythromycin. The use of ciprofloxacin and vancomycin in vivo, therefore, warrants further evaluation.

The stretch blow moulding (SBM) process is the main method for the mass production of PET containers. And understanding the constitutive behaviour of PET during this process is critical for designing the optimum product and process. However due to its nonlinear viscoelastic behaviour, the behaviour of PET is highly sensitive to its thermomechanical history making the task of modelling its constitutive behaviour complex. This means that the constitutive model will be useful only if it is known to be valid under the actual conditions of interest to the SBM process. The aim of this work was to develop a new material characterization method providing new data for the deformation behaviour of PET relevant to the SBM process. In order to achieve this goal, a reliable and robust characterization method was developed based on an instrumented stretch rod and a digital image correlation system to determine the stress-strain relationship of material in deforming preforms during free stretch-blow tests. The effect of preform temperature and air mass flow rate on the deformation behaviour of PET was also investigated.

Injection stretch blow moulding is a wellestablished method of forming thin-walled containers and has been extensively researched for numerous years. This paper is concerned with validating the finite element analysis of the free-stretch-blow process in an effort to progress the development of injection stretch blow moulding of poly(ethylene terephthalate). Extensive data was obtained experimentally over a wide process window accounting for material temperature and air flow rate, while capturing cavity pressure, stretch-rod reaction force and preform surface strain. This data was then used to assess the accuracy of the correlating FE simulation constructed using ABAQUS/Explicit solver and an appropriate viscoelastic material subroutine. Results reveal that the simulation is able to give good quantitative correlation for conditions where the deformation was predominantly equal biaxial whilst qualitative correlation was achievable when the mode of deformation was predominantly sequential biaxial. Overall the simulation was able to pick up the general trends of how the pressure, reaction force, strain rate and strain vary with the variation in preform temperature and air flow rate. The knowledge gained from these analyses provides insight into the mechanisms of bottle formation, subsequently improving the blow moulding simulation and allowing for reduction in future development costs.

Our aim was to determine if the detection rate of infection of total hip replacements could be improved by examining the removed prostheses. Immediate transfer of prostheses to an anaerobic atmosphere, followed by mild ultrasonication to dislodge adherent bacteria, resulted in the culture of quantifiable numbers of bacteria, from 26 of the 120 implants examined. The same bacterial species were cultured by routine microbiological techniques from only five corresponding tissue samples. Tissue removed from 18 of the culture-positive implants was suitable for quantitative tissue pathology and inflammatory cells were present in all samples. Furthermore, inflammatory cells were present in 87% of tissue samples taken from patients whose implants were culture-negative. This suggests that these implants may have been infected by bacteria which were not isolated by the techniques of culture used.The increased detection of bacteria from prostheses by culture has improved postoperative antibiotic therapy and should reduce the need for further revision.

No abstract