The developed multilayer bonding system optimizes the interface strength between acetabular bone stock and bone cement significantly for cemented cups in total hip arthroplasty. In contrast to cementing techniques with complete removal of the subchondral sclerotic zone (in order to optimize micro-interlocking) the biologically effective and load bearing acetabular bone stock can be preserved using the newly developed multilayer bonding system. This aspect might be highly important especially with regard to possible acetabular bone defects caused by the process of aseptic cup loosening.
Depending from the amount of positive energy flux density applied to distal rabbit femur a significantly increased ventral-periosteal new bone formation results in the proximal rabbit femur outside the shock wave focus.
The pathogenesis is still unknown. Diagnosis often is obtained much too late due to missing specific symptoms. PVNS occurs in local forms as well as in a diffuse growth pattern. Recurrence rates of up to 78% are very high. Besides arthroscopic and open synovectomy, the treatment with radiosynoviorthesis must be considered. Depending on the growth pattern, the tumour masses, and the affected joint, the therapy has to be chosen very carefully and sometimes different forms have to be combined if a recurrence--free result is to be achieved.
The present in vitro study highlights the supposition that the quality of the cementing technique is of eminent importance in determining the long-term stability of cemented hip arthroplasties.
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