Arthrography in loosened hip prostheses. Assessment of possibilities for intra-articular therapy

The volume of the human knee joint

“…A volume of 1.34 ± 0.46 ml was determined for the radiocarpal joint and 0.97 ± 0.32 ml for midcarpal joints [15]. In the case of endoprosthetic hip replacements and symptomatic hip joints, a volume of 31 ± 12.7 ml has been determined [16].…”

On stabilization of loosened hip stems via cement injection into osteolytic cavities

“…They involve inhibition of inflammatory processes within the joint aimed at prevention or slowing of peri-prosthetic osteolysis (Carmody et al, 2002;Sud et al, 2001;Yang et al, 2002). In our group, an approach was developed (de Poorter et al, 2006(de Poorter et al, , 2008 that uses percutaneous gene therapy in order to destroy the interface tissue and subsequently stabilize the prosthesis. The procedure is performed in three steps: injection of a viral vector; injection of a prodrug aimed at killing the infected cells; rinsing the osteolytic cavities with water and refixation of the hip prosthesis with percutaneous bone cement injection under radiological guidance (Fig.…”

Water Jet Applicator for Interface Tissue Removal in Minimally Invasive Hip Refixation: Testing the Principle and Design of Prototype

“…Malan et al [7] showed that removal of this periprosthetic interface tissue facilitates a better cement distribution compared to patients without interface removal. De Poorter et al investigated a gene therapy approach to remove the interface tissue, with promising results [8][9][10]. The latter is still experimental and limited to academic centers with facilities to perform gene therapy [11].…”