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In a recent investigation the effect of various cementing techniques on cement mantle propertieswas studied. This study showed distinct differences in cement mantle volume, filling index andmorphology.In this study, we investigated the effect of these cement mantle variations on the heat generationduring polymerization, and its consequences in terms of thermal bone necrosis.Materials and methodsTwo FEA models of resurfacing reconstructions were created based on CT-data of in vitroimplantations (Fig 1). The two models had distinct differences with respect to the amount ofcement that was used for fixation. The first model was based on an implantation with lowviscositycement, with anchoring holes drilled in the bone, and suction applied to maximizecement penetration. The second model was based on an implantation with medium viscositycement smeared onto the bone, with no holes and no suction, leading to a thin cement layer.Thermal analyses were performed of the polymerization process, simulating three differenttypes of bone cement: Simplex P (Stryker), CMW3 (DePuy J&J) and Osteobond (Zimmer),with distinct differences in polymerization characteristics. The polymerization kinematics werebased on data reported previously.During the polymerization simulations the cement and bone temperature were monitored. Basedon the local temperature and time of exposure, the occurrence of thermal bone necrosis waspredicted. The total volume of necrotic bone was calculated for each case.Results and discussionThe simulations showed distinct differences between the temperature distributions in thevarious models. The highest temperature was found in the CMW3 model with a large cementvolume (Fig. 2, Table 1), while the Osteobond model with a thin cement mantle produced thelowest temperature rise in the bone.The necrotic bone volume was highest in the CMW3 model with a large cement mantle, whilethe lowest volume was found in the model with a thin cement layer (Table 1).Assuming that the bone that is being penetrated by cement also is affected by thermal and toxicnecrosis, more than 70% of the bone inside the resurfacing implant may become necrotic. Incontrast, when using a less invasive cementing technique, thermal necrosis can be reduced toapproximately 20% of the volume inside the resurfacing implant. A large zone of necrotic boneat the cement-bone interface may have serious implications for the strength and stability ofresurfacing arthroplasty.ConclusionWe conclude that the cementing technique and type of cement used for fixation of a resurfacingimplant can dramatically affect the viability of the femoral bone, and therefore the survival ofthe reconstruction. Thermal necrosis may be reduced by minimizing cement penetration,although this may also have consequences for the mechanical stability.file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]
FiguresThursday, October 7, 2010, 8:30-9:20Session B2: Knee Arthroplasty in the Indian Sub ContinentAnalysis of Valgus Angle Following Navigation Total Knee Arthroplasty.*Jai Thilak Kailathuvalapil - Amrita Institute of Medical Sciences - Cochin, IndiaBinu Sasidharan - Amrita Institute - Kochi, IndiaIntroduction*Email: jaithilak@gmail.comProper alignment of the components and soft tissue balance are the two factors thatdetermine the long term outcome of total knee arthroplasty (TKA). On the femoral side a distalcut made perpendicular to the MA will restore the MA of the leg. Different methods arecommonly used to resect the femur perpendicular to its MA. In uncomplicated cases, mostsurgeons routinely use a fixed valgus cut angle (VCA) of 5° or 6°. Various studies havequestioned the use of fixed valgus angle resection to restore the mechanical axis. The purpose ofthis prospective study is to analyze the variability in the valgus angle following computerassisted TKA.Materials and methodsTwenty-three patients who underwent computer assisted TKA in our institution in2009 were involved in the study. A total of 40 knees were available for analysis. All the kneesunderwent a CT scanogram postoperatively. Each scanogram was analyzed using the Amritamedvision® software. The angle subtended between the mechanical axis and the distal femoralanatomic axis is the valgus angle. Two independent observers calculated all the values and theinterobserver reliability was calculated.ResultsThe average age of the patients was 65.6 years. The kappa coefficient of agreementwas 0.8, which shows good interobserver reliability.The average angle formed by the femoral component with the mechanical axis was 91.6 0 andthe average valgus angle calculated was 7.41 0 . 14 knees out of 40 (35%) were lying within therange of 4 - 7 degrees. In 25 knees (65%) valgus angle was more than 7 degrees. In one case thevalgus angle was less than 4 degrees .file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]
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Convened under the auspicious of es
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Special Thank YouISTA’s Board of
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Invited SpeakersJean Noel ArgensonM
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Thursday, October 7, 2010Session AS
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Oxinium Versus Metal on Polyethylen
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13:30 - 14:00Invited talk: Hip Arth
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What Can We Do With Periprosthetic
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New Concept in Soft Tissue Balancin
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Comparison of Drain Clamp After Bil
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Session - A7:45 - 8:15Invited talk:
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Massive Endoprosthetic Replacement
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Hydroxyapatite Block for Reconstruc
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13. Dilute Betadine Lavage Prior to
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37. Fluoroscopic Analysis of Advanc
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60. Influence of Impaction Forces o
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85. Surgical Wound Infection as a P
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Saturday, October 9, 2010, 8:15-9:0
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algorithm was tested for short incr
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Ten patients with fracture acetabul
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Saturday, October 9, 2010, 14:00-14
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*Email: drbaldiniandrea@yahoo.itThe
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evision surgery were aseptic loosen
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*Dante Parodi - Clinica Alemana De
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Thursday, October 7, 2010, 17:30-18
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and subsequent exposure time to rad
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of the patient during the acetabula
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FiguresFriday, October 8, 2010, 11:
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Results: No further revisions were
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Minimally Invasive Total Knee Arthr
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and are due to insufficient fixatio
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Methods: An inverse finite element
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Finally a subject-specific model co
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prosthesis component have been calc
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novel tools and devices that are ab
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from 48.6 to 92.2, while functional
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Friday, October 8, 2010, 8:00-8:30S
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The Kaplan-Meier survival rate was
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especially because most of the stan
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knee and offer a new development of
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This was the patient with revision
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Ain Shams UniversityCairo, EgyptPle
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Two-stage revision arthroplasty is
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inexpensive modular femoral compone
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successful treatment outcome was de
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Pathogen N PercentStaphylococcus au
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component as their permanent prosth
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Page 108 and 109: FiguresFigure 1Friday, October 8, 2
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Page 114 and 115: *Email: joseph.fetto@nyumc.orgNon-c
Page 116 and 117: MATERIAL AND METHODS423 total knee
Page 118 and 119: MATERIALS AND METHODSFrom January 1
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Page 124 and 125: Introduction:Mike Reed - Wansbeck G
Page 126 and 127: Conclusions:To the best our knowled
Page 128 and 129: ing superior clinical results when
Page 130 and 131: one) in 11 (26%), type II (failure
Page 132 and 133: Correction of leg length discrepanc
Page 134 and 135: motion is separated from the transv
Page 136 and 137: Is the Frecnh Paradox a Reality? Lo
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Page 140 and 141: found in the currently used MOM bea
Page 142 and 143: followed since their initial presen
Page 144 and 145: ã€€On the axial plane, the ave
Page 146 and 147: For revision hip replacements, the
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Page 152 and 153: ResultCup geometries with screws ha
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Page 160 and 161: Conclusions.Fixed valgus angle rese
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Page 166 and 167: ResultsMean follow-up was 6 yrs (SD
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Page 170 and 171: *J. Philippe Kretzer - Laboratory o
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Page 176 and 177: In the present study, the patella h
Page 178 and 179: characteristic of the MB prosthesis
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Page 188 and 189: Conclusion: The results of this stu
Page 190 and 191: The incidence of periprosthetic fra
Page 192 and 193: *Email: sgh_iizu@grn.janis.or.jpAbs
Page 194 and 195: components (78 %) that remained rig
Page 196 and 197: hydroxyapatite ceramic in bone tumo
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Page 200 and 201: Keywords: total knee arthroplasty,
Page 202 and 203: of the tensor (Fig. 1B). During eac
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Corne van Loon - rijnstate hospital
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Osaka, JapanTomonori Arita - Gradua
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Gary Poehling - Wake forest univers
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mean Harris hip score was 98 points
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Discussion:This study demonstrates
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Thursday, October 7, 2010, 8:00-8:5
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we usually excise both ACL & PCL, s
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true and false acetabulum2- In Femo
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Minimal invasive surgery (MIS)is ac
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*Stephen Murphy - New England Bapti
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scratching effect against the femor
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transformation associated with the
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Bearing Surfaces in Primary Total H
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Introduction: Proper rotational ali
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Materials and Method4 cases and 5 k
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to improve exposure in difficult ca
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We have used different stems (strai
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Our preliminary results are encoura
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A modified titanium spinal pedicle
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Use of a novel ligament gap balanci
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femur 659, proximal tibia 198, prox
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*Pietro Ruggieri - University of Bo
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The presentattion will focus on tec
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Accuracy of Femoral Component Align
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Results.Dislocation: no.Clinical ou
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iocompatible material to man,it is
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BackgroundThe current literature te
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axis and component positioning. We
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stability of joint in full extensio
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with femoralrevision combined with
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arthroplasty. Obesity is an appropr
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Conclusions:We conclude that with u
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There was no difference in function
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We present the results of a consecu
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Barbara Maestri - university of rom
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gap balancing and providing reasona
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Highly Crosslinked PE as Alternativ
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plastic limit of UHMWPe. Changes in
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equired blood transfusion (RD -0.34
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age limit for THA can be lowered.Fr
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lood transfusion might be necessary
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The hammering sounds in press-fit i
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We investigated the period from fir
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technique.The subjects were 16 knee
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Persistent patellofemoral symptoms
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peak dynamic varus angle over time.
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slope on the medial side was minima
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for the follow-up examination. A te
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Tateaki Shimakawa - Tokushima Munic
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male.We retrospectively reviewed pr
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affected the interface stresses cal
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Introduction:Cadaveric Evaluation o
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defects.Conclusion: Periprosthetic
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FiguresFigure 1 Figure 2 Figure 3 F
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Poster: 4Testing High Performance A
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Background:Modular endoprosthetic r
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The mean follow up was 4.2 years (3
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compared to the attending surgeon.D
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Poster: 13Postural Control Features
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e extended to the cup with malposit
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Poster: 17A Novel Method to Determi
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and it’s the highest rate has bee
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otation and 19 had a paradoxical ti
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Poster: 23Lumbar Disc Replacement.
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VTE-, we considered that the two co
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Poster: 27Accuracy of Acetabular Cu
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Poster: 29In Vivo Measurement of Pe
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Poster: 31Clinical and Laboratory V
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Figure 1: Typical steps used for co
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Alignment & bonecutting errorsMeanT
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allowing bone cutting to consume 25
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17. Jonsson B, Astrom J. Alignment
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Branislav Jaramaz - The Western Pen
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Poster: 34What Is the Blood Transfu
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dislocation after total hip arthrop
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Poster: 38Intraarticular Injection
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Sudhir Rao - South London Heathcare
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*Naoyuki Katayama - Hokkaido Orthop
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198.5±5.5°and 157.0±7.5°, respe
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Introduction*Sujith Konan - Univers
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Poster: 48IntroductionRevision Hip
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In conclusion we have developed a s
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laxity on wear and joint kinematics
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measurement interval. The wear rate
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spring model for AP translation and
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Haider, H., Walker, P. S., 2002. An
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Poster: 52Development of a Constant
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*Takahiro Lida - Osaka City Univers
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coating, have been developed with t
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3. Push-out Biomechanical AnalysisM
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anodized/hydrothermally treated tit
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However, she then suffered from sev
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central osteophytes in hip osteoart
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Lucia Manunta - University - sassar
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Based on above measurement we had t
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3, 6, 12, 18, and 24 months post-op
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amorphous and degrades faster in th
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Conclusion: the longivity of hip ar
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Poster: 70Outcome of Ceramic-Cerami
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posterior structures (facets and fa
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After thirty-eight months in vivo,
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disadvantages are provided by this
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chipping of the insert. Therefore a
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Metal cups, embedded in a cast resi
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about their preferences regarding f
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A periprosthetic femoral fracture a
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Superficial wound infection occurre
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International scientific literature
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were balanced to within 2° to 3°
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ecause of deep infction. One was ma
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Poster: 91So Are Sutures Actually B
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patients having staged bilateral pr
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adiographs often underestimate the
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A total of 7 osteoarthritis hip wer
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Poster: 98Appropriate Spatial Desig
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Poster: 100Total Hip Arthroplasty i
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Poster: 102Aggressive Early Debride
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this study was to assess the agreem
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Hemiarthroplasty - an Innovative Me
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p=0.55. This minimal change in leng
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Poster: 109Severe Persistent Synovi
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*Email: jerome.tonetti@free.frIn pr
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in 5 QFT-G positive patients with a
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arthroplasty (TKA). In the other ha
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