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spring model for AP translation and IE rotation as described by Haider et al. (2008, 2006,2002). However, the use of an asymmetric-nonlinear soft tissue motion restraint model that isindependent for AP translation and IE rotation seems to be more advisable.In Figure 5 the wear scar areas on the superior surface of the tibial inserts are shown. Thesesurface alterations do not solely represent surface wear because they may also be related tocreep. Thus, the dimension of these areas should be interpreted carefully with respect to wearand kinematics. The simulation is limited to level walking in the current study. Patient activitiessuch as climbing the stairs and getting up from a chair may substantially influence in vivo kneewear behavior. The authors believe that the surgical technique used, and in particular thealignment, also plays a major role in kinematics, wear and long-term stability. Consequently,clinical studies are needed to verify the results of this experimental study. Furthermore, theconformity of the implant may cause changes in kinematics and PE wear. Follow-up studies aretherefore needed to assess the influence of different implant concepts, in combination withrealistic joint laxities, on PE wear and joint kinematics.ConclusionCare should be taken when simulating the complex mechanism of the human knee joint, asligament motion restraints strongly influence joint kinematics and PE wear in simulator wearstudies. Therefore, appropriate ligament models should be used to evaluate the wear behavior ofTKR. This study provides a mathematical ligament model that accounts for the absence of theACL. Further experimental studies examining the influence of surgical technique, alignmentand implant design may prove to be essential.FiguresFigure 1: Motion restraint for AP translation according to 14243-1:2002(E) is based on alinear approximation of the tibial anterior-posterior displacement when the ACL is intact. Asectioned ACL increases tibial anterior-posterior displacement. In the neutral zone(displacement close to zero) the slope of the curve according to the 14243-1:2002(E) standard ismuch higher compared to the asymmetric and nonlinear curves given by Fukubayashi et al.(1982) even for an intact ACL.Figure 2: Motion restraint for IE rotation according to 14243-1:2002(E) is based on alinear approximation of the tibial IE rotation. Close to the neutral zone the motions restraint foran intact or sectioned ACL is almost linear. Nevertheless, the slope of the curve according tothe 14243-1:2002(E) standard is much higher compared to the curves of an intact or sectionedACL as given by Kanamori et al. (2002).Figure 3: The ultracongruent fixed bearing TKR implant used in the study (mounted in awear station of the simulator).Figure 4: Experimental setup: AMTI knee simulator with wear and soak control stationsas well as serum circulation system.Figure 5: Wear scars on the superior surface of the tibial inserts are larger whensimulating nonlinear soft tissue motion restraints (a), compared to 14243-1:2002(E) conforminglinear motion restraints (b).file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]
ReferencesAmstutz, H. C., Campbell, P., Kossovsky, N., Clarke, I. C., 1992. Mechanism and clinicalsignificance of wear debris-induced osteolysis. Clin Orthop Relat Res 276, 7-18.Andriacchi, T. P., Stanwyck, T. S., Galante, J. O., 1986. Knee biomechanics and total kneereplacement. J Arthroplasty 1, 211-219.Argenson, J. N., O'Connor, J. J., 1992. Polyethylene wear in meniscal knee replacement. A oneto nine-year retrieval analysis of the Oxford knee. J Bone Joint Surg Br 74, 228-232.Benson, L. C., DesJardins, J. D., LaBerge, M., 2001. Effects of in vitro wear of machined andmolded UHMWPE tibial inserts on TKR kinematics. J Biomed Mater Res 58, 496-504.Blunn, G. W., Joshi, A. B., Minns, R. J., Lidgren, L., Lilley, P., Ryd, L., Engelbrecht, E.,Walker, P. S., 1997. Wear in retrieved condylar knee arthroplasties. A comparison of wear indifferent designs of 280 retrieved condylar knee prostheses. J Arthroplasty 12, 281-290.Butler, D. L., Noyes, F. R., Grood, E. S., 1980. Ligamentous restraints to anterior-posteriordrawer in the human knee. A biomechanical study. J Bone Joint Surg Am 62, 259-270.D'Lima, D. D., Hermida, J. C., Chen, P. C., Colwell, C. W., Jr., 2001. Polyethylene wear andvariations in knee kinematics. Clin Orthop Relat Res 392, 124-130.DesJardins, J. D., Banks, S. A., Benson, L. C., Pace, T., LaBerge, M., 2007. A directcomparison of patient and force-controlled simulator total knee replacement kinematics. JBiomech 40, 3458-3466.DesJardins, J. D., Walker, P. S., Haider, H., Perry, J., 2000. The use of a force-controlleddynamic knee simulator to quantify the mechanical performance of total knee replacementdesigns during functional activity. J Biomech 33, 1231-1242.Engh, G. A., Dwyer, K. A., Hanes, C. K., 1992. Polyethylene wear of metal-backed tibialcomponents in total and unicompartmental knee prostheses. J Bone Joint Surg Br 74, 9-17.Fukubayashi, T., Torzilli, P. A., Sherman, M. F., Warren, R. F., 1982. An in vitro biomechanicalevaluation of anterior-posterior motion of the knee. Tibial displacement, rotation, and torque. JBone Joint Surg Am 64, 258-264.Galvin, A. L., Kang, L., Udofia, I., Jennings, L. M., McEwen, H. M., Jin, Z., Fisher, J., 2009.Effect of conformity and contact stress on wear in fixed-bearing total knee prostheses. JBiomech 42, 1898-1902.Grupp, T. M., Stulberg, D., Kaddick, C., Maas, A., Fritz, B., Schwiesau, J., Bloemer, W., 2009.Fixed bearing knee congruency -- influence on contact mechanics, abrasive wear andkinematics. Int J Artif Organs 32, 213-223.Haider, H., Garvin, K., 2008. Rotating platform versus fixed-bearing total knees: an in vitrostudy of wear. Clin Orthop Relat Res 466, 2677-2685.Haider, H., Walker, P., DesJardins, M. S., Blunn, G., 2006. Effects of patient and surgicalalignment variables on kinematics in TKA simulation under force-control. JAI 3, 3-16.Haider, H., Walker, P., DesJardins, M. S., Blunn, G., 2006. Effects of patient and surgicalalignment variables on kinematics in TKR simulation under force-control. JAI 3, 3-16.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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FiguresFigure 1Friday, October 8, 2
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*Email: joseph.fetto@nyumc.orgNon-c
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MATERIAL AND METHODS423 total knee
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MATERIALS AND METHODSFrom January 1
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Introduction:Mike Reed - Wansbeck G
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Conclusions:To the best our knowled
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ing superior clinical results when
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one) in 11 (26%), type II (failure
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Correction of leg length discrepanc
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motion is separated from the transv
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Is the Frecnh Paradox a Reality? Lo
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uncovered in the remaining 53 hips.
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found in the currently used MOM bea
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followed since their initial presen
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ã€€On the axial plane, the ave
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For revision hip replacements, the
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Friday, October 8, 2010, 15:20-16:0
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ResultCup geometries with screws ha
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to insert the guide pin into the fe
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to 8% of THA patients have cups mal
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In a recent investigation the effec
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Conclusions.Fixed valgus angle rese
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fluoroscopic analysis of kinematics
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vivo motion of MB total knee arthro
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ResultsMean follow-up was 6 yrs (SD
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precision of implant placement. We
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*J. Philippe Kretzer - Laboratory o
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COM group whereas both components w
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In the present study, the patella h
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characteristic of the MB prosthesis
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Friday, October 8, 2010, 15:00-16:0
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The ceramic on ceramic strategy wit
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acetabulum, which with a modern por
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Friday, October 8, 2010, 14:00-14:5
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Conclusion: The results of this stu
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The incidence of periprosthetic fra
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*Email: sgh_iizu@grn.janis.or.jpAbs
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components (78 %) that remained rig
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hydroxyapatite ceramic in bone tumo
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one month later to a mean value of
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Keywords: total knee arthroplasty,
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of the tensor (Fig. 1B). During eac
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structures including MCL cut for ac
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31. Whiteside LA, Kasselt MR, Hayne
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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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Page 350 and 351: Poster: 17A Novel Method to Determi
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Page 356 and 357: Poster: 23Lumbar Disc Replacement.
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Page 360 and 361: Poster: 27Accuracy of Acetabular Cu
Page 362 and 363: Poster: 29In Vivo Measurement of Pe
Page 364 and 365: Poster: 31Clinical and Laboratory V
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Page 372 and 373: 17. Jonsson B, Astrom J. Alignment
Page 374 and 375: Branislav Jaramaz - The Western Pen
Page 376 and 377: Poster: 34What Is the Blood Transfu
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Page 380 and 381: Poster: 38Intraarticular Injection
Page 382 and 383: Sudhir Rao - South London Heathcare
Page 384 and 385: *Naoyuki Katayama - Hokkaido Orthop
Page 386 and 387: 198.5±5.5°and 157.0±7.5°, respe
Page 388 and 389: Introduction*Sujith Konan - Univers
Page 390 and 391: Poster: 48IntroductionRevision Hip
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Page 402 and 403: Poster: 52Development of a Constant
Page 404 and 405: *Takahiro Lida - Osaka City Univers
Page 406 and 407: coating, have been developed with t
Page 408 and 409: 3. Push-out Biomechanical AnalysisM
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Page 416 and 417: Lucia Manunta - University - sassar
Page 418 and 419: Based on above measurement we had t
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Page 424 and 425: Conclusion: the longivity of hip ar
Page 426 and 427: Poster: 70Outcome of Ceramic-Cerami
Page 428 and 429: posterior structures (facets and fa
Page 430 and 431: After thirty-eight months in vivo,
Page 432 and 433: disadvantages are provided by this
Page 434 and 435: chipping of the insert. Therefore a
Page 436 and 437: Metal cups, embedded in a cast resi
Page 438 and 439: about their preferences regarding f
Page 440 and 441: A periprosthetic femoral fracture a
Page 442 and 443: Superficial wound infection occurre
Page 444 and 445: International scientific literature
Page 446 and 447: 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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