Patient-Reported Outcomes After Revision of Metal-on-Metal Total Bearings in Total Hip Arthroplasty

Background

Failure of metal-on-metal (MOM) total hip arthroplasty (THA) bearings is often accompanied by an aggressive local reaction associated with destruction of bone, muscle, and other soft tissues around the hip. Little is known about whether patient-reported physical and mental function following revision THA in MOM patients is compromised by this soft tissue damage, and whether revision of MOM THA is comparable with revision of hard-on-soft bearings such as metal-on-polyethylene (MOP).

预紧及尺寸误差对角接触球轴承-转子振动性能的影响

通过对角接触球轴承受力分析,建立了单个滚子受力变形、滚动轴承整体受力变形、轴承承载区范围与预紧量关系的数学表达式,并在此基础上给出了考虑滚子、滚道尺寸误差,保证轴承滚子与内、外滚道全接触时的最小轴向预紧量的计算公式,建立了刚度和阻尼的计算模型。以7012C型角接触球轴承支承的Jeffcott转子为算例,计算研究了预紧量和尺寸误差对转子的振动性能的影响,计算了在不同预紧量下、有误差和无误差时的轴承振动频谱图,计算了预紧量变化对最大振幅和临界转速的影响规律曲线,并对计算结果进行了理论分析。     

探讨耳石复位法在分型诊治良性阵发性位置性眩晕中的应用价值

目的：探讨CRP（耳石复位法）在分型诊治良性阵发性位置眩晕（BPPV）中的临床应用价值。方法随机选取接受耳石复位法诊治的BPPV患者150例,主要对其中的97例PC-BPPV和29例HC-BPPV患者进行观察分析,将这126例患者随机分成观察组和对照组,各63例。观察组PC-BPPV患者采取改良的Epley耳石复位法,HC-BPPV患者采取Banbecue翻滚法;对照组患者统一采取Epley耳石复位法。对余下的24例SC-BPPV患者也采取改良的Epley耳石复位法。结果观察组患者临床的改善时间比对照组低,治疗1个月的前庭功能较治疗前与对照组比均较低,差异有统计学意义（P<0.05）。结论耳石复位法在BPPV的治疗中效果良好,对于不同的半规管BPPV采取不同的治疗办法,对HC-BPPV采取Barbecue方案,对PC-BPPV及SC-BPPV采取改良后的Epley耳石复位法方案,均有显著的效果。     

The Stability of Spiral-Grooved Air Journal Bearings in Ultrahigh Speeds

The spiral-grooved structure has been proposed for promoting the load capacity and stiffness of hybrid air journal bearings. In this paper, the dynamic characteristics of spiral-grooved hybrid bearings are first calculated. The stability criteria of the bearings are proposed and analyzed with different groove structure parameters using frequency domain analysis. It is found that the length of the spiral-groove has significant influence on the stability of the spindle system. Finally, the critical speed of the spiral-grooved hybrid bearing and rotor system is analyzed, and an experiment is carried out to validate the proposed model, finding that groove structure can promote the stability of the air bearing systems.     

Microstructure and Hardness of Hollow Tube Shells at Piercing in Two-High Screw Rolling Mill with Different Plugs

AA6060 ingots were pierced in a two-high screw rolling mill (MISIS-130D) with guiding shoes (Mannesmann mill type). Three different plugs, i.e., a conventional entire plug, a plug with a cavity, and a hollow plug, were used for piercing. We established that the grain size decreases after piercing, by order of magnitude, compared to the initial non-pierced annealed bill, with a grain size of 100–400 μm, and the hollow shell grains are elongated along the piercing direction. The produced hollow shells had 30% higher hardness than the initial billet. The highest hardness values were obtained after piercing the conventional entire plug. The most uniform hardness distribution through the hollow shell’s volume was obtained after piercing the hollow plug. The cross and longitudinal section hardness measurements demonstrate that the hardness decreases from the outer surface to the inner surface of the hollow shells.     

Influence of Asymmetric Rolling Process on the Microstructure Properties of Bimetallic Sheet Metals

This paper presents the results of research on the determination of the influence of kinetic asymmetry of work rolls on structural changes in hot-rolled bimetallic sheet metals. The tests were conducted on bimetallic samples composed of materials 10CrMo9-10 + X2CrNiMo17-12-2. The scope of the research included a comparative analysis for two cooling variants: I in water (freezing the structure immediately after rolling) and II for cooling in air. The research conducted showed that the introduction of asymmetric conditions to the rolling process results in a greater grain fragmentation in the so-called hard layer and does not have a negative effect on microstructural changes in the soft layer.     

Long-term follow-up of metal-on-metal total hip replacement.

Metal-on-metal articulations were reintroduced to reduce polyethylene particle-induced osteolysis. Elevated serum metal levels have been detected at short- and intermediate-term follow-up. There is little knowledge about long-term effects of increased ionic metal generation. Our study was undertaken to provide information about long-term survival, clinical outcome, radiographic appearance, and serum metal concentrations after a minimum 10 years follow-up with a metal-on-metal hip prosthesis: 105 cementless primary total hip prostheses with metal-on-metal articulating surfaces were implanted in 98 patients with a mean age of 56 years. Clinical data, radiographs, and blood samples were obtained at a follow-up visit 10 years after implantation. Serum cobalt and chromium levels were determined with use of atomic absorption spectrometry. General laboratory analyses included a full blood count and kidney function parameters. The Harris score was 92 points and the UCLA score 6 points after 10 years. Small osteolytic lesions and radiolucent lines were found in Gruen's zones 1, 7, 8, and 14. The probability of survival was 98.6%. The median serum cobalt concentration of the 22 patients with their hip replacement as the only source of cobalt was 0.75 microg/L (range, 0.3-50.1 microg/L). No patient was diagnosed with renal insufficiency during the study period. Five patients were diagnosed with a malignancy between surgery and the follow-up. We do not have evidence of an increased rate of primary malignancies nor could we detect renal failure in our study group. Serum metal levels did not differ from short- and intermediate term follow-up values.     

Heparan sulfate on activated glomerular endothelial cells and exogenous heparinoids influence the rolling and adhesion of leucocytes.

BACKGROUND: Proliferative glomerulonephritides are characterized by the influx of leucocytes. Heparan sulfate (HS) plays an important role in the recruitment, rolling and firm adhesion of leucocytes to activated endothelium. Recently, we have shown the importance of HS on activated mouse glomerular endothelial cells (mGEnC-1) for the firm adhesion of leucocytes in a static adhesion assay. In the present study, we evaluated the role of HS on glomerular endothelial cells and the effect of adding heparinoids on the leucocyte-glomerular endothelium interaction under dynamic flow conditions. METHODS: The number of rolling and firmly adhering leucocytes, and the rolling velocity of leucocytes was determined on a monolayer of unactivated or TNF-alpha-activated mGEnC-1 under dynamic flow conditions using physiological relevant shear stress rates in a flow chamber system. Furthermore, the effects of removal of HS on TNF-alpha-activated mGEnC-1 by heparinase III treatment, and of different concentrations of heparin, tinzaparin and HS, on the rolling and adhesion of leucocytes were evaluated. RESULTS: At the calculated physiological shear stress rate of 0.8 dynes/cm2 the number of rolling and firmly adhering leucocytes to mGEnC-1 increased 2-fold after activation with TNF-alpha, whereas the rolling velocity of the leucocytes decreased 2-fold. Addition of heparin, tinzaparin or HS, and the removal of HS on mGEnC-1 reduced the number of leucocytes rolling and adhering to activated mGEnC-1 about 2-3-fold, while the rolling velocity increased more than 2-fold. CONCLUSIONS: HS on activated glomerular endothelial cells is important for the interaction with leucocytes under flow conditions, while exogenous heparinoids interfere with this interaction. These results suggest that supplementary treatment of proliferative glomerulonephritides with heparinoids is an interesting option to pursue.     

High Strain Rate Quasi-Superplasticity Behavior in an Ultralight Mg-9.55Li-2.92Al-0.027Y-0.026Mn Alloy Fabricated by Multidirectional Forging and Asymmetrical Rolling

To explore new approaches to severe plastic deformation and the ductility of a multicomponent magnesium–lithium alloy, an ultralight microduplex Mg-9.55Li-2.92Al-0.027Y-0.026Mn alloy was made by novel multidirectional forging and asymmetrical rolling, and the superplasticity behavior was investigated by optical microscope, hot tensile test, and modeling. The average grain size is 1.9 μm in this alloy after multidirectional forging and asymmetrical rolling. Remarkable grain refinement caused by such a forming, which turns the as-cast grain size of 144.68 μm into the as-rolled grain size of 1.9 μm, is achieved. The elongation to failure of 228.05% is obtained at 523 K and 1 × 10⁻² s⁻¹, which demonstrates the high strain rate quasi-superplasticity. The maximum elongation to failure of 287.12% was achieved in this alloy at 573 K and 5 × 10⁻⁴ s⁻¹. It was found that strain-induced grain coarsening at 523 K is much weaker than the strain-induced grain coarsening at 573 K. Thus, the ductility of 228.05% is suitable for application in high strain rate superplastic forming. The stress exponent of 3 and the average activation energy for deformation of 50.06 kJ/mol indicate that the rate-controlling deformation mechanism is dislocation-glide controlled by pipe diffusion.