Migration and wear of hydroxyapatite-coated press-fit cups in revision hip arthroplasty: A radiostereometric study

Screw-fixated and hydroxyapatite-coated press-fit cups were studied using radiostereometry in 29 revision and 14 primary arthroplasties. The acetabular defects in the revision cases varied from none to type 3 (wall defects) according to Gustilo—Pasternak. Morsellized allograft was used in 25 revisions. Nine of these cups rested on less than 50% living bone. After 2 years, the mean migration in the revised group reached 0.36, 0.21, and 0.49 mm in the horizontal, longitudinal, and anteroposterior (AP) directions. The mean rotations varied between 0.5° and 0.7° depending on direction. The primary implants displayed smaller mediolateral migration and AP tilt. The mean proximal wear rate for the whole group was 0.11 mm/y. A central gap on the postoperative AP view implied less migration. The size of the preoperative bone defects or amount of bone—graft used had no influence on the migration. Despite extensive use of morsellized allograft, this implant displayed the smallest migration so far reported in revision hip arthroplasty.     

Biomechanical evaluation of total ankle arthroplasty. Part II: Influence of loading and fixation design on tibial bone–implant interaction

Finite element (FE) models to evaluate the burden placed on the interaction between total ankle arthroplasty (TAA) implants and the bone often rely on peak axial forces. However, the loading environment of the ankle is complex, and it is unclear whether peak axial forces represent a challenging scenario for the interaction between the implant and the bone. Our goal was to determine how the loads and the design of the fixation of the tibial component of TAA impact the interaction between the implant and the bone. To this end, we developed a framework that integrated robotic cadaveric simulations to determine the ankle kinematics, musculoskeletal models to determine the ankle joint loads, and FE models to evaluate the interaction between TAA and the bone. We compared the bone–implant micromotion and the risk of bone failure of three common fixation designs for the tibial component of TAA: spikes, a stem, and a keel. We found that the most critical conditions for the interaction between the implant and the bone were dependent on the specimen and the fixation design, but always involved submaximal forces and large moments. We also found that while the fixation design influenced the distribution and the peak value of bone–implant micromotion, the amount of bone at risk of failure was specimen dependent. To account for the most critical conditions for the interaction between the implant and the bone, our results support simulating multiple specimens under complex loading profiles that include multiaxial moments and span entire activity cycles.     

涂层修饰的柔性神经电极力学综合性能评估

目的对带有涂层修饰的柔性神经电极进行力学综合性能的评估,为电极及涂层参数的优化设计提供依据。方法对接触、植入以及微动阶段建立简化力学模型,以聚酰亚胺为电极材料,PEG为涂层材料,PDMS模具注塑法为涂层涂覆方法,设置40、80、120、160、200μm涂层厚度梯度,对3个因素(临界载荷、最大形变、脑组织最大应变)进行综合对比评估。结果厚度增加会引起临界载荷增大、最大形变减小以及脑组织最大应变减小,同时也会导致脑组织应变区域增大。均衡3个因素考虑,选择200μm作为涂层最佳厚度,在该厚度下,临界载荷为17.9 m N,最大形变为10.1μm,脑组织最大应变为0.011 4。结论涂层厚度对神经电极的力学性能有较大影响,在具体情况下可通过设置多个力学性能因素的影响因子选择最优参数。涂层的最优参数选择可提高电极的性能,对神经电极的临床应用具有重要意义。     

Toxicity of gold-nanoparticles: Synergistic effects of shape and surface functionalization on micromotility of epithelial cells

Abstract

Nanoparticle exposure is monitored by a combination of two label-free and non-invasive biosensor devices which detect cellular shape and viscoelasticity (quartz crystal microbalance), cell motility and the dynamics of epithelial cell-cell contacts (electric cell-substrate impedance sensing). With these tools we have studied the impact of nanoparticle shape on cellular physiology. Gold (Au) nanoparticles coated with CTAB were synthesized and studied in two distinct shapes: Spheres with a diameter of (43 ± 4) nm and rods with a size of (38 ± 7) nm × (17 ± 3) nm. Dose-response experiments were accompanied by conventional cytotoxicity tests as well as fluorescence and dark-field microscopy to visualize the intracellular particle distribution. We found that spherical gold nanoparticles with identical surface functionalization are generally more toxic and more efficiently ingested than rod-shaped particles. We largely attribute the higher toxicity of CTAB-coated spheres as compared to rod-shaped particles to a higher release of toxic CTAB upon intracellular aggregation.     

Quantification of interfacial motions following primary and revision total knee arthroplasty: A verification study versus experimental data

Motion at the bone–implant interface, following primary or revision knee arthroplasty, can be detrimental to the long‐term survival of the implant. This study employs experimentally verified computational models of the distal femur to characterize the relative motion at the bone–implant interface for three different implant types; a posterior stabilizing implant (PS), a total stabilizing implant (TS) with short stem (12 mm × 50 mm), and a total stabilizing implant (TS) with long offset stem (19 mm × 150 mm with a 4 mm lateral offset). Relative motion was investigated for both cemented and uncemented interface conditions. Monitoring relative motion about a single reference point, though useful for discerning global differences between implant types, was found to not be representative of the true pattern and distribution of motions which occur at the interface. The contribution of elastic deformation to apparent reference point motion varied based on implant type, with the PS and TSSS implanted femurs experiencing larger deformations (43 and 39 μm, respectively) than the TSLS implanted femur (22 μm). Furthermore, the pattern of applied loading was observed to greatly influence location and magnitude of peak motions, as well as the surface area under increased motion. Interestingly, the influence was not uniform across all implant types, with motions at the interface of long stemmed prosthesis found to be less susceptible to changes in pattern of loading. These findings have important implications for the optimization and testing of orthopedic implants in vitro and in silico. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:387–396, 2018.     

Stability of fused versus nonfused THA femoral impaction grafts.

Impaction grafting for THA involves compacting morselized cancellous bone (MCB) into a cavitary defect to build up bone stock. Ideally, the MCB subsequently remodels into a new contiguous cancellous lattice. A recent laboratory model of MCB fusion allows simulating an impaction graft construct in this ideal eventual clinical state. The purpose of the present study was to determine the relative stability of femoral impaction graft constructs in which the MCB has fused versus that for MCB in the freshly impacted nonfused condition. Cemented femoral impaction graft constructs were created in composite femurs. For fused constructs, the MCB was mixed with an amine epoxy that causes the MCB to set up into a contiguous structure biomechanically comparable to intact cancellous bone in compression. The constructs were loaded with 500,000 physiologic gait cycles. Three-dimensional motion was measured between the femur and the stem. The fused femoral impaction grafts were much more stable than the nonfused grafts at the proximal stem location, but MCB fusion had only a modest effect on distal stem stability. These results indicate that most of the opportunity to reduce femoral stem micromotion and migration lies proximal, and that steps to enhance impaction graft remodeling and fusion are most effectively focused proximally.     

Acetabular micromotion as a measure of initial implant stability in primary hip arthroplasty: An in vitro comparison of different methods of intial acetabular component fixation

Micromotion has been shown to affect bony ingrowth into cementless components. This study was designed both to quantitate initial micromotion at the prosthesis-periacetabular bony interface and to compare different methods of commonly employed acetabular component fixations, ie, a press-fit hemispherical titanium cup, a press-fit hemispherical titanium cup with one and two dome screws, a press-fit titanium hemispherical cup with three spikes, and a cemented chromium-cobalt cup. The press-fit component without screws demonstrated the greatest motion equaling 162 μm at the ilium, 97 μm at the pubis, and 54 μm at the ischium. With one and two screws placed into the dome, the mean ileal displacement decreased by 28 μm (17%) and 36 μm (22%), respectively. Dome screw placement demonstrated a minimal effect at the pubis and ischium. Compared to the press-fit component without augmentation, the tri-spike motion was less at the pubis and ischium. The cemented prosthesis provided the least amount of motion in all three areas tested. This experiment demonstrates that the ilium provides the least amount of support to immediate acetabular fixation, while the pubis (anterior column) and ischium (posterior column) provide more stability. One dome screw does not afect the stability of a hemispherical prosthetic cup significantly. A two dome screw fixation provides an added method of support at the ilium, but fails to decrease motion at the pubis or ischium significantly. The tri-spike fixation does not restrict motion at the ilium to the extent as the dome screws, but its effect at the ischium and pubis is much more pronounced. The obvious difference between initial motion seen with cemented versus uncemented components may suggest that before surgery, patients may need a period of protected weight bearing until ingrowth has occurred.