Cement for the fixation of bone prostheses - Europe PMC
8 – Acrylic cements for bone fixation in joint replacement * ..
Cement for fixation of bone prostheses Info ..
In a hybrid fixation for total knee replacement, the femoral component is inserted without cement, and the tibial and patellar components are inserted with cement. This technique was introduced in the early 1980s; long-term results are just now being measured and are generally positive.
The aim of this review paper is to define the fixation of the cemented stem. Polymethyl methacrylate, otherwise known as “bone cement”, has been used in the fixation of hip implants since the early 1960s. Sir John Charnley, the pioneer of modern hip replacement, incorporated the use of cement in the development of low frictional torque hip arthroplasty. In this paper, the concepts of femoral stem design and fixation, clinical results, and advances in understanding of the optimal use of cement are reviewed. The purpose of this paper is to help understanding and discussions on the thickness and the porosity of the cement mantle in total hip arthroplasty. Cement does not act as an adhesive, as sometimes thought, but relies on an interlocking fit to provide mechanical stability at the cement–bone interface, while at the prosthesis– cement interface it achieves stability by optimizing the fit of the implant in the cement mantle, such as in a tapered femoral stem.
Cementless Prosthetic Fixation: When Less Is More—In …
Shoulder arthroplasty procedures have generally excellent clinical outcomes, but infection following shoulder arthroplasty continues to be a difficult problem both diagnostically and therapeutically. Two-stage reimplantation with use of a temporary Prosthesis of Antibiotic-Loaded Acrylic Cement (PROSTALAC) (DePuy, Warsaw, Indiana) is the standard treatment for chronic infection. Optimizing surgical technique regarding cement spacer is a priority, but detailed technical descriptions are sparse.
The senior authorâs original technique for creation of a PROSTALAC implant for shoulder infection following arthroplasty is outlined and illustrated. This includes the use of a custom 44-mm hemispherical mold and a 3.5-mm limited contact dynamic compression plate pre-bent to 125 degrees to mimic the anatomic neck-shaft angle of the humerus. A new technical tip is presented whereby a standard culture tube is injected with antibiotic laden cement followed by plate insertion into the cement-filled tube, thus creating an improved prosthesis with delivery of antibiotics into the humeral canal.
A joint prosthesis system is suitable for cemented fixation
The microscopic debris particles are absorbed by cells around the joint and initiate an inflammatory response from the body, which tries to remove them. This inflammatory response can also cause cells to remove bits of bone around the implant, a condition called osteolysis. As wear continues, so does the bone loss. The bone weakens, and the loosening of the implant from bone increases. Despite these recognized failure mechanisms, the bond between cement and bone is generally very durable and reliable. Cemented fixation has been used successfully in all patient groups for whom total knee replacement is appropriate, including young and active patients with advanced degenerative joint disease.
They may be press-fit implants that allow the body to form new bone connections to it. Or, they may be cemented in place. For some joints, hybrid fixation is used, with cement on one component and press-fit on the other.
to fill up a cavity or to create a mechanical fixation
monomer released from methacrylics-based bone cement ..
Bone cement containing antibiotics is an established procedure in orthopedics for the fixation of cemented ..
The term Hip replacement fixation refers to the method used ..
Bone cement - Wikipedia
Fixation hip prosthesis - Heraeus
Hip Replacement Fixation
Implant Fixation with bone cement - Heraeus Group
In a normal knee, four ligaments help hold the bones in place so that the joint works properly. When a knee becomes arthritic, these ligaments can become scarred or damaged. During knee replacement surgery, some of these ligaments, as well as the joint surfaces, are substituted or replaced by the new artificial prostheses. Two types of fixation are used to hold the prostheses in place. Cemented fixation uses a fast-curing bone cement (polymethylmethacrylate) to hold the prostheses in place. Cementless fixation relies on bone growing into the surface of the implant for fixation.
Fixation knee prothesis - Heraeus
Most knee replacements done today are cemented into place. Cemented fixation has a generally excellent track record and may last more than 20 years. The longevity and performance of a knee replacement depends on several factors, including activity level, weight, and general health.
How is the knee prosthesis secured
Cemented fixation relies on a stable interface between the prosthesis and the cement as well as a solid mechanical bond between the cement and the bone. Metal alloy components rarely break, but they can occasionally come loose from the bone. Two processes, one mechanical and one biological, can contribute to loosening.
or along the gap between cement and prosthesis up to the ..
Shoulder arthroplasty procedures have increased dramatically over the last several decades with generally excellent clinical outcomes and satisfactory long-term survival rates.1 However, infection following shoulder arthroplasty continues to be a difficult problem presenting challenges both diagnostically and therapeutically. As opposed to prosthetic infections of the hip and knee, treatment algorithms are not well defined and shoulder surgery textbooks contain little information concerning the therapy of infected shoulder replacements.2 The prevalence of infection ranges from approximately 1% to 5%, with a higher rate associated with revision arthroplasty.3-5
ingrowth and direct bone-prosthesis fixation are ..
Two-stage revision with use of a temporary Prosthesis of Antibiotic-Loaded Acrylic Cement (PROSTALAC) (DePuy, Warsaw, Indiana) is the standard treatment for chronic infection (defined as that persisting for more than four weeks postoperatively) at the site of knee and hip arthroplasty.6 The PROSTALAC implant elutes a high concentration of local antibiotics while maintaining appropriate periarticular soft-tissue tension and preventing capsular and ligament contracture. The quality of apposition between bone-cement interfaces is important in determining the longevity and stability of an antibiotic spacer as well as a cemented prosthesis. Optimizing surgical technique regarding cement spacer creation and implantation is a priority because the prosthesisâ surface properties and shape impact stability.7
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