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2. The Ethical Approval Process

Author

Takamura, Karren, Petrigliano, Frank, Musahl, Volker, editor, Karlsson, Jón, editor, Hirschmann, Michael T., editor, Ayeni, Olufemi R., editor, Marx, Robert G., editor, Koh, Jason L., editor, and Nakamura, Norimasa, editor

Published
2019
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6. Histological Features of Pseudotumor-like Tissues From Metal-on-Metal Hips

Author

Campbell, Pat, Ebramzadeh, Edward, Nelson, Scott, Takamura, Karren, Smet, Koen, and Amstutz, Harlan C.

Subjects
Medicine & Public Health, Conservative Orthopedics, Sports Medicine, Surgery, Medicine/Public Health, general, Surgical Orthopedics, Orthopedics
Abstract

Pseudotumor-like periprosthetic tissue reactions around metal-on-metal (M-M) hip replacements can cause pain and lead to revision surgery. The cause of these reactions is not well understood but could be due to excessive wear, or metal hypersensitivity or an as-yet unknown cause. The tissue features may help distinguish reactions to high wear from those with suspected metal hypersensitivity.We therefore examined the synovial lining integrity, inflammatory cell infiltrates, tissue organization, necrosis and metal wear particles of pseudotumor-like tissues from M-M hips revised for suspected high wear related and suspected metal hypersensitivity causes.Tissue samples from 32 revised hip replacements with pseudotumor-like reactions were studied. A 10-point histological score was used to rank the degree of aseptic lymphocytic vasculitis-associated lesions (ALVAL) by examination of synovial lining integrity, inflammatory cell infiltrates, and tissue organization. Lymphocytes, macrophages, plasma cells, giant cells, necrosis and metal wear particles were semiquantitatively rated. Implant wear was measured with a coordinate measuring machine. The cases were divided into those suspected of having high wear and those suspected of having metal hypersensitivity based on clinical, radiographic and retrieval findings. The Mann-Whitney test was used to compare the histological features in these two groups.The tissues from patients revised for suspected high wear had a lower ALVAL score, fewer lymphocytes, but more macrophages and metal particles than those tissues from hips revised for pain and suspected metal hypersensitivity. The highest ALVAL scores occurred in patients who were revised for pain and suspected metal hypersensitivity. Component wear was lower in that group.Pseudotumor-like reactions can be caused by high wear, but may also occur around implants with low wear, likely because of a metal hypersensitivity reaction. Histologic features including synovial integrity, inflammatory cell infiltrates, tissue organization, and metal particles may help differentiate these causes.Painful hips with periprosthetic masses may be caused by high wear, but if this can be ruled out, metal hypersensitivity should be considered.

Published
2010

19. The insidious risk of periprosthetic fracture in clinically functional total hip arthroplasties: A biomechanical study of willed joints.

Author

Takamura, Karren M., McCarty, Colin P., Ho, Nathan C., Diehl, Jennifer, Longjohn, Donald B., Ebramzadeh, Edward, and Sangiorgio, Sophia N.

Subjects
*PERIPROSTHETIC fractures, *FEMUR neck, *BONE density, *TOTAL hip replacement, *TORSIONAL load, *DUAL-energy X-ray absorptiometry, *HIP fractures
Abstract

Femoral bone quality is a major risk factor of periprosthetic fracture after total hip arthroplasty (THA), which has mortality similar to native hip fractures but higher short‐term morbidity. The goal of this study was to quantify cortical strains at the site of expected Vancouver Type‐B periprosthetic fracture as a function of bone mineral density, femoral stem material, and fixation method using a series of 29 autopsy‐retrieved, clinically asymptomatic hip joints with THA. Periprosthetic bone mineral content and density was assessed using dual‐energy X‐ray absorptiometry by Gruen Zone. Specimens then underwent combined cyclic axial and torsional loading, increasing incrementally from 100 N and ±1 Nm to peaks of 700 N and ±5 Nm. All specimens experienced significantly higher strains on the lateral surface than on the anterior surface, indicating that the bending loads in the frontal plane, rather than axial/torsional loads, had the predominant effect. Multiple significant relationships (p = 0.04, p = 0.02) were found between predicted periprosthetic strains calculated from radiographic measurements and observed principal strains. Though THA in the present study were in successful clinical service, the produced results indicated that some femurs with rigid cemented or noncemented implants were potentially at high risk for Vancouver Type‐B fractures, which may be predicted radiographically. [ABSTRACT FROM AUTHOR]

Published
2022
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20. Contributors

Author

Amstutz, Harlan C., primary, Ball, Scott T., additional, Beaulé, Paul E., additional, Nasser, Ahmad Bin, additional, Boitano, Paul D., additional, Campbell, Patricia A., additional, Dorey, Frederick J., additional, Gill, Richie H.S., additional, Gruen, Thomas A., additional, Le Duff, Michel J., additional, Little, J. Paige, additional, Lundergan, William, additional, Medley, John B., additional, Schmalzried, Thomas P., additional, Simpson, David J., additional, Su, Edwin P., additional, and Takamura, Karren Midori, additional

Published
2008
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28. Colaboradores

Author

Agrawal, Yuvraj, Aït-Si-Selmi, Tarik, Amanatullah, Derek F., Angerame, Marc R., Barnes, C. Lowry, Barry, Jeffrey J., Beaulé, Paul E., Beck, Martin, Becker, Edward H., Bedair, Hany, Berend, Keith R., Berend, Michael E., Bergmann, Georg, Bernthal, Nicholas M., Berry, Daniel J., Bingham, Joshua, Blumstein, Gideon W., Bolognesi, Michael P., Bostrom, Mathias P., Bothorel, Hugo, Box, Hayden N., Bozic, Kevin, Brown, Nicholas M., Browne, James A., Burke, Dennis W., Burke, Zachary D.C., Burnett, R. Stephen J., Byrd, J. W. Thomas, Campbell, Patricia A., Carter, Aaron, Chatelet, Jean-Christophe, Charity, John, Chen, Kevin K., Clohisy, John C., Cohen-Rosenblum, Anna R., Colwell, Clifford W., Cordry, Ryan, Couch, Cory G., Courtney, P. Maxwell, Crawford, David A., Cross, Michael B., Daines, Brian, Damm, Philipp, Valle, Craig J. Della, De Martino, Ivan, Dennis, Douglas A., Di Cesare, Paul E., Donaldson, Matthew J., Dorr, Lawrence D., Duda, Georg N., Dunbar, Michael J., Duncan, Clive, Duwelius, Paul J., Edelstein, Adam I., Edwards, Paul K., Engh, C. Anderson, Engstrom, Stephen M., Esposito, Christina, Estrera, Kenneth, Fehring, Keith, Fehring, Thomas, Ferguson, Stephen, Fessy, Michel-Henri, Ford, Marcus C., Frisch, Nicholas B., Gandhi, Rajiv, Garbuz, Donald S., Garvin, Kevin L., Geller, Jeffrey A., Gibon, Emmanuel, Gie, Graham A., Goldstein, Rachel Y., Goodman, Stuart B., Goodnough, Lawrence H., Grammatopoulos, George, Gross, Allan E., Haddad, Fares S., Haidukewych, George J., Hamadouche, Moussa, Hampton, Chadwick, Han, Shuyang, Hanke, Markus S., Hardwick, Mary E., Hartman, Curtis, Heckmann, Nathanael, Heller, Markus O.W., Horlocker, Terese T., Hornicek, Francis J., Howell, Jonathan R., Hozack, William J., Hubble, Matthew J.W., Huddleston, James I., III, Hunt, Devyani, Huo, Michael H., Iorio, Richard, Jacobs, Joshua J., Jeffers, Jonathan R.T., Jennings, Jason M., Jiranek, William A., Kadado, Allen, Kashiwagi, Deanne T., Kassam, Al-Amin M., Keating, E. Michael, Keeney, James, Keller, A. Scott, Khakharia, Saurabh, Khlopas, Anton, Kildow, Beau J., Kim, Harry K.W., Klein, Gregg R., Konigsberg, Beau S., Kopp, Sandra L., Koval, Kenneth J., Kregor, Philip J., Kurmis, Andrew, Kuzyk, Paul R., Kyle, Richard F., Lachiewicz, Paul F., Larson, Tyler J., Laurent, Michel P., Leibold, Christiane S., Leighton, Jennifer L., Lerch, Till D., Leunig, Michael, Lewallen, David G., Liporace, Frank A., Lombardi, Adolph V., Ma, Ting, Mabry, Tad M., Mahomed, Nizar, Malchau, Henrik, Maloney, William J., Mann, Kenneth, Manrique, Jorge, Mantilla, Carlos B., Marker, David R., Martin, Hal David, Mason, Thomas G., Masri, Bassam A., Mayle, Robert E., McDonald, Douglas, McGrory, Brian J., Meneghini, R. Michael, Mont, Michael A., Morris, Michael J., Nadeau, Richard P., Nassif, Nader A., Nelson, Charles, Nestor, Bryan J., Noble, Philip C., Nord, Keith M., Novais, Eduardo N., Novikov, David A., Oakes, Daniel A., Padgett, Douglas E., Pagnano, Mark W., Paprosky, Wayne G., Parry, Joshua A., Patel, Jay, Patel, Ronak M., Peck, Jeffrey B., Pellegrini, Vincent D., Perka, Carsten, Pickering, Trevor R., Pietrzak, Jurek R.T., Prather, Heidi, Rakhra, Kawan S., Reeves, Russell A., Ries, Michael D., Rimnac, Clare M., Ritting, Andrew W., Rose, Peter S., Rutherford, Richard W., Safir, Oleg A., Sandoval, Enrique, Santore, Richard, Schmaranzer, Florian, Schmidt, Andrew H., Schoenecker, Perry L., Schwab, Joseph H., Schwarzkopf, Ran, Sems, S. Andrew, Seyler, Thorsten M., Sharkey, Peter F., Sheikh, Adnan M., Sheth, Neil P., Siebenrock, Klaus A., Sierra, Rafael J., Sink, Ernest L., Sobieraj, Michael C., Southgate, Richard D., Spangehl, Mark J., Sporer, Scott M., Springer, Bryan D., Stal, Drew N., Stans, Anthony A., Stefl, Michael D., Steppacher, Simon D., Stulberg, S. David, Sucato, Daniel J., Swanson, Megan A., Takamura, Karren, Tannast, Moritz, Tanzer, Dylan, Tanzer, Michael, Taunton, Michael J., Timperley, A. John, Trasolini, Nicholas, Trousdale, Robert T., Vail, Thomas P., Vestermark, George L., Vidalain, Jean-Pierre, Walter, William L., Wasterlain, Amy S., Watts, Evan, Weber, Alexander E., Weber, Elizabeth, Whitehouse, Sarah L., Wilkin, Geoffrey P., Wilson, Matthew J., Wimmer, Markus A., Wooster, Benjamin M., Wright, Timothy M., Wyatt, Michael, Wyles, Cody C., Yingling, John M., Yoon, Richard S., Zaltz, Ira, Zierenberg, Adam, Zmugg, Stephan, and Zywiel, Michael G.

Published
2021
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29. Contributors

Author

Agrawal, Yuvraj, Aït-Si-Selmi, Tarik, Amanatullah, Derek F., Angerame, Marc R., Barnes, C. Lowry, Barry, Jeffrey J., Beaulé, Paul E., Beck, Martin, Becker, Edward H., Bedair, Hany, Berend, Keith R., Berend, Michael E., Bergmann, Georg, Bernthal, Nicholas M., Berry, Daniel J., Bingham, Joshua, Blumstein, Gideon W., Bolognesi, Michael P., Bostrom, Mathias P., Bothorel, Hugo, Box, Hayden N., Bozic, Kevin, Brown, Nicholas M., Browne, James A., Burke, Dennis W., Burke, Zachary D.C., Burnett, R. Stephen J., Byrd, J.W. Thomas, Campbell, Patricia A., Carter, Aaron, Chatelet, Jean-Christophe, Charity, John, Chen, Kevin K., Clohisy, John C., Cohen-Rosenblum, Anna R., Colwell, Clifford W., Jr., Cordry, Ryan, Couch, Cory G., Courtney, P. Maxwell, Crawford, David A., Cross, Michael B., Daines, Brian, Damm, Philipp, Della Valle, Craig J., Martino, Ivan De, Dennis, Douglas A., Di Cesare, Paul E., Donaldson, Matthew J., Dorr, Lawrence D., Duda, Georg N., Dunbar, Michael J., Duncan, Clive, Duwelius, Paul J., Edelstein, Adam I., Edwards, Paul K., Engh, C. Anderson, Jr., Engstrom, Stephen M., Esposito, Christina, Estrera, Kenneth, Fehring, Keith, Fehring, Thomas, Ferguson, Stephen, Fessy, Michel-Henri, Ford, Marcus C., Frisch, Nicholas B., Gandhi, Rajiv, Garbuz, Donald S., Garvin, Kevin L., Geller, Jeffrey A., Gibon, Emmanuel, Gie, Graham A., Goldstein, Rachel Y., Goodman, Stuart B., Goodnough, Lawrence H., Grammatopoulos, George, Gross, Allan E., Haddad, Fares S., Haidukewych, George J., Hamadouche, Moussa, Hampton, Chadwick, Han, Shuyang, Hanke, Markus S., Hardwick, Mary E., Hartman, Curtis, Heckmann, Nathanael, Heller, Markus O.W., Horlocker, Terese T., Hornicek, Francis J., Howell, Jonathan R., Hozack, William J., Hubble, Matthew J.W., Huddleston, James I., III, Hunt, Devyani, Huo, Michael H., Iorio, Richard, Jacobs, Joshua J., Jeffers, Jonathan R.T., Jennings, Jason M., Jiranek, William A., Kadado, Allen, Kashiwagi, Deanne T., Kassam, Al-Amin M., Keating, E. Michael, Keeney, James, Keller, A. Scott, Khakharia, Saurabh, Khlopas, Anton, Kildow, Beau J., Kim, Harry K.W., Klein, Gregg R., Konigsberg, Beau S., Kopp, Sandra L., Koval, Kenneth J., Kregor, Philip J., Kurmis, Andrew, Kuzyk, Paul R., Kyle, Richard F., Lachiewicz, Paul F., Larson, Tyler J., Laurent, Michel P., Leibold, Christiane S., Leighton, Jennifer L., Lerch, Till D., Leunig, Michael, Lewallen, David G., Liporace, Frank A., Lombardi, Adolph V., Jr., Ma, Ting, Mabry, Tad M., Mahomed, Nizar, Malchau, Henrik, Maloney, William J., Mann, Kenneth, Manrique, Jorge, Mantilla, Carlos B., Marker, David R., Martin, Hal David, Mason, Thomas G., Masri, Bassam A., Mayle, Robert E., Jr., McDonald, Douglas, McGrory, Brian J., Meneghini, R. Michael, Mont, Michael A., Morris, Michael J., Nadeau, Richard P., Nassif, Nader A., Nelson, Charles, Nestor, Bryan J., Noble, Philip C., Nord, Keith M., Novais, Eduardo N., Novikov, David A., Oakes, Daniel A., Padgett, Douglas E., Pagnano, Mark W., Paprosky, Wayne G., Parry, Joshua A., Patel, Jay, Patel, Ronak M., Peck, Jeffrey B., Pellegrini, Vincent D., Jr., Perka, Carsten, Pickering, Trevor R., Pietrzak, Jurek R.T., Prather, Heidi, Rakhra, Kawan S., Reeves, Russell A., Ries, Michael D., Rimnac, Clare M., Ritting, Andrew W., Rose, Peter S., Rutherford, Richard W., Safir, Oleg A., Sandoval, Enrique, Santore, Richard, Schmaranzer, Florian, Schmidt, Andrew H., Schoenecker, Perry L., Schwab, Joseph H., Schwarzkopf, Ran, Sems, S. Andrew, Seyler, Thorsten M., Sharkey, Peter F., Sheikh, Adnan M., Sheth, Neil P., Siebenrock, Klaus A., Sierra, Rafael J., Sink, Ernest L., Sobieraj, Michael C., Southgate, Richard D., Spangehl, Mark J., Sporer, Scott M., Springer, Bryan D., Stal, Drew N., Stans, Anthony A., Stefl, Michael D., Steppacher, Simon D., Stulberg, S. David, Sucato, Daniel J., Swanson, Megan A., Takamura, Karren, Tannast, Moritz, Tanzer, Dylan, Tanzer, Michael, Taunton, Michael J., Timperley, A. John, Trasolini, Nicholas, Trousdale, Robert T., Vail, Thomas P., Vestermark, George L., Vidalain, Jean-Pierre, Walter, William L., Wasterlain, Amy S., Watts, Evan, Weber, Alexander E., Weber, Elizabeth, Whitehouse, Sarah L., Wilkin, Geoffrey P., Wilson, Matthew J., Wimmer, Markus A., Wooster, Benjamin M., Wright, Timothy M., Wyatt, Michael, Wyles, Cody C., Yingling, John M., Yoon, Richard S., Zaltz, Ira, Zierenberg, Adam, Zmugg, Stephan, and Zywiel, Michael G.

Published
2020
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33. Cement Technique Changes Improved Hip Resurfacing Longevity.

Author

Campbell, Pat, Takamura, Karren, Lundergan, William, Esposito, Christina, and Amstutz, Harlan C.

Abstract

Background: Most designs of metal-on-metal hip resurfacing utilize cement for femoral fixation, but the amount, application, and distribution of cement varies considerably according to implant design and surgeon preference. In one type of hip resurfacing system (Conserve® Plus), the objective was to achieve a 1-mm cement mantle and several millimeters of penetration. In early cases of the senior investigator's (HCA) series, cement fixation failures were noted, and this prompted changes in femoral head preparation and cement application techniques. Survivorship improved following implementation of these changes. The aim of the current study was to examine revised femoral components for the cement distribution, especially in cases where the improved techniques were subsequently applied. Method: Fifteen resurfacing femoral components were sectioned and the slices were radiographed and photographed, and the amount and distribution of cement were examined and measured. Cases representative of the evolving cementing techniques were examined in detail. Results: There was considerable variation observed in the amount and distribution of cement, partly as a consequence of variable bone quality in this "all-comers" included series. The cement analyses showed that the newer cementing techniques helped to reduce over-penetration while providing better cement interdigitation. Tire use of extra fixation holes and cementing the stem in cases with poor bone quality were associated with improved cement-to-bone contact area. Conclusion: Meticulous femoral head preparation was helpful in providing durable cement fixation and is essential in cases with poor bone quality. [ABSTRACT FROM AUTHOR]

Published
2009

34. Contributors

Author

Amanatullah, Derek F., Andersen, Phillip J., Backstein, David J., Barnes, C. Lowry, Beaulé, Paul E., Becker, Edward H., Bedair, Hany, Berend, Keith R., Berend, Michael E., Bergmann, Georg, Bolhofner, Brett, Bostrom, Mathias P.G., Bourne, Robert B., Bozic, Kevin, Briggs, Karen K., Bumgardner, Joel D., Burke, Dennis W., Burnett, R. Stephen J., Byrd, J.W. Thomas, Cabanela, Miguel E., Callaghan, John J., Campbell, Patricia A., Capello, William N., Caravelli, Michael L., Carter, Aaron, Cheung, Yeukkei, Clarke, Ian C., Clohisy, John, Cohen, Adam M.M., Colwell, Clifford W., Jr., Cordry, Ryan, Corten, Kristoff, Cross, Michael B., D'Antonio, James A., Davidson, Darin, Valle, Craig J. Della, Dennis, Douglas A., Cesare, Paul E. Di, Dorr, Lawrence D., Duda, Georg N., Dunbar, Michael J., Duncan, Clive P., Anderson Engh, C., Jr., Engh, Charles A., Fehring, Thomas, Ferguson, Stephen, Fisher, John, Fitzgerald, Steven J., Fuchs, Bruno, Gandhi, Rajiv, Garbuz, Donald S., Garvin, Kevin L., Geller, Jeffrey A., Gie, Graham A., Gooding, Christopher R., Goodman, Stuart, Griffin, William L., Gross, Allan E., Gyomorey, Sandor, Haddad, Fares S., Haggard, Warren O., Haidukewych, George, Harandi, Armin Aalami, Heller, Markus O.W., Horlocker, Terese T., Hornicek, Francis J., Howell, Jonathan R., Hozack, William J., Hubble, Matthew J.W., Huddleston, James I., III, Hunt, Devyani, Huo, Michael H., Hurson, Conor J., Incavo, Stephen J., Iorio, Richard, Jackson, J. Benjamin, III, Jiranek, William A., Johnson, Derek R., Kashiwagi, Deanne T., Kavolus, Joseph J., Keating, E. Michael, Keeney, James, Keller, A. Scott, Kellett, Catherine F., Khakharia, Saurabh, Kim, Harry, Kim, Raymond H., Kim, Young-Jo, Klein, Gregg R., König, Christian, Kopp, Sandra L., Koval, Kenneth J., Kregor, Philip J., Kyle, Richard F., Lanting, Brent A., Larkin, Brian, Laurent, Michel P., Lee, Paul Tee Hui, Leunig, Michael, Lewallen, David G., Li, Stephen, Lombardi, Adolph V., Jr., Ly, Thuan V., Ma, Ting, Mabry, Tad M., MacDonald, Steven J., Mahomed, Nizar, Malchau, Henrik, Maloney, William J., Mantilla, Carlos B., Marker, David R., Martin, Hal David, Mason, Thomas G., Masonis, John L., Masri, Bassam A., Matar, Wadih Y., Mayle, Robert E., Jr., McCarthy, Edward F., McGrory, Brian J., Meneghini, R. Michael, Michael, Andrew M., Mont, Michael A., Morris, Michael J., Nestor, Bryan, Noble, Philip C., O'Connor, Philip A., Padgett, Douglas E., Pagnano, Mark W., Paprosky, Wayne G., Parvizi, Javad, Patel, Jay, Patel, Ronak M., Pellegrini, Vincent, Jr., Perka, Carsten, Pezzotti, Giuseppe, Philippon, Marc, Pickering, Trevor R., Pilliar, Robert M., Prather, Heidi, Rakhra, Kawan S., Ries, Michael D., Ritting, Andrew W., Rizek, Randy, Rose, Peter S., Safir, Oleg A., Santore, Richard, Scheerlinck, Thierry, Schmalzried, Thomas P., Schmidt, Andrew H., Schoenecker, Perry L., Souza, Bruno G. Schroder e, Schwab, Joseph H., Sems, S. Andrew, Seyler, Thorsten M., Sharkey, Peter F., Sheikh, Adnan M., Sheth, Neil P., Sierra, Rafael J., Silverstein, Eric A., Sink, Ernest L., Spangehl, Mark J., Sporer, Scott M., Springer, Bryan P., Stal, Drew N., Stans, Anthony A., Stulberg, S. David, Sucato, Daniel J., Sugano, Nobuhiko, Sumner, Dale R., Swanson, Megan A., Swiontkowski, Marc F., Syed, Khalid, Takamura, Karren, Tannous, Oliver O., Tanzer, Dylan, Tanzer, Michael, Tarwala, Rupesh, Taunton, Michael J., Terefenko, Christi J. Sychterz, Tilzey, John F., Timperley, Andrew J., Tohtz, Stephan, Trousdale, Robert T., Vail, Thomas Parker, Vidalain, Jean-Pierre, Virdi, Amarjit S., Weber, Elizabeth, Whitehouse, Sarah L., Williams, Daniel H., Williams, Sophie, Wilson, Matthew J., Wimmer, Markus A., Wright, Geoffrey, Zaltz, Ira, Zierenberg, Adam, and Zywiel, Michael G.

Published
2011
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36. Contributors

Author

Amstutz, Harlan C., Ball, Scott T., Beaulé, Paul E., Nasser, Ahmad Bin, Boitano, Paul D., Campbell, Patricia A., Dorey, Frederick J., Gill, Richie H.S., Gruen, Thomas A., Le Duff, Michel J., Little, J. Paige, Lundergan, William, Medley, John B., Schmalzried, Thomas P., Simpson, David J., Su, Edwin P., and Takamura, Karren Midori

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