Abstract:
Cement mantle defects in total hip arthroplasty: influence of stem size and cementing technique
The cause of isolated osteolysis in the femoral shaft around stem implants in patients with cemented THR has so far not been established. A number of factors have been considered such as torsional stability of the femoral stem implant, the time of reduction intraoperatively after cementing and iatrogenic and load- induced defects in the cement mantle.
The aim of this in vitro investigation was to determine if cementing technique or the thickness of the prosthesis stem, and thus its bending strength, influence the formation, extent and localisation of cement mantle defects. In vitro biomechanical loading tests were performed on twelve anatomically shaped femoral stem prostheses of two different thicknesses which were implanted in artificial bone. Six of the implants were fixed by conventional cementing technique, the other six by means of the vacuum technique. Compared with thicker implant stems, the slimmer stems fixed with the conventional cementing technique had a higher number of cracks in the cement mantle. Pore formation was localised predominantly in the interface area between the bone cement and the “cancellous” bone or “cortex” of the artificial bone. This was observed especially in the non-vacuum mixed cement, regardless of stem thickness. Large pores were found mainly in the cement around the thicker stems which had been mixed by the conventional method. The thickness of the stems, whether fixed with vacuum- mixed or non-vacuum mixed cement, had no significant influence on the percentage of pore area in the cement. In the non-vacuum mixed cement, there was no significant difference between the percentages of pore area in the proximal and distal parts of the shafts, whereas in the vacuum mixed cement the percentage of pore area was significantly larger in the distal than in the proximal part of the shafts. In the specimens of both stem sizes, the percentage of pore area in the vacuum mixed cement was significantly smaller than in the non-vacuum mixed cement. This explains the greater fatigue strength of vacuum mixed cement. The cyclic loading on the thicker stem prostheses, especially in those fixed with vacuum mixed cement, resulted in fracture between the prosthesis tip and the clamping device due to the local stiffness of the artificial bone. Due to this unfavourable biomechanical property of the artificial bone, further studies will be carried out on human femurs. Nevertheless, in view of the results presented here, the vacuum mixing technique has to recommended as the “state of the art” method in cemented total hip arthroplasty.
Erschienen: Wiley Online Library – 2016
Autoren: Alexander Katzer, Michael Hahn, Björn Busse, Mathias Procop, Jozef Zustin, Michael Amling
Erschienen: ACTA ORTHOPEDICA – November 2008
Autoren: Wolfram Steens, Jochen F. Loehr, Joachim Wodtke, Alexander Katzer
Erschienen: Journal of Biomedical Materials Research Part A – November 2008
Autoren: B. Busse, M. Hahn, M. Niecke, B. Jobke, K. Püschel, G. Delling, A. Katze
Erschienen: Journal of Orthopaedics and Traumatology - December 2007
Autoren: A. Katzer, A. Ince, M. Hahn, M.M. Morlock, W. Steens
Erschienen: The Journal of Bone & Joint Surgery – November 2006
Autoren: J. Gille, A. Ince, O. González, A. Katzer, J. F. Loehr
Weiterlesen … Single-stage revision of peri-prosthetic infection following total elbow replacement
Erschienen: ACTA ORTHOPEDICA – November 2008
Autoren: Wolfram Steens, Goetz von Foerster, Alexander Katzer
Erschienen: Orthopädische Praxis – 41 / 2005
Autoren: A. Katzer, J. Gille, K. Seemann
Erschienen: The Journal of Bone & Joint Surgery - 2005
Autoren: A. Ince, K. Seemann, L. Frommelt, A. Katzer, J.F. Loehr
Weiterlesen … Onestage exchange shoulder arthroplasty for peri-prosthetic infection
Erschienen: Clinical Infectious Diseases – Januar 2005
Autoren: A. Ince, J. Rupp, L. Frommelt, A. Katzer, J. Gille, J.F. Löhr
Erschienen: Orthopedics – Dezember 2004
Autoren: Alexander Katzer, Frank Sickelmann, Klaus Seemann, Jochen F. Löhr
Weiterlesen … Two-Year Results After Exchange Shoulder Arthroplasty Using Inverse Implants
Erschienen: Biomaterials – Mai 2002
Autoren: A. Katzer, H. Marquardt, J. Westendorf, J.V. Wening, G. von Foerster
Weiterlesen … Polyetheretherketone - Cytotoxicity and mutagenicity in vitro
Autoren: Alexander Katzer, Wolf-Peter Niedermauntel, Corinna Haack, Jörg Rump
Weiterlesen … Mittelfristige Ergebnisse mit der CFP-Prothese
Autoren: R. Souffrant, R. Schubert, W. Steens, A. Katzer, W. Mittelmeier, R. Bader
Erschienen: In vivo - Juli 2011
Autoren: Andreas Burkandt, Alexander Katzer, Karlheinz Thaler, Volker von Baehr, Reinhard E. Friedrich, Wolfgang Rüther, Michael Amling, Jozef Zustin
Weiterlesen … Proliferation of the synovial lining cell layer in suggested metal hypersensitivity
Erschienen: Biology of Metals – Mai 2008
Autoren: Wolfram Steens, Alexander Katzer
Weiterlesen … Severe cobalt poisoning in endoprosthetic replacement of the hip
Autoren: Alexander Katzer, Michel Hahn, M. Niecke, B. Jobke, K. Püschel, G. Delling, Björn Busse
Erschienen: Der Orthopäde – September 2006
Autoren: W. Steens, J. F. Loehr, G. von Foerster, A. Katzer
Weiterlesen … Chronic cobalt poisoning in endoprosthetic replacement
Erschienen: Der Orthopäde – September 2006
Autoren: W. Steens, J. F. Loehr, G. von Foerster, A. Katzer
Weiterlesen … Chronische Kobaltvergiftung in der Endoprothetik
Erschienen: The Journal of Arthroplasty – Juli 2006
Autoren: Alexander Katzer, Akif Ince, Joachim Wodtke, Jochen F. Loehr
Weiterlesen … Component Exchange in Treatment of Periprosthetic Femoral Fractures
Erschienen: European Journal of Trauma – April 2006
Autoren: Alexander Katzer, Wolfram Steens, Akif Ince
Erschienen: Journal of Orthopaedics and Traumatology – Juli 2004
Autoren: A. Ince, A. Katzer, J. Gille, J. F. Löhr, P. Moubayed
Erschienen: Hüftchirurgie in der Praxis – Dezember 2005
Autoren: J.F. Löhr, A. Katzer
Erschienen: Toxicology – September 2003
Autoren: A Katzer, S. Hockertz, G. H. Buchhorn, J. F. Loehr
Weiterlesen … In vitro toxicity and mutagenicity of CoCrMo and Ti6Al wear particles
Erschienen: Toxicology – September 2003
Autoren: A Katzer, S. Hockertz, G. H. Buchhorn, J. F. Loehr
Weiterlesen … In-vitro-Toxizität und Mutagenität von CoCrMo und TiAl-Abriebpartikeln
Erschienen: Der Orthopäde 09/2003
Autoren: J F Loehr, N. Gschwend, B. R. Simmen, A. Katzer
Erschienen: Der Orthopäde – Juli 2003
Autoren: J. F. Loehr, N. Gschwend, B. R. Simmen, A. Katzer
Autoren: Alexander Katzer, Akif Ince, Joachim Wodtke, Jochen F. Loehr
Weiterlesen … Komponentenwechsel bei periprothetischen Femurfrakturen
Erschienen: Journal of Orthopaedics and Traumatology – März 2003
Autoren: A. Katzer, H.C. Moeller, J.V. Wening, K.H. Jungbluth
Erschienen: Journal of Orthopaedics and Traumatology – Januar 2003
Autoren: A. Katzer, J.F. Lœhr
Weiterlesen … Early loosening of hip replacements: Causes, course and diagnosis
Erschienen: Aktuelle Traumatologie – August 2002
Autoren: A. Katzer, R. Sellckau, W. Siemsen, G. von Foerster
Weiterlesen … Rotating Knee Total Prosthesis ENDO-Modell - A functional analysis
Erschienen: Archives of Orthopaedic and Trauma Surgery - Juli 2002
Autoren: Alexander Katzer, Norbert M. Meenen, Frederike Grabbe, Johannes Maria Rueger
Erschienen: Journal of Orthopaedics and Traumatology – Januar 2002
Autor: Alexander Katzer