Thesis (M.S.)--West Virginia University, 2002. / Title from document title page. Document formatted into pages; contains vii, 79 p. : ill. Includes abstract. Includes bibliographical references (p. 71-79).

As implant survival extends into the second and third decades focal osteolysis around cemented femoral components in total hip replacement is emerging as an important failure mechanism. Whilst the problem of focal osteolysis is well recognised, there are many aspects of its development which are poorly understood. The broad aim of this thesis is to try to provide some insights into how, why and where focal osteolysis develops around the cemented femoral component. There are broadly two sections to this thesis, chapters 2-5 present clinical and geometrical studies and chapters 6-10 a series of experimental studies. The aim of the first section was to establish what is observed in clinical practice, the aim of the second to try to explain these findings. A mid-term clinical study showed that focal osteolysis is more common with rough than polished stems that differed in no aspect other than their surface finish. Further studies established that focal osteolysis is probably always associated with defects in the cement mantle. These defects occur anteriorly at the mid-stem of the prosthesis and posteriorly at the component tip. The distribution of focal osteolysis and its strong association with cement mantle defects suggests the importance of the stemcement interface as a pathway for fluid and debris to reach the distal femur. However, at 15-25 years, osteolysis rarely develops with the polished Exeter stem even in the presence of confirmed defects in the cement mantle, suggesting that the stem seals the stem-cement interface against fluid and debris. In an attempt to explain the clinical findings a series of bench top experiments were undertaken. These studies showed that the behaviour of fluid and dye at the stemcement interface was significantly influenced by component surface finish. Bonded and debonded stem-cement interfaces of rough stems provided an incomplete barrier to fluid movement along this interface. In contrast, polished stems both bonded and debonded were able to provide a seal at the stem-cement interface. The seal at this interface was improved with component subsidence in the presence of rotational stability. It is believed that this thesis provides a rationale explanation for why focal osteolysis rarely develops around the Exeter stem in clinical practice. It also explains how, where, and why osteolysis develops around certain designs of cemented femoral components used in total hip replacement.

Thesis (MAppSc in Physiotherapy) -- University of South Australia, 1998

Thesis (MAppSc in Physiotherapy) -- University of South Australia, 1998

Thesis (MTech (Biomedical Sciences))--Cape Peninsula University of Technology, 2015. / Previous international studies have documented a marked variation in transfusion practice for Total Hip Replacement (THR) surgery. This is despite widespread dissemination of clinical guidelines for the use of blood products. The cost and potential wastage of blood products as well as concerns regarding patient care and outcomes are important drivers of optimal blood management. The aim of this study was to audit red cell product utilisation for THR surgeries at two tertiary referral hospitals.

No description available.

No description available.

Hip simulators are designed to reproduce the forces and motion patterns of normal walking. In vivo demands on total hip replacements, however, are varied and often more severe than normal walking conditions. It is these severe conditions that often lead to implant failure. This is clinically based research aimed at understanding some of the more severe conditions in hips and the effect that these have on the performance of the total hip replacement. The polyethylene liner can act as a pump in an acetabular component, forcing fluid and wear particles through the holes to the retroacetabular bone causing osteolysis. Ten patients were studied at revision surgery. Pressures were measured in retroacetabular osteolytic lesions while performing pumping manouvers with the hip. Two laboratory experiments were then designed to study pumping mechanisms in vitro. In patients with contained osteolytic lesions, fluid pressure fluctuations could be measured in the lesion in association with the pumping action. Patients with uncontained osteolytic lesions showed no such pressure fluctuations. In the laboratory we identified 3 distinct mechanisms whereby fluid can be pumped from the hip joint to the retroacetabular bone. These pumping effects could be mitigated by improved implant design. Loading of the femoral head against the edge of the acetabular component produces dramatically increased contact pressures particularly in hard-on-hard bearings. In an analysis of 16 retrieved ceramic-on-ceramic bearings we were able to characterise the mechanism of edge loading based on the pattern of edge loading wear on the bearing surface. Finally in a radiographic study of patients with squeaking ceramic-on-ceramic hips. Squeaking was found to be associated with acetabular component malposition. It seems that edge loading or impingement may be an associated factor in these cases.

Thesis (Ph. D.)--University of Hong Kong, 2006. / Title proper from title frame. Also available in printed format.

Thesis (Ph. D.)--West Virginia University, 2002. / Title from document title page. Document formatted into pages; contains xi, 95 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 85-92).