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Angelo A Caputo - One of the best experts on this subject based on the ideXlab platform.
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Osseointegration enhanced by chemical etching of the titanium surface a torque removal study in the rabbit
Clinical Oral Implants Research, 1997Co-Authors: Perry R Klokkevold, Russell D Nishimura, Moriyasu Adachi, Angelo A CaputoAbstract:Roughened implant surfaces are thought to enhance Osseointegration. Torque removal forces have been used as a biomechanical measure of anchorage or Osseointegration in which the greater forces required to remove implants may be interpreted as an increase in the strength of Osseointegration. The purpose of this study was to compare the torque resistance to removal of screw shaped titanium implants having an acid etched (HC1/H2SO4) surface (Osseotite) with implants having a machined surface. Two custom screw shaped implants, 1 acid etched and the other machined, were placed into the distal femurs of 10 adult New Zealand White rabbits. These implants were 3.25 mm in diameter x 4.00 mm in length without holes, grooves or slots to resist rotation. Following a 2 month healing period, the implants were removed under reverse torque rotation with a digital torque measuring device. Two implants with the machined surface preparation failed to achieve Osseointegration. All other implants were found to be anchored to bone. Resistance to torque removal was found to be 4 x greater for the implants with the acid etched surface as compared to the implants with the machined surface. The mean torque values were 20.50 +/- 6.59 N cm and 4.95 +/- 1.61 N cm for the acid etched and machined surfaces respectively. The results of this study suggest that chemical etching of the titanium implant surface significantly increases the strength of Osseointegration as determined by resistance to reverse torque rotation.
Stephane Boisgard - One of the best experts on this subject based on the ideXlab platform.
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acetabular bone defects in tha revision reconstruction using morsellised virus inactivated bone allograft and reinforcement ring seven year outcomes in 95 patients
Orthopaedics & Traumatology-surgery & Research, 2017Co-Authors: Guillaume Villatte, Roger Erivan, G Salles, Bruno Pereira, M Galvin, Stephane Descamps, Stephane BoisgardAbstract:Abstract Background Acetabular cup loosening is among the main reasons for revision total hip arthroplasty (THA). The implantation of a cryopreserved morsellised bone allograft is a reference method for filling bone defects. However, the outcomes of bone grafts treated with viral inactivation and secured into the host bone (notably using a reinforcement device) are unclear. We therefore retrospectively reviewed cases of acetabular revision with morsellised bone allograft implanted into a reinforcement ring for acetabular revision to assess: (1) clinical survival of the acetabular implant (time to new revision with acetabular component removal), (2) radiological implant survival, (3) and bone graft Osseointegration evaluated using Oswestry's criteria. Hypothesis Virus-inactivated bone allografts provide similar outcomes to cryopreserved allografts. Material and methods From 2004 to 2009, 95 patients underwent acetabular revision. There were 60 (63%) females and 35 (37%) males with a mean age of 71.7 years (range: 44.2–90 years). Over 90% of patients had bone defects type 2 or higher in the AAOS classification. Each patient was evaluated after at least 5 years, by an examiner who had not been involved in the revision and who determined the Postel-Merle d’Aubigne (PMA) score and patient satisfaction. We assessed the clinical survival of the acetabular implant (time to new revision with acetabular implant removal), radiological implant survival (migration > 5 mm, active radiolucent line, failure of graft Osseointegration, or reinforcement ring failure), and allograft osteointegration evaluated using Oswestry's criteria. Results After a mean follow-up of 7 years (range: 5.2–10 years), 7 (7.4%) patients had been lost to follow-up and 3 (3.4%) had required surgical revision, after 3 to 73 months (for aseptic loosening in 2 cases and infection in 1 case). The estimated 10-year survival rate was 96.2% (95% confidence interval [95%CI]: 88.2–98.7). The mean PMA score at last follow-up had increased significantly, by 2.8 points (p Discussion In our population, allografts previously subjected to virus inactivation and implanted into a reinforcement ring produced outcomes similar to those reported previously with cryopreserved allografts. Level of evidence IV, retrospective case-series study.
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Acetabular bone defects in THA revision: Reconstruction using morsellised virus-inactivated bone allograft and reinforcement ring. Seven-year outcomes in 95 patients
Orthopaedics and Traumatology - Surgery and Research, 2017Co-Authors: Guillaume Villatte, Roger Erivan, G Salles, Bruno Pereira, M Galvin, Stephane Descamps, Stephane BoisgardAbstract:Background Acetabular cup loosening is among the main reasons for revision total hip arthroplasty (THA). The implantation of a cryopreserved morsellised bone allograft is a reference method for filling bone defects. However, the outcomes of bone grafts treated with viral inactivation and secured into the host bone (notably using a reinforcement device) are unclear. We therefore retrospectively reviewed cases of acetabular revision with morsellised bone allograft implanted into a reinforcement ring for acetabular revision to assess: (1) clinical survival of the acetabular implant (time to new revision with acetabular component removal), (2) radiological implant survival, (3) and bone graft Osseointegration evaluated using Oswestry's criteria. Hypothesis Virus-inactivated bone allografts provide similar outcomes to cryopreserved allografts. Material and methods From 2004 to 2009, 95 patients underwent acetabular revision. There were 60 (63%) females and 35 (37%) males with a mean age of 71.7 years (range: 44.2–90 years). Over 90% of patients had bone defects type 2 or higher in the AAOS classification. Each patient was evaluated after at least 5 years, by an examiner who had not been involved in the revision and who determined the Postel-Merle d’Aubigné (PMA) score and patient satisfaction. We assessed the clinical survival of the acetabular implant (time to new revision with acetabular implant removal), radiological implant survival (migration > 5 mm, active radiolucent line, failure of graft Osseointegration, or reinforcement ring failure), and allograft osteointegration evaluated using Oswestry's criteria. Results After a mean follow-up of 7 years (range: 5.2–10 years), 7 (7.4%) patients had been lost to follow-up and 3 (3.4%) had required surgical revision, after 3 to 73 months (for aseptic loosening in 2 cases and infection in 1 case). The estimated 10-year survival rate was 96.2% (95% confidence interval [95%CI]: 88.2–98.7). The mean PMA score at last follow-up had increased significantly, by 2.8 points (p < 0.05), to 13.8 (95%CI: 78.4–88.1). Of the 88 re-evaluated patients, 78 (89%) were satisfied or very satisfied. The overall radiological survival rate was 84.5% (95%CI: 78.4–88.1) after a mean of 5.9 years (range: 0.5–10). Allograft Osseointegration was satisfactory (Oswestry score ≥ 2) in 95.8% of patients. Discussion In our population, allografts previously subjected to virus inactivation and implanted into a reinforcement ring produced outcomes similar to those reported previously with cryopreserved allografts. Level of evidence IV, retrospective case-series study.
Perry R Klokkevold - One of the best experts on this subject based on the ideXlab platform.
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Osseointegration enhanced by chemical etching of the titanium surface a torque removal study in the rabbit
Clinical Oral Implants Research, 1997Co-Authors: Perry R Klokkevold, Russell D Nishimura, Moriyasu Adachi, Angelo A CaputoAbstract:Roughened implant surfaces are thought to enhance Osseointegration. Torque removal forces have been used as a biomechanical measure of anchorage or Osseointegration in which the greater forces required to remove implants may be interpreted as an increase in the strength of Osseointegration. The purpose of this study was to compare the torque resistance to removal of screw shaped titanium implants having an acid etched (HC1/H2SO4) surface (Osseotite) with implants having a machined surface. Two custom screw shaped implants, 1 acid etched and the other machined, were placed into the distal femurs of 10 adult New Zealand White rabbits. These implants were 3.25 mm in diameter x 4.00 mm in length without holes, grooves or slots to resist rotation. Following a 2 month healing period, the implants were removed under reverse torque rotation with a digital torque measuring device. Two implants with the machined surface preparation failed to achieve Osseointegration. All other implants were found to be anchored to bone. Resistance to torque removal was found to be 4 x greater for the implants with the acid etched surface as compared to the implants with the machined surface. The mean torque values were 20.50 +/- 6.59 N cm and 4.95 +/- 1.61 N cm for the acid etched and machined surfaces respectively. The results of this study suggest that chemical etching of the titanium implant surface significantly increases the strength of Osseointegration as determined by resistance to reverse torque rotation.
Rory Maguire - One of the best experts on this subject based on the ideXlab platform.
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Re-Osseointegration on previously contaminated surfaces : a systematic review
Clinical Oral Implants Research, 2009Co-Authors: Stefan Renvert, Ioannis Polyzois, Rory MaguireAbstract:Objectives: The aim of this review was to search the literature for the existing evidence of re-Osseointegration after treatment of peri-implantitis at contaminated implant surfaces. Material and Methods: A search of PubMed as well as additional hand search of articles were conducted. Publications and articles accepted for publication up to November 2008 were included. Results: A total of 25 animal studies fulfilled the inclusion criteria for this review. Access surgery with closed healing has been observed to positively influence the rate of re-Osseointegration when compared with non-surgical decontamination of the implant surface with open healing. Open debridement including surface decontamination may result in re-Osseointegration and this integration was more pronounced on rougher than on smooth implant surfaces. The adjunctive use of regenerative procedures resulted in varying amounts of re-Osseointegration. Conclusions: Re-Osseointegration is possible to obtain on a previously contaminated implant surface and can occur in experimentally induced peri-implantitis defects following therapy. The amount of re-Osseointegration, varied considerably within and between studies. Implant surface characteristics may influence the degree of re-Osseointegration. Surface decontamination alone can not achieve substantial re-Osseointegration on a previously contaminated implant surface. No method predictably accomplished complete resolution of the peri-implant defect.
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Re-Osseointegration on previously contaminated surfaces: a systematic review.
Clinical oral implants research, 2009Co-Authors: Stefan Renvert, Ioannis Polyzois, Rory MaguireAbstract:The aim of this review was to search the literature for the existing evidence of re-Osseointegration after treatment of peri-implantitis at contaminated implant surfaces. A search of PubMed as well as additional hand search of articles were conducted. Publications and articles accepted for publication up to November 2008 were included. A total of 25 animal studies fulfilled the inclusion criteria for this review. Access surgery with closed healing has been observed to positively influence the rate of re-Osseointegration when compared with non-surgical decontamination of the implant surface with open healing. Open debridement including surface decontamination may result in re-Osseointegration and this integration was more pronounced on rougher than on smooth implant surfaces. The adjunctive use of regenerative procedures resulted in varying amounts of re-Osseointegration. Re-Osseointegration is possible to obtain on a previously contaminated implant surface and can occur in experimentally induced peri-implantitis defects following therapy. The amount of re-Osseointegration, varied considerably within and between studies. Implant surface characteristics may influence the degree of re-Osseointegration. Surface decontamination alone can not achieve substantial re-Osseointegration on a previously contaminated implant surface. No method predictably accomplished complete resolution of the peri-implant defect.
C. Engh - One of the best experts on this subject based on the ideXlab platform.
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RADIOGRAPHIC SIGNS OF Osseointegration IN POROUS-COATED ACETABULAR COMPONENTS
2008Co-Authors: J. Mcauley, M. Moore, A. Young, C. EnghAbstract:Purpose: Radiographic signs of Osseointegration have been well established for cementless femoral components, but not for cementless acetabular components. At our institution using principles similar to those applied to cementless femoral components, we have observed apparent radiographic signs of Osseointegration of porous-coated cups. We then hypothesized that these signs could be used to predict bone ingrowth of porous-coated acetabular components Methods: In a series of 119 total hip arthroplasties with porous-coated cementless cups, we reviewed post-primary and prerevision serial radiographs and proposed five radiographic signs for detecting Osseointegration of a porous-coated acetabular component: absence of radiolucent lines, presence of a superolateral buttress, medial stress shielding, radial trabeculae, and an infero-medial buttress. We compared the predictability of each sign to intraoperative findings of cup stability and measured the sensitivity, specificity, and intra-observer agreement of each sign Results: . In our population, ninety-eight cups had three to five radiographic signs of Osseointegration; of these, ninety-five cups (97%) were found to be bone-ingrown at the revision operation. Conversely, twelve cups had only one or no sign; of these, ten (83%) were clinically unstable at the revision operation. Conclusions: We concluded these five, readily detectable signs of acetabular Osseointegration are very useful in predicting acetabular component stability found at surgery.
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Radiographic signs of Osseointegration in porous-coated acetabular components.
Clinical Orthopaedics and Related Research, 2006Co-Authors: Milan S Moore, James P. Mcauley, Anthony M. Young, C. EnghAbstract:UNLABELLED There currently is no direct method to radiographically determine Osseointegration of an uncemented, porous-coated acetabular component. We defined five radiographic signs for detecting acetabular Osseointegration: (1) absence of radiolucent lines; (2) presence of a superolateral buttress; (3) medial stress-shielding; (4) radial trabeculae; and (5) an inferomedial buttress. We assessed their ability to predict acetabular Osseointegration by reviewing the postprimary and prerevision radiographs from a series of 119 total hip arthroplasties that had revision surgery. Each sign had a high positive predictive value for the presence of bone ingrowth (range, 92.2-96.3%). The absence of radiolucent lines, presence of superolateral buttresses, and presence of medial stress-shielding were the most sensitive signs for indicating bone ingrowth. Ninety-seven percent of the cups with three to five signs were bone ingrown, whereas 83% of the cups with one or no signs were unstable. When three or more signs were present, the positive predictive value of the radio-graphic test was 96.9%, the sensitivity was 89.6%, and the specificity was 76.9%. The five signs of acetabular Osseointegration reliably predicted Osseointegration, especially when used in combination. They can be used as a tool for radio-graphically assessing the status of patients with porous-coated uncemented cups. LEVEL OF EVIDENCE Diagnostic study, Level III (Study of nonconsecutive patients; without consistently applied reference "gold" standard). See the Guidelines for Authors for a complete description of levels of evidence.
