Biomedical subjects

Bertram Barden

Publications and source records attributed to Bertram Barden.

4 recordsLinked to original sources

PubMed2005

The decrease of particle-induced osteolysis after a single dose of bisphosphonate.

The most common cause of implant failure in joint replacement is aseptic loosening due to particle-induced osteolysis. Bisphosphonates have been shown to be effective against particle-induced osteolysis when administered daily. We investigated the effect of a single subcutaneous dose of a more potent third generation bisphosphonate on particle-induced osteolysis. We utilized the murine calvaria osteolysis model in C57BL/J6 mice. Bone resorption was measured as resorption within the midline suture using Giemsa staining. Twenty-eight mice were used, seven per group. Seven animals were treated with a single dose of zoledronic acid (ZA) directly after surgery and seven animals were treated four days postoperatively. For statistical analysis one-way ANOVA and a Student's t-test were used. Bone resorption was 0.26+/-0.09 mm(2) in animals with particle implantation, 0.14+/-0.05 mm(2) in animals with particle implantation and ZA treatment directly after surgery (p = 0.0047), and 0.15+/-0.05 mm(2) in animals with particle implantation and ZA treatment on the fourth postoperative day (p = 0.006). In conclusion, particle-induced bone resorption was markedly decreased by a single s.c. dose of a third generation bisphosphonate. This important new finding holds great promise, because single dose treatment of particle-induced osteolysis may reduce side effects compared to repeated application of bisphosphonates.

Animals↗

PubMed2004

Rotating platform components for revisions of hinged knee prostheses.

If hinged prostheses are revised with smaller and nonhinged prostheses, do these implants provide adequate fixation, do massive bone grafts in combination with smaller implants reinforce host bone stock, do less constrained prostheses restore ligament tension, and do they avoid problems of the extensor mechanism? To answer these questions, 20 failed hinges were revised to rotating platform revision prostheses with short intramedullary stems in a prospective study. Meticulous soft tissue release techniques and extensive bone grafts were used (tibia, impaction grafting in 16 cases, and structural grafts in four cases; femur, impaction grafting in four cases and structural grafts in 16 cases). The mean followup was 5.3 years (range, 2.3-10.5 years). The Knee Society score improved from a preoperative mean of 21 points (range, 7-49 points) to a mean 81.2 points (range, 59-94 points). One cementless tibial component with extensive impaction grafting became loose. The remaining components (95%) were well-fixed. All cancellous bone grafts showed trabecular remodeling. All structural grafts united to the host bone without resorption. All knees had ligamentous stability after surgery. There were no problems of the extensor mechanism. In this series the rotating platform revision prostheses were used successfully for failed hinged prostheses.

Adult↗

PubMed2004

The diagnostic value of digital subtraction arthrography and radionuclide arthrography in revision total hip arthroplasty.

An analysis of plain radiographs, digital subtraction arthrography, and radionuclide arthrography was performed in 25 revision hip arthroplasties to evaluate the efficacy and usefulness of these methods in the diagnosis of loosening. The findings by each method were compared with intraoperative assessment of the status of components and expressed in terms of sensitivity, specificity, and predictive accuracy. Overall accuracy for the acetabular component by plain radiographs was 80%; by digital subtraction arthrography, 88%; by radionuclide arthrography, 68%. Overall accuracy for the femoral component by plain radiographs was 92%; by digital subtraction arthrography, 84%; radionuclide arthrography, 76%. We consider subtraction arthrography and radionuclide arthrography to be adjuvant diagnostic tools which may be indicated in individual cases of suspected implant loosening of total hip arthroplasty. The routine use of these two methods is not warranted when compared to plain radiographs.

Arthrography↗

PubMed2003

Strut allografts for failed treatment of periprosthetic femoral fractures: good outcome in 13 patients.

Strut allografts are not recommended after a femoral shaft exposure, because they may endanger the femoral blood supply. Up till now, we have seen no clinical reports on this problem. We treated 13 consecutive patients with very large anteromedial and anterolateral femoral strut allografts to restabilize periprosthetic fractures which had become loose after a previous attempt at surgical fixation (Vancouver type B fractures with severe bone loss). In 8 cases, the stem was revised in conjunction with the use of strut allografts and in 5 cases, strut allografts alone were used. All refractures and nonunions healed without further treatment. At a mean follow-up of 3 (1.2-7) years, the mean Harris Hip Score was 78 (65-92). All strut grafts showed ingrowth with augmentation of periprosthetic bone on the radiographs. There were 3 complications, 1 nonprogressive subsidence of a revision stem (fibrous stable), 1 deep hematoma and 1 partial lesion of the sciatic nerve. In this series, strut grafts gave reliable healing with augmentation of the host bone stock despite previous femoral exposure, severe bone loss, adverse type of fracture, and persistent instability at the index operation.

Aged↗