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Jan-Herman Kuiper

Publications and source records attributed to Jan-Herman Kuiper.

2 recordsLinked to original sources

Stereolithographic models for biomechanical testing.

Variable properties and limited availability are pitfalls in using cadaveric bones for implant stability tests. Artificial bones avoid these, but tailoring them to specific studies may be difficult. Stereolithography (SLA) techniques produce tailor-made bones with realistic geometries, but their lower Young's modulus might affect outcomes. We investigated whether implant stability and cortical strains with SLA made bones match those with stiffer artificial bones and, if not, whether a thicker cortex to compensate the lower modulus gives a better match. Tibial trays were cemented in place and cyclically loaded while determining cortical strain and tray migration. Permanent and cyclic migration of trays in both types of SLA model (range: 13-28 and 58-85 mum) was within the range of those in composite models (range: 4-62 and 51-105 microm). Strains more distally were approximately inversely proportional to the material stiffness and cortical thickness of the tibiae. We conclude this first study provides a strong indication for SLA tibiae as a valid model for the biomechanical assessment of new techniques in knee surgery and compare favourably with previously utilised models.

Bone Cements↗

Variables affecting initial stability of impaction grafting for hip revision.

Impaction grafting allows restoration of bone stock in hip revision, but there are reports of massive early subsidence. The aim of this study was to determine prognostic factors for stem and cup migration in a group of 56 consecutive patients followed up from 1 to 5 years. Cup and stem migration was correlated with 13 predictors including stem design, stem positioning, femoral anatomy, patient characteristics, and bone graft density. All migration occurred mainly during the first 3 months after surgery. Stem alignment changed by an average of 4.8 degrees . Fifty percent of the change in stem alignment was explained by four variables: age, femoral diameter, stem design, and density of the graft at the tip of the stem. Stem subsidence averaged 2.7 mm, and cup migration averaged 3.0 mm. None of the predictors explained the wide variation of migration of the cup or distal migration of the stem. It may be necessary to determine implant stability at the time of surgery.

Adult↗