Biomedical subjects

Kate Sutton

Publications and source records attributed to Kate Sutton.

4 recordsLinked to original sources

PubMed2005

Unicompartmental knee arthroplasty: troubleshooting implant positioning and technical failures.

Improvements to implant design and the advent of minimally invasive surgery have increased the popularity of unicompartmental knee arthroplasty. Minimally invasive techniques for implant placement can augment the unicompartmental knee arthroplasty procedure and allow for more rapid rehabilitation and return to activities of daily living. Nevertheless, new technologies are accompanied by learning curves and rediscovery of past mistakes. Unicompartmental knee arthroplasty tends to be more technically demanding than total knee arthroplasty, and complications occur with placement of unicompartmental knee devices. This article discusses proper and improper implantation techniques and provides technical guidance and suggestions for improving the outcomes of unicompartmental knee arthroplasty.

Arthroplasty, Replacement, Knee↗

PubMed2005

Five-year experience with Crossfire highly cross-linked polyethylene.

UNLABELLED: Our purpose was to compare the clinical wear performance of highly cross-linked (Crossfire) polyethylene with conventional (N2Vac) polyethylene total hip bearings. We implanted 56 hips (47 patients) with Crossfire acetabular bearing liners and compared their wear performance with 53 conventional polyethylene inserts. Wear and clinical data were collected retrospectively at a minimum 4-year and average 5-year followup. The linear femoral head penetration rate measured from plain radiographs was 0.055 mm/year +/- 0.022 mm/year for the Crossfire polyethylene and 0.138 mm/year +/- 0.073 mm/year for the control, a reduction of 60% for the Crossfire components. Calculated annual wear was 0.036 mm/year for the Crossfire components and 0.131 mm/year for the controls, a reduction of 72%. Radiographic review at most recent followup showed a reduction in erosive osteolytic lesions of the proximal femur for the Crossfire components compared with controls, also suggesting a reduction in debris release for the Crossfire components. Complications leading to revision were not seen in the Crossfire or control groups. These clinical findings suggest that this particular highly cross-linked polyethylene can provide wear reduction and an alternate bearing surface for active patient populations. LEVEL OF EVIDENCE: Therapeutic study, Level III (retrospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence.

Aged↗

PubMed2005

A titanium-encased alumina ceramic bearing for total hip arthroplasty: 3- to 5-year results.

UNLABELLED: We examined whether encasing the alumina ceramic total hip arthroplasty insert in a thin titanium sleeve would reduce significantly or eliminate insert chipping on impaction of the insert into the shell. We also compared results, including observations of osteolysis, of the Trident study group with those of the predecessor alumina bearing couple design to determine clinical improvement and radiographic stability. Beginning in October 1996, 328 alumina ceramic bearings were implanted by six surgeons in 316 patients as a part of a prospective, randomized United States Investigational Device Exemption three-arm study comparing an alumina ceramic bearing with a control bearing of cobalt-chromium on polyethylene. In September 1999, a fourth arm of the study (Trident) was added. The Trident insert was recessed within a thin titanium sleeve. At three to five years followup, osteolysis was found in 0% of the patients with the Trident insert and in 0.5% of the patients with an alumina bearing couple. At a mean followup of 4.2 years (range, 3-5 years) no ceramic chips, fractures, or ceramic bearing failures have occurred. Encasing the alumina ceramic insert in a titanium sleeve seems to have resolved the issue of insert chipping on impaction and supports the continued use of Trident bearings in relatively young patients. LEVEL OF EVIDENCE: Therapeutic study, Level II-1 (prospective comparative study-patients treated one way compared with a group of patients treated in another way at the same institution). See the Guidelines for Authors for a complete description of levels of evidence.

Aluminum Oxide↗

PubMed2005

Alumina ceramic bearings for total hip arthroplasty: five-year results of a prospective randomized study.

UNLABELLED: Three hundred twenty-eight ceramic bearings were implanted by six surgeons in 316 patients as a part of a prospective randomized US Investigational Device Exemption study comparing alumina ceramic bearings with cobalt chrome-on-polyethylene bearings. There was no difference between the control metal-on-polyethylene and the alumina bearing couple patient cohorts regarding demographics or clinical scores through 7 years. Revision for any reason occurred in 2.7% of the patients with alumina bearings and 7.5% of the control patients with polyethylene bearings. Osteolysis was found in 1.4% of the patients with alumina bearings and in 14.0% of the control patients. At an average followup of 5.0 years (range, 1-86 months) no ceramic fractures or ceramic bearing failures have occurred. Results of this study suggest that alumina ceramics perform as well as the metal-on-polyethylene in clinical scores, but the patients with ceramic bearings had fewer revisions and less osteolysis. These results lead us to think that this new alumina ceramic bearing provides a safe option for younger and more active patients. LEVEL OF EVIDENCE: Therapeutic study, Level I-1b (randomized controlled trial, no significant difference, but narrow confidence intervals). See the Guidelines for Authors for a complete description of levels of evidence.

Aluminum Oxide↗