Wear-caused failure of a polyethylene acetabular cup with associated granuloma. A case report.
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Biomedical subjects
Publications and source records attributed to W L Jaffe.
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A case of a dissociation of a metal-backed patellar component with a resultant metallic synovitis is presented. The mechanism of failure is discussed and an analysis of patellar component design is reviewed.
An acrylic-headed prosthesis was removed after 30 years and analyzed for material deterioration. Although the acrylic head showed some wear and minor corrosion of the cobalt-chromium stem was found, tissue responses were not significant, indicating that use of these materials is consistent with the long-time survival of a prosthesis.
This paper reviews a number of recent advances in understanding the evolution of the human foot. The foot has gradually changed from the grasping and clinging organ of early Eocene and Miocene primate ancestors to the specialized weightbearing structure of modern man. Recent studies have indicated that postcranial remains commensurate with the requirements of bipedal locomotion may have been present as far back as 3 1/2 million years ago in the forerunners of modern man known as the australopithecines. Subsequent modifications appear to be refinements to increase the efficiency of weight transmission in habitual bipedalism.
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Two cases of tenosynovial chondromatosis of the shoulder are presented, the literature on this rare lesion is reviewed, and the differential diagnosis, diagnosis, and treatment are discussed. Synovial chondromatosis is a benign monoarticular lesion. It may also be found in tendon sheaths de novo and secondary to local extension. The two cases presented show tenosynovial chondromatosis involving both the shoulder joint and extension into the bicipital groove.
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Passive film and accelerated corrosion tests were performed on both wrought AISI 316L stainless steel and wrought Vitallium (Haynes Stellite 25) Charnley Type cement restrictors. The morphology and incidence of corrosion at the wire-wire crevices and the methacrylate-metal crevices were determined by scanning electron microscopy. The results are interpreted in view of the previously-documented crevice corrosion susceptibility of these two alloys.
Two patients in whom corrosion failure of stainless steel implants occurred had the surgically removed implants subjected to metallurgic analysis. Both implants showed marked pitting corrosion and required removal due to adverse tissue reaction. Analysis of the failed implants showed them to be fabricated of alloys with a chemical composition that resulted in inferior corrosion resistance. A simple magnetic test is suggested to indicate this type of stainless steel.
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Marked bending prior to fatigue failure of the femoral component of a total hip arthroplasty points out the necessity for proper valgus placement of the prosthesis in the femoral shaft, especially in large active patients. This failure also indicates the need for limiting activities in such a patient.
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Laboratory measurement of the tensile forces on the plate fixation screws of the sliding hip nail demonstrated that most of the force is borne by the proximal three screws in an intertrochanteric fracture model. Testing of an intact femur, which simulate a healed femur, demonstrated a proximal shift of the screw forces. Four screws appear adequate for fixation if screw torque is controlled.