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Biologic Fixation of Total Hip Implants by Charles R. Bragdon, Murali Jasty, Meridith Greene, Harry E. Rubash, and William H. Harris J Bone Joint Surg.

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Presentation on theme: "Biologic Fixation of Total Hip Implants by Charles R. Bragdon, Murali Jasty, Meridith Greene, Harry E. Rubash, and William H. Harris J Bone Joint Surg."— Presentation transcript:

1 Biologic Fixation of Total Hip Implants by Charles R. Bragdon, Murali Jasty, Meridith Greene, Harry E. Rubash, and William H. Harris J Bone Joint Surg Am Volume 86(suppl 2):105-117 December 1, 2004 ©2004 by The Journal of Bone and Joint Surgery, Inc.

2 Different types of porous surfaces available for biologic ingrowth. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

3 The canine surface-replacement model. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

4 Undecalcified histologic section of a specimen with a titanium fiber-mesh porous surface, showing uniformly excellent bone ingrowth (Sanderson's rapid bone stain, with acid fuchsin counterstain, ×2). Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

5 The effect of pore size, apposition, and weight-bearing stresses on bone ingrowth. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

6 The gaps between the porous coating and the host bone were predominantly filled with dense fibrous tissue. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

7 An example of the hemispherical acetabular components with central holes for screw fixation. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

8 A straight-stem, proximally porous-coated femoral component. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

9 Quantitative measurements of bone growth into sphere and mesh coatings. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

10 In implants that were subjected to 0 μm of motion, bone growth occurred into the porous coating with areas of fibrous tissue observed only close to the solid substrate. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

11 Histological examination of the implants that had been subjected to 40 μm of motion showed evidence of fibrocartilage, in some cases at the bone-implant interface (Sanderson's rapid bone stain with acid fuchsin counterstain ×400). Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

12 With 150 μm of interface motion, the bone within the porous layer was separated from the host bone by a layer of fibrous tissue. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

13 Quantitative measurements of bone ingrowth into composite and control stems. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

14 Quantitative measurements of bone ingrowth in control and alendronate-treated animals. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

15 Histological section demonstrating the intimate association between the coating and the bone. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

16 Contact radiograph of an rhBMP-2/BSM-treated component, showing extensive bone-bridging of the defect. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

17 Scanning electron microscopic image of the gap region of a BSM-treated component, showing the formation of some new bone and partial retention of the carrier paste, as denoted by the arrows, at twelve weeks. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

18 Histologic section from an rhBMP/BSM-treated specimen, showing osteoclastic resorption (A) and osteoblastic bone formation (B) around a remnant of the carrier deep in the porous layer. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

19 Contact radiograph showing de novo bone formation in the uncovered region of the porous coating (arrow) of a rhBMP/BSM-treated specimen. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

20 Quantitative measurements of bone ingrowth in the control, BSM, and rhBMP/BSM groups. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

21 Extensive bone growth occurred into the tantalum trabecular metal surface under the gap region at twelve weeks. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

22 Contact radiograph of a tantalum trabecular metal section, showing bone-bridging of the gap. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.

23 A histologic section from the gap area in a trabecular metal specimen. Charles R. Bragdon et al. J Bone Joint Surg Am 2004;86:105-117 ©2004 by The Journal of Bone and Joint Surgery, Inc.


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