Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Iatrogenic Electrocautery Damage And Cellular-Based Corrosion Of Total Joint Arthroplasty Biomaterials, Kirsten Carol Miller

Theses and Dissertations (ETD)

Introduction. The number of patients undergoing a Primary Total Knee Arthroplasty (PTKA) has been increasing steadily each year. Of those PTKA patients, 20% report long-term pain and/or some functional deficit. Cobalt-Chromium-Molybdenum (CoCrMo) alloy is one of the most used materials in Total Joint Arthroplasty (TJA) implants due the material’s high strength, high corrosion resistance, and biocompatibility. The release of metal ions and potential occurrence of metallosis in TJA has been shown to be detrimental to the longevity of the implant. The mechanisms leading to this increase in metal ion concentrations have been up for debate, with some believing it is …

Failure Of Primary Total Knee Arthroplasty: Establishing A Baseline For Retrieval Analysis Using Well-Functioning Necropsy Specimens, Meredith Perkins

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) is an effective treatment for end-stage osteoarthritis of the knee. While many patients have positive functional and pain outcomes following primary TKA, a subset of patients have suboptimal outcomes, such as unexplained pain or aseptic loosening of the implant components necessitating revision of the index procedure. The understanding of the exact etiology of these suboptimal outcomes of primary TKA is in its infancy. In order to elucidate the etiology of failure in primary TKAs, a baseline for the factors contributing to arthroplasty failure and dissatisfaction must first be established. The purpose of this study …

Retrieval Analysis Of Necropsy Total Hip Replacements: Considerations Beyond The Implant, Julie Alyse Lowell

Theses and Dissertations (ETD)

Introduction. Total hip arthroplasty (THA) surgery is one of the most commonly performed and successful orthopedic procedures in the United States. More than 300,000 primary THAs and 40,000 revision THAs performed in the United States every year. While the need for revision surgeries can stem from a variety of causes, there have been, to the author’s knowledge, no studies attempting to correlate the concentrations of certain inflammatory cytokines to metal ion concentrations found in the tissue surrounding the implant, amount of polyethylene wear, or strength of the interface of the modular taper. The purpose of this study was to begin …

Determination Of The Functional Relationship Between Lumbar Lordosis And Pelvic Tilt, Casey Tyler Hebert

Theses and Dissertations (ETD)

Americans are undergoing spinal fusion surgery (SFS) at an ever increasing rate; in 2008 over 400,000 Americans underwent SFS with a national cost of approximately $33.9 billion. During SFS it is difficult for the surgeon to properly align the spine’s s-shape, as viewed from the patient’s side. Abnormal alignment of the spine then alters the position of the pelvis and hip joints, which may impact the function and hip contact patterns. Several studies have shown that patients with spinal pathology, such as arthritis, often have a coexisting hip pathology or subsequently develop hip pathology, and it is estimated that 18% …

Total Knee Arthroplasty Wear Is Caused By Malrotation And Excessive Laxity, Erik Woodard

Theses and Dissertations (ETD)

Total knee arthroplasty is a proven technique which combines specially designed components and surgical processes to treat cartilage degeneration and alleviate pain in arthritic knees. However, this technique is limited by component design and surgical precision. Due to these limitations, knee arthroplasty components will eventually wear out, causing rejection and necessitating the need for a replacement. For this reason, it would be beneficial to experts if the primary causes of this wear could be identified in order to minimize the number of replacements.

This study aims to determine if a correlation exists between instability of a knee joint and the …

Biomechanical Comparison Of Lumbar Disc Replacements, Peter Wong

Theses and Dissertations (ETD)

Surgical options for lumbar spinal disorders are rapidly expanding. One seemingly promising area is the lumbar disc replacement. Design specifications vary among the manufacturers based upon differing perceptions of ideal motion. Comparison studies are important in quantifying different features for future improvements but are currently lacking. The objective of this study was to compare the biomechanical properties of three currently available treatments: disc replacement with ProDisc-L, disc replacement with Maverick, and a pedicle screw fixation. It was hypothesized that structural designs differences of ProDisc-L and Maverick could be distinguished in both motion and loading patterns. It was also hypothesized that …

Kinematic Demands Of Nucleus Arthroplasty Technology, Elizabeth J. Sander

Theses and Dissertations (ETD)

Recent advancements in biomaterial technologies have fostered growth in alternative surgical procedures to fusion surgery for treatment of early stages of degenerative disc disease. One application of immediate interest is that of nucleus arthroplasty (NA). Novel materials are being developed to better match the nonlinear biomechanical properties of the native tissue. The effects of changing the motion segment unit (MSU) properties via surgery (nucleotomy) or placement of a nucleus arthroplasty material, changes the effort or work required to move the altered spine condition through a prescribed kinematic path relative to the intact spine condition. The closer the loading mechanics of …

Biomechanical Testing Of Two-Level Cervical Disc Arthroplasty, Laura J. Gilmour

Theses and Dissertations (ETD)

In vitro biomechanical studies comparing two-level cervical disc arthroplasty with two-level fusion were completed using an established cadaveric cervical spine model. Three conditions were tested: non-instrumented, instrumented with two-level fusion (C5-C6 and C6-C7), and instrumented with two-level arthroplasty (C5-C6, C6-C7) using the Prestige Low-Profile (Medtronic Sofamor Danek, Memphis TN) or ProDisc-C (Synthes Spine, West Chester PA) prosthetic disc. Specimens were tested non-destructively in physiologic flexion-extension, lateral bending, and axial rotation to an end-limit load of 3-Nm or 45o rotation. Rotations at the superior, implanted, and inferior motion segment units (MSU) of the instrumented conditions were normalized to the non-instrumented condition …