Search

In total hip prosthesis (THP), we have been using alumina ceramic femoral heads to reduce polyethylene debris and the modified cementing technique, which was named “interface bioactive bone cement (IBBC)” method to improve implant fixation. In this study, we investigated the long-term clinical performance of THPs with an alumina ceramic head and IBBC method. From 1986 to 1988, 285 joints (215 patients) were operated on by a senior surgeon, and 265 joints (192 patients) could be followed up. The presence of radiolucent lines, loosening, osteolysis and ultrahigh-molecular-weight polyethylene (UHMWPE) socket wear were observed. In IBBC, a radiolucent line appeared as a ’space’, and loosening appeared as a ’separation’ between the HA layer and the cement. A ‘space’ appeared in 3 joints (1.4%) on the acetabulum and in 4 joints (1.8%) on the femur, while a ‘separation’ appeared in 3 joints (1.4%) on the acetabulum. Osteolysis was noted in 1 joint (0.5%) on the acetabulum and in 2 joints (0.9%) on the femur. No revision surgery was required. In our previous study, we reported that the thickness of the socket affected its clinical wear rate and that the wear rate of sockets with an alumina ceramic head was 20% lower than that of sockets with a metal head. By reducing wear debris through the use of ceramic heads, osteolysis could be reduced. Long-term fixation of THPs to the bone has been achieved by using IBBC. Thus, the long-term clinical results of THPs with an alumina head that were fixed using IBBC were excellent.

Beta-tricalcium phosphate/carboxymethyl chitin composites [TCP/CMCh] of various ratios of TCP granules and CMCh were made and their mechanical properties, handling properties and repair performance for bone defects and for osteochondral defects were investigated. Water pooling ratio of CMCh was approximately 40 times the weight itself. TCP/CMCh of a higher TCP ratio had higher stress at 50%-strain. The stress at 50%-strain of TCP/CMCh with 0, 2.5, 5.0, 7.5, 10 TCP ratios was 0.12, 0.51, 1.08, 1.46, 1.67 (MPa, n=5), respectively. The TCP/CMCh with 5.0 TCP ratios had the best total scores in handling tests. The bone repair rate of TCP/CMCh was TCP ratio 2.5< Blank= TCP ratio 7.5< TCP ratio 5.0. In the implantation test for osteochondral defects, TCP/CMCh was completely absorbed at four weeks after surgery. Regeneration of the articular cartilage was seen with TCP/CMCh and HA/CMCh but not with TCP granules, which remained eight weeks after implantation. The regenerated articular cartilage had remained 32 weeks after implantation. In conclusion, it was demonstrated that this TCP/CMCh composite was a promising material for repairing osteochondral defects.