Main description:

Total joint arthroplasty is an effective surgical procedure for end-stage osteoarthritis of major joints with satisfactory long term clinical outcome. A large and growing number of arthroplasties are performed annually worldwide and a great number of orthopaedic surgeons are practicing arthroplasty surgery as their main surgical activity. The biological behavior of the bone-implant interface is crucial for the long term survival of the artificial joint. All factors which have a positive or negative effect on the interface are of great interest for those practicing arthroplasty surgery. Basic scientists and the industry are continuously searching for new implant fixation mechanisms and improved materials. There is an accumulation of a great amount of basic science data (both biological, material and mechanical) related to the incorporation or loosening of the bone-implant interface. However, basic science data does not always translate to satisfactory clinical application, and orthopaedic practitioners often wonder which piece of information is clinically useful. A further problem is that basic scientists often speak their own scientific language and may not fully appreciate common clinical practice needs. In this textbook the biological and mechanical mechanisms of implant incorporation and loosening will be presented. All new data concerning materials and methods for incorporation enhancement will be critically analyzed. Data useful for clinical application will be stressed. Orthopaedic Surgeons will find information which will improve their clinical practice and basic scientists will be helped to understand and appreciate clinical needs.

Contents:

Current evidence in designs and fixation surfaces in total hip arthroplasty (a brief overview).- Early and late mechanical stability of the cementless bone implant interface in total joint arthroplasty.- Cement- bone interface in total joint arthroplasty.- The implant cement interface in total hip arthroplasty.- Cobalt-Chrome porous coated implant-bone interface in total joint arthroplasty.- Titanium porous coated implant-bone Interface in Total Joint Arthroplasty.- Grit blasted implant bone interface in total joint arthroplasty Eduardo Garcia-Rey, Eduardo Garcia-Cimbrelo.- HA coated implant - bone interface in total joint arthroplasty.- Trabecular metal - bone interface in total joint arthroplasty.- Assessment of bone implant interface failure in total joint arthroplasty.- The biology of aseptic loosening.- Cement-bone interface in total joint revision arthroplasty.- Cementless fully porous coated implant-bone interface in revision total hip arthroplasty.- Cementless tapered fluted implant bone interface in revision total joint arthroplasty.- Bone-graft and implant-graft interface in total hip arthroplasty.- The effect of pharmacological agents on the bone implant interface.- Bone-implant interface in biofilm associated bone and joint infections.- Modular interfaces.- Local and distant reaction to metallic wear debris.- Bone-implant interface in spine surgery.- Bone-tendon and bone- ligament interface.- Bone implant interface in patients with neoplasmatic disease.