Periprosthetic osteolysis after total hip replacement: molecular pathology and clinical management

Periprosthetic osteolysis is a serious complication of total hip replacement (THR) in the medium to long term. Although often asymptomatic, osteolysis can lead to prosthesis loosening and periprosthetic fracture. These complications cause significant morbidity and require complex revision surgery. Here, we review advances in our understanding of the cell and tissue response to particles produced by wear of the articular and non-articular surfaces of prostheses. We discuss the molecular and cellular regulators of osteoclast formation and bone resorptive activity, a better understanding of which may lead to pharmacological treatments for periprosthetic osteolysis. We describe the development of imaging techniques for the detection and measurement of osteolysis around THR prostheses, which enable improved clinical management of patients, provide a means of evaluating outcomes of non-surgical treatments for periprosthetic osteolysis, and assist in pre-operative planning for revision surgery. Finally, there have been advances in the materials used for bearing surfaces to minimise wear, and we review the literature regarding the performance of these new materials to date.Donald W. Howie, Susan D. Neale, David R. Haynes, Oksana T. Holubowycz, Margaret A. McGee, Lucian B. Solomon, Stuart A. Callary, Gerald J. Atkins, David M. Findla

Stories and gesture: Redundant and non-redundant gesture use in narrative comprehension

Theoretical thesis.Bibliography: pages 54-58.Introduction -- Method -- Results -- Discussion -- Gesture redundancy on children's narrative comprehension -- Narrative comprehension -- Conclusion.Teachers naturally produce hand gestures when they teach. While there is evidence for gesture effectiveness when teaching mathematics and conservation, there has been limited research investigating the role of co-speech gestures on narrative comprehension. Specifically, the redundancy of the gesture with the associated speech content has been underexplored in this area. This study investigated the role that iconic and deictic, redundant and non-redundant hand gestures had on children's comprehension. The 129 3 to 5-year-old children who participated in the study watched a video of a narrated story. The narration was accompanied by either iconic, deictic or no gestures which were redundant or non-redundant to the story content. Participants were asked both a free recall and cued recall questions relevant to the narrative. Observing gesture facilitated comprehension as measured by free recall but not cued recall. However, the interaction between gesture type and gesture redundancy was not significant. Although children's individual language levels were positively associated with recall, there was also no observed interaction between gesture type, gesture redundancy and language ability. Results were unable to conclusively support one mechanism for the facilitative effect of gesture, findings tentatively supported the dual coding theory, the interactive contribution hypothesis and the attentional hypothesis.1 online resource (ix, 75 pages) colour illustration

Cognitive function and young drivers: The relationship between driving, attitudes, personality and cognition

Young drivers (aged 17–25 years) are the highest risk age group for driving crashes and are over-represented in car crash statistics in Australia. A relationship between cognitive functioning and driving in older drivers (60 years and older) has been consistently supported in previous literature, however, this relationship has been neglected in research regarding younger drivers. The role of cognitive functioning in young people’s driving was investigated both independently and within a current model of younger peoples driving performance. With young drivers as participants, driving behaviour, attitudes, personality and cognitive functioning were tested and driving performance was operationalised through two measures on a driving simulator, speeding and lane deviations. Cognitive functioning was found to contribute to driving behaviour, along with driving attitudes and personality traits, in accounting for young people’s driving performance. The young drivers who performed better on cognitive functioning tasks engaged in less speeding behaviour and less lane deviation on the driving simulator than those who performed worse on these tasks. This result was found independent of the role of driving behaviour, driving attitudes and personality traits, accounting for unique variance in driving ability

The influence of total hip arthroplasty metallurgy on migration: A RSA study.

Third generation alumina-on-alumina ceramic bearings in cementless total hip arthroplasty in patients 55 years and younger: A 10 year follow-up

The histological and elemental characterisation of corrosion particles from taper junctions

© 2016 Munir et al. Objectives: This study aimed to characterise and qualitatively grade the severity of the corrosion particles released into the hip joint following taper corrosion. Methods: The 26 cases examined were CoC/ABG Modular (n = 13) and ASR/SROM (n = 13). Blood serum metal ion levels were collected before and after revision surgery. The haematoxylin and eosin tissue sections were graded on the presence of fibrin exudates, necrosis, inflammatory cells and corrosion products. The corrosion products were identified based on visible observation and graded on abundance. Two independent observers blinded to the clinical patient findings scored all cases. Elemental analysis was performed on corrosion products within tissue sections. X-Ray diffraction was used to identify crystalline structures present in taper debris. Results: The CoC/ABG Modular patients had a mean age of 64.6 years (49.4 to 76.5) and ASR/SROM patients had a mean age of 58.2 years (33.3 to 85.6). The mean time in situ for CoC/ABG was 4.9 years (2 to 6.4) and ASR/SROM was 6.1 years (2.5 to 8.1). The blood serum metal ion concentrations reduced following revision surgery with the exception of Cr levels within CoC/ABG. The grading of tissue sections showed that the macrophage response and metal debris were significantly higher for the ASR/SROM patients (p < 0.001). The brown/red particles were significantly higher for ASR/SROM (p < 0.001). The taper debris contained traces of titanium oxide, chromium oxide and aluminium nitride. Conclusion: This study characterised and qualitatively graded the severity of the corrosion particles released into the hip joint from tapers that had corrosion damage