Patient and surgery related factors associated with fatigue type polyethylene wear on 49 PCA and DURACON retrievals at autopsy and revision

<p>Abstract</p> <p>Background</p> <p>Polyethylene wear is an important factor for longevity of total knee arthroplasty. Proven and suspicious factors causing wear can be grouped as material, patient and surgery related. There are more studies correlating design and/or biomaterial factors to in vivo wear than those to patient and surgery related factors. Many retrieval studies just include revision implants and therefore may not be representative. This study is aimed to correlate patient- and surgery- related factors to visual wear score by minimizing design influence and include both autopsy and revision implants. Comparison between the groups was expected to unmask patient and surgery-related factors responsible for wear.</p> <p>Methods</p> <p>The amount of joint side wear on polyethylene retrievals was measured using a modification of an established visual wear score. Fatigue type wear was defined as summation of the most severe wear modes of delamination, pitting and cracks. Analysis of patient and surgery related variables suspicious to cause wear included prospectively sampled patient activity which was measured by self reported walking capacity. Statistical analysis was done by univariate analysis of variance. Activity level and implantation time were merged to an index of use and correlated to the wear score.</p> <p>Results</p> <p>Wear score after comparable implantation time was significantly less in the autopsy group. Even so, fatigue type wear accounted for 84 and 93 % of total wear score on autopsy and revision implants respectively. A highly significant influence on wear score was found in time of implantation (p = 0.002), level of activity (p = 0.025) and inserts belonging to revision group (p = 0.006). No influence was found for the kind of patella replacement (p = 0.483). Body mass index and accuracy of component alignment had no significant influence on visual wear score. Fatigue-type wear in the medial compartment was closely correlated to the index of use in the autopsy (R²= 0.383) and the revision group (R²= 0.813).</p> <p>Conclusion</p> <p>The present study's finding of substantial fatigue type wear in both autopsy and revision retrievals supports the theory that polyethylene fatigue strength is generally exceeded in this type of prosthesis. Furthermore, this study correlated fatigue-type polyethylene wear to an index of use as calculated by activity over time. Future retrieval studies may use activity over time as an important patient related factor correlated to the visual wear score. When evaluating total knee arthroplasty routine follow up, the surgeon must think of substantial wear present even without major clinical signs.</p

Bitterness and astringency of flavan-3-ol monomers, dimers and trimers

International audienc

Histological and ultrastructural evaluation of Leeds-Keio ligament 20 years after implant: a case report

We were capable of undertaking a histological and ultrastructural evaluation of an intact Leeds-Keio ligament implanted 20 years ago to assess the neoligamentization process inside this artificial ligament. The histological evaluation disclosed a collagen fibrils orientation very close to the structure of a normal anterior cruciate ligament (ACL) where the collagen fibres are multidirectional [Strocchi et al. in J Anat 180(3):515-519, 1992]. On the other hand we found an unimodal distribution of collagen fibrils in the reconstructed ACL. This suggests that even at long-term follow-up stress exerts a variable influence. The multidirectional arrangement of collagen fibres resembles a normal ACL, but the unimodal distribution of fibrils is quite different from those seen in normal tendon and ligaments which tend to have a bimodal peak [Decker et al. in J Submicrosc Cytol Pathol 23:9-21, 1991; Strocchi et al. in J Anat 180(3):515-519, 1992]. Studies based on biopsy suffer from the potential weakness that the specimen may not have been representative of the entire prosthesis. Further long-term studies, possibly with the entire prosthesis and not only a biopsy, would highlight the behaviour and remodelling of this artificial ligament in greater detail and could be important for the development of future generations of artificial ligaments or tissue engineering ACL reconstruction

Photoreduction of Sm(3+) in nanocrystalline BaFCl

We demonstrate that exposure of nanocrystalline BaFCl:Sm3+ X-ray storage phosphor to blue laser pulses with peak power densities on the order of 10 GW/cm2 results in conversion of Sm3+ to Sm2+. This photoreduction is found to be strongly power-dependent with an initial fast rate, followed by a slower rate. The photoreduction appears to be orders of magnitude more efficient than that for previously reported systems, and it is estimated that up to 50% of the samarium ions can be photoreduced to the divalent state. The main mechanism is most likely based on multiphoton electron–hole creation, followed by subsequent trapping of the electrons in the conduction band at the Sm3+ centers. Nanocrystalline BaFCl:Sm3+ is an efficient photoluminescent X-ray storage phosphor with possible applications as dosimetry probes, and the present study shows for the first time that the power levels of the blue light have to be kept relatively low to avoid the generation of Sm2+ in the readout process. A system comprising the BaFCl:Sm3+ nanocrystallites embedded into a glass is also envisioned for 3D memory applications.Nicolas Riesen, Alexandre François, Kate Badek, Tanya M. Monro, and Hans Riese

Prison escape and its political imaginary in times of political crisis : Tunisia, 2011–2016

International audienceIn 2011, during and after the revolutionary events in Tunisia, over a third of the total prison population escaped. These widespread jailbreaks could have been a symbol of emancipation from an abusive state power; but in Tunisia they instead came to represent the threat of criminal destabilization, and rumors of conspiracies against the democratic movement. Beyond the anecdotal dimension of these unusual events, this chapter analyzes the changing meanings of mass prison escapes in times of political transition, as they can be interpreted as part of liberatory moves, or reframed in a security-oriented political imaginary fueling more punitive policies