Wear of highly crosslinked polyethylene acetabular components: a review of RSA studies

Background and purpose - Wear rates of highly crosslinked polyethylene (XLPE) acetabular components have varied considerably between different published studies. This variation is in part due to the different techniques used to measure wear and to the errors inherent in measuring the relatively low amounts of wear in XLPE bearings. We undertook a scoping review of studies that have examined the in vivo wear of XLPE acetabular components using the most sensitive method available, radiostereometric analysis (RSA). Methods - A systematic search of the PubMed, Scopus, and Cochrane databases was performed to identify published studies in which RSA was used to measure wear of XLPE components in primary total hip arthroplasty (THA). Results - 18 publications examined 12 primary THA cohorts, comprising only 260 THAs at 2-10 years of follow-up. The mean or median proximal wear rate reported ranged from 0.00 to 0.06 mm/year. However, differences in the manner in which wear was determined made it difficult to compare some studies. Furthermore, differences in RSA methodology between studies, such as the use of supine or standing radiographs and the use of beaded or unbeaded reference segments, may limit future meta-analyses examining the effect of patient and implant variables on wear rates. Interpretation - This scoping review confirmed the low wear rates of XLPE in THA, as measured by RSA. We make recommendations to enhance the standardization of reporting of RSA wear results, which will facilitate early identification of poorly performing implants and enable a better understanding of the effects of surgical and patient factors on wear.Stuart A Callary, Lucian B Solomon, Oksana T Holubowycz, David G Campbell, Zachary Munn, and Donald W Howi

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

Drink-driving in South Australia: the women's experience

O.T. Holubowyc

Alcohol-involved pedestrians: the Australian experience

Australian studies of alcohol involvement in pedestrian crashes are reviewed. The paper tabulates the results of these studies with respect to distribution of blood alcohol concentration (BAC), age and sex of intoxicated pedestrians, relationship between age and BAC among both males and females, time of day and day of week of crashes involving intoxicated pedestrians, pedestrian movement and pre-crash drinking patterns. Overall only seven studies were identified. These indicated that 20-30% of pedestrian casualties had a BAC in excess of 150 mg/dL, with alcohol involvement being greater among fatalities. Few of the seven studies presented results pertaining to the other factors listed above. Those that did found that males comprised 60-70% of casualties with a known BAC and 80-90% of those with a BAC exceeding 150 mg/dL. Crashes occurring at night or on weekends were most likely to involve intoxicated pedestrians. Intoxicated pedestrians were hit most commonly as they crossed a road some distance from a traffic control; in those instances where the site had a traffic control, it was rarely used correctly. The one study that reported pre-crash drinking behaviour of intoxicated pedestrians found that about two-thirds had been drinking beer and about one-half had been drinking in a hotel. The paper concludes that knowledge of the characteristics of alcohol-related pedestrian crashes in Australia is inadequate; recommendations are made to address these inadequacies.O.T. Holubowyczhttp://trove.nla.gov.au/work/2117963

Gamma glutamyltransferase activity. Blood alcohol concentration and suspension history of injured male drivers and riders

O.T. Holubowyc

An Australian study of alcohol dependence in women : the significance of sex role identity, life event stress, social support, and other factors / Oksana Tamara Holubowycz

Bibliography: leaves 540-587xxii, 587 leaves ; 30 cm.Thesis (Ph.D.)--University of Adelaide, 198

Legal limits of blood alcohol concentration (BAC) and road accidents in Australia

O. Holubowyc