Biomedical subjects

Y Matsusue

Publications and source records attributed to Y Matsusue.

At least 19 recordsLinked to original sources

PubMed2003

Decrease in serum nucleotide pyrophosphatase activity in ankylosing spondylitis.

OBJECTIVE: Ankylosing spondylitis (AS) is a prototype of a group of rheumatic diseases referred to as spondyloarthropathy. AS patients show marked ectopic ossification in the spine, occasionally resulting in so-called bamboo spine. Although a strong association with HLA-B27 has been reported, its aetiology remains undetermined. Another rheumatic disease, ossification of the posterior longitudinal ligament of the spine (OPLL), demonstrates ectopic ossification of the spinal ligaments very similar to that of AS. Recently, nucleotide pyrophosphatase (NPPS) was implicated in the aetiology of OPLL: an Npps mutation was found to cause OPLL in mice, and an association between a polymorphism of the human NPPS gene and OPLL was identified. The clinical similarities between AS and OPLL led us to hypothesize that NPPS may also be implicated in the aetiology of AS. To elucidate the role of NPPS in the pathogenesis of AS, we examined serum NPPS activity and the possible association of the NPPS gene with AS. METHODS: Forty-four Japanese patients with AS, 43 patients with OPLL, and age- and sex-matched normal volunteers took part in this study. We determined serum NPPS activity using high-performance liquid chromatography and examined the association between AS and NPPS using single nucleotide polymorphisms (SNPs) of the NPPS gene. RESULTS: Serum NPPS activity in AS patients was significantly decreased compared with the controls (P < 0.0001). However, there was no association between AS and NPPS gene SNPs. CONCLUSION: NPPS is implicated in the pathogenesis of AS.

Adult↗

PubMed2003

Cytokine production in the infrapatellar fat pad: another source of cytokines in knee synovial fluids.

BACKGROUND: Recent studies have shown that adipose tissue is an endocrine organ that releases various cytokines. OBJECTIVE: To investigate the production of growth factors and proinflammatory cytokines in infrapatellar fat pad specimens. METHODS: Infrapatellar fat pad tissues were obtained from patients during knee surgery. Protein levels of basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), tumour necrosis factor (TNF)alpha, and interleukin (IL)6 in homogenised tissues were measured by an enzyme immunoassay. Gene expressions for those cytokines were examined by reverse transcription-polymerase chain reaction (RT-PCR). Localisation of bFGF and VEGF was evaluated by immunohistochemistry and in situ hybridisation. RESULTS: Infrapatellar fat pads were found to contain various protein levels of bFGF, VEGF, TNF alpha, and IL6. Further, gene expressions for these cytokines were detected by RT-PCR. Immunohistochemistry and in situ hybridisation showed that the expressions of both bFGF and VEGF were localised in immature adipocytes, interstitial undifferentiated mesenchymal cells, and vascular endothelial cells. CONCLUSION: The production of bFGF, VEGF, TNF alpha, and IL6 in the infrapatellar fat pad was demonstrated. Although synovial cells and articular chondrocytes are thought to be primary sources of cytokines found in knee synovial fluids, the results suggest that they may also originate from this fat pad.

Adipose Tissue↗

PubMed2002

Effects of serotonin 1A agonist on acute spinal cord injury.

STUDY DESIGN: We evaluated the effects of serotonin (5-HT) agonists on in vitro models of spinal cord compressive injury. Evoked potentials in injured rat spinal cords (n=24) were recorded during perfusion with 5-HT agonists. OBJECTIVES: To evaluate the therapeutic effects of 5-HT agonists on the recovery of compound action potentials in injured spinal cords. METHODS: Rat dorsal columns were isolated, placed in a chamber, and injured by extradural compression with a clip. Conducting action potentials were activated by supramaximal constant current electrical stimuli and recorded during perfusion with 5-HT agonists and antagonists. RESULTS: After inducing compression injuries, mean action potential amplitudes were reduced to 33.9+/-5.4% of the pre-injury level. After 120 min of perfusion with Ringer's solution, the mean amplitudes recovered to 62.8+/-8.4% of the pre-injury level. At a concentration of 100 micro M, perfusion with tandospirone (a 5-HT1A agonist) resulted in a significantly greater recovery of mean action potential amplitudes at 2 h after the injury (86.2+/-6.9% of pre-injury value) as compared with the control Ringer's solution (62.8+/-8.4% of pre-injury value, P<0.05). In contrast, quipazine (a 5-HT2A agonist) accelerated the decrease of amplitude (54.5+/-11.7% of pre-injury value). 5-HT1A and 5-HT2A agonist did not consistently alter latencies of the action potentials. CONCLUSION: The 5-HT1A receptor agonist was effective for the recovery of spinal action potential amplitudes in a rat spinal cord injury model.

Action Potentials↗

PubMed2002

Articular cartilage degradation and de-differentiation of chondrocytes by the systemic administration of retinyl acetate-ectopic production of osteoblast stimulating factor-1 by chondrocytes in mice.

OBJECTIVE: Vitamin A derivatives are widely used therapeutic agents for the treatment of dermatological and rheumatological disorders. Long-standing administration of these drugs, in turn, causes skeletal changes including ossification of ligaments, premature fusion of epiphyses and abnormalities of modeling. Recent in vitro experiments have further suggested that retinoid treatment of cultured chondrocytes may cause apoptotic cell death. The present study aims to address detailed cartilage changes associated with in vivo administration of vitamin A derivatives. METHODS: Retinyl acetate was administrated to experimental mice, C3H-Heston, for more than 12 months. Modified morphometry on the articular cartilage and fluorescent labeling of the subchondral bone were carried out to address the changes in the articular cartilage and subchondral bone. In order to address the detailed chondrocytes phenotypes, electron microscopy was carried out. Since findings of these studies suggested that biological properties of the cartilage matrix might be altered, the present study also immunolocalized functional matrix molecules, type I collagen and osteoblast-stimulating factor-1 (OSF-1). RESULTS: Histomorphometry demonstrated that retinoid administration lead to progressive atrophy of the articular cartilage with concomitant proliferation of subchondral bone. Furthermore, detailed light and electron microscopy suggested that the subchondral bone proliferates into the degenerating cartilage. The affected articular cartilage also resembled that of osteoarthritis in terms of ectopic type I collagen production. Furthermore, the affected articular cartilage produced a developmentally regulated matrix molecule, osteoblast-stimulating factor-1 (OSF-1) that is normally expressed in both the fetal cartilage and the epiphyseal growth plate cartilage but not in the articular cartilage. CONCLUSION: The present results indicate that the systemic retinoid administration may alter the biological properties of the articular cartilage.

Adjuvants, Immunologic↗

PubMed2001

Arthroscopic osteochondral autograft transplantation for chondral lesion of the tibial plateau of the knee.

Arthroscopic osteochondral autograft transplantation is often used to treat chondral/osteochondral lesions of the femoral condyle of the knee. However, arthroscopic autologous osteochondral grafting to the tibial plateau has not been reported. We report the surgical technique and the clinical course of a patient who underwent engraftment by this method. A 26-year-old man developed symptoms of pain and catching in his knee. Arthroscopy revealed a deep chondral lesion, 10 x 15 mm in size, down to the subchondral bone on the posterocentral area of the lateral tibial plateau. The injured cartilage was debrided using a curette and an abrader until normal healthy cartilage bordered the debrided defect. An osteochondral plug, 10 mm in diameter and 20 mm long, the chondral surface of which was orientated 25 degrees obliquely, was harvested from the most peripheral and proximal part of the lateral patellar groove. A bony hole was created in the center of the defect through the tibia using a core reamer. The osteochondral plug was inserted from the tibial window through the bony hole. To enhance the stability of the osteochondral fragment, bioactive ceramic fillers were used to fill the space below the plug. A second-look arthroscopy 10 months after surgery showed that the grafted osteochondral plug was well adapted and integrated into the surrounding cartilage on the lateral tibial plateau.

Adult↗

PubMed2001

Bridging a peripheral nerve defect using collagen filaments.

We describe bridging a peripheral nerve defect using collagen filaments instead of a tube. Cords of collagen filaments were grafted to bridge 20-mm defects of rat sciatic nerves. Nerve autografts were grafted as the control. The mean number and the mean fiber diameter of regenerated myelinated axons were approximately 4,800 and 3.3 microm, respectively, in the distal end of the nerve autograft and approximately 5,500 and 2.3 microm, respectively, in the distal end of the collagen-filaments nerve guide 8 weeks after surgery. The mean number and the mean fiber diameter of regenerated myelinated axons were approximately 6,900 and 3.1 microm, respectively, in the distal end of the nerve autograft and approximately 6,300 and 3.3 microm, respectively, in the distal end of the collagen-filaments nerve guide 25 weeks after surgery. Histologic studies suggested that the collagen filaments guided regenerating axons effectively. This new procedure offers a possible solution for the need to sacrifice a healthy nerve and for the shortage of graft material available for the repair of severed nerves.

Animals↗

PubMed2000

Histomorphometric study on high-strength hydroxyapatite/poly(L-lactide) composite rods for internal fixation of bone fractures.

The purpose of this study was to investigate the bone-implant interface of high-strength hydroxyapatite (HA)/poly(L-lactide) (PLLA) composite rods. As reinforcing particles, two types of HA particles-calcined HA (c-HA) and uncalcined HA (u-HA)-were applied to allow comparison of their suitability as bioactive fillers. Four types of composites (c-HA30, c-HA40, u-HA30, and u-HA40), which contained 30 or 40% by weight of each HA particle, were used. Unfilled PLLA rods were used as controls. A hole was drilled in the distal femora of 50 rabbits, and a composite or unfilled PLLA rod was implanted in a press-fit manner. Two, 4, 8, and 25 weeks after implantation, the samples were examined histologically by light microscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). An image analyzer was used for histomorphometric analysis of the bone-implant interface. An affinity index was calculated for each material; this was the length of bone directly apposed to the rods expressed as a percentage of the total length of the rod surface. In all the composites, histologic examination showed new bone formation at 2 weeks after implantation. The bone gradually grew along the composite surface. SEM showed direct bone contact with the composites without intervening fibrous tissue. During follow-up, the affinity indices of all the composite rods were significantly higher than those of the unfilled PLLA rods (p < 0.01; two-way ANOVA). The maximum affinity index (41%) was attained at 4 weeks in c-HA40 rods. In contrast, little bone contact was seen in unfilled PLLA rods. The only significant difference in affinity indices among the composites was that c-HA40 had a higher affinity index than u-HA40 (p < 0.05 at 4 weeks). No disintegration of rods or polymer debris, which could elicit inflammatory tissue reactions, was observed even at 25 weeks. Our results indicate that osteoconductive bone formation on composites could enhance the stability between bone and implant in fracture repair.

Absorbable Implants↗

PubMed2000

Bonding of alkali- and heat-treated tantalum implants to bone.

Alkali- and heat-treated tantalum (Ta) has been shown to bond to bone. The purpose of this study was to investigate the effects of chemical treatments on the bone-bonding ability of tantalum implants in rabbit tibiae. Miyazaki et al. reported in vitro that alkali- and heat-treated tantalum had an apatite forming ability in an acellular simulated body fluid (SBF). In this study, smooth-surfaced rectangular plates (15 x 10 x 2 mm) of pure tantalum and treated tantalum were prepared. The plates were implanted transcortically into the proximal metaphyses of bilateral rabbit tibiae, alkali- and heat-treated plates for one limb and untreated plates for the contralateral limb, which served as a paired control. Bone bonding at the bone/implant interface was evaluated by tensile testing and undecalcified histological examination, at 8 and 16 weeks after implantation. The treated implants showed weak bonding to bone at 8 weeks, and exhibited significantly higher tensile failure loads compared with untreated tantalum implants at 16 weeks. The untreated implants showed almost no bonding, even at 16 weeks. Histological examination by Giemsa surface staining, contact microradiography (CMR), and scanning electron microscopy (SEM) revealed that treated tantalum implants bonded directly to bone tissue. In contrast, the untreated tantalum implants had a intervening fibrous tissue layer between the bone and the plate and did not bond to bone at 8 and 16 weeks. It is clear from these results that alkali and heat treatment induce the bone-bonding ability of tantalum. This new bioactive tantalum should be an effective material for weight-bearing and bone-bonding orthopedic devices.

Alkalies↗

PubMed2000

Biodegradation behavior of ultra-high-strength hydroxyapatite/poly (L-lactide) composite rods for internal fixation of bone fractures.

The purpose of this study was to investigate the biodegradation behavior of the ultra-high-strength hydroxyapatite/poly(L-lactide) (HA/PLLA) composite rods for fracture repair. Two kinds of composite materials were used in this study: u-HA/PLLA. which contained 30% by weight of uncalcined HA as reinforcing particles, and c-HA/PLLA, which contained 30% by weight of calcined HA as reinforcing particles. These composite rods were implanted in the subcutis and in the medullary cavities of rabbits. The specimens were removed at specific intervals between 2 and 52 weeks and the mechanical strength was measured for the rods in the subcutis, and the molecular weight and crystallinity were measured for the rods in both the subcutis and medullary cavities. The rod surfaces were examined using a scanning electron microscope (SEM). The specimens were examined histologically by light microscopy. The bending strength of the composites implanted in the subcutis was maintained at more than 200 M Pa at 25 weeks and at 150 MPa at 52 weeks. The molecular weight dropped to 45% of the initial values at 8 weeks and to approximately 10% at 52 weeks. Significant differences in the molecular weight were seen between c-HA/PLLA and u-HA/PLLA, with u-HA/PLLA showing a faster rate of decrease than c-HA/PLLA after 8 weeks. SEM demonstrated that HA particles disappeared increasingly from the rod surfaces over time and that the spaces left by these HA particles formed many pores in the composite surfaces at 52 weeks. Histologically, a fibrous tissue layer was formed around the composite rod from 4 weeks in the subcutis and in the diaphyseal area of the medullary canal. This became more mature over time. Bony tissue contact to the composites without fibrous tissue layers was seen in the metaphyseal area of the medullary canal. During the experimental period, there were no inflammatory cells such as mono- or multi-nuclear phagocytes. Although further long-term studies for degradation are needed, the composites have promising mechanical strength and no adverse tissue reaction for use as fracture-fixation devices during the experimental periods.

Animals↗

PubMed2000

Bone bonding ability of a new biodegradable composite for internal fixation of bone fractures.

Hydroxyapatite particles and poly(L-lactide) composites for internal fixation of bone fractures have been developed based on the hypothesis that incorporation of hydroxyapatite particles in a poly(L-lactide) matrix might enhance bone bonding. This study evaluated the bone bonding ability of these biodegradable composites. Two types of hydroxyapatite and poly(L-lactide) composite were used in this study: calcined hydroxyapatite/poly(L-lactide) and uncalcined hydroxyapatite/poly(L-lactide). Rectangular plates (2 x 10 x 15 mm) of each composite or poly(L-lactide) were implanted into the metaphysis of the tibiae of 33 male rabbits, and the failure load was measured by conducting a detaching test 8, 16, and 25 weeks after implantation. The failure loads of calcined hydroxyapatite/poly(L-lactide), uncalcined hydroxyapatite/poly(L-lactide), and poly(L-lactide), respectively, were 13.60, 13.95, and 0.46 N at 8 weeks; 29.84, 24.09, and 2.86 N at 16 weeks; and 25.50, 29.67, and 2.43 N at 25 weeks. Histologic observation revealed that the composites formed direct contact with the bone. The results in this study indicate that the composites improved the strength of the interface between bone and plate. This improved interfacial strength lead to a substantial decrease in the frequency of implant loosening in the treatment of fractured bones by internal fixation.

Absorbable Implants↗

PubMed2000

Cemented total hip arthroplasty with acetabular bone graft for developmental dysplasia. Long-term results and survivorship analysis.

Although the technique of autogenous acetabular bone grafting has been widely used to augment containment of the acetabulum in total hip arthroplasty (THA) for developmental dysplasia, the role of this technique in improving long-term results remains controversial. We present the long-term results of cemented THA with acetabular bone grafting in 112 patients (133 hips) in order to clarify the factors which affect the outcome. The mean follow-up was for 12.3 years (8 to 24). Kaplan-Meier survivorship analysis predicted a rate of survival of the acetabular component at 15 years of 96% (95% confidence interval (CI) 92 to 99) with revision for aseptic loosening as the endpoint, and of 75% (95% CI 65 to 85) when radiological loosening was used. Parametric survivorship analysis using the Cox proportional-hazards model indicated that trochanteric nonunion, lateral placement of the socket, and delayed trabecular reorientation of the bone graft were risk factors for loosening of the acetabular component. Our findings have shown that autologous acetabular bone grafting is of value for long-term success provided that the risk factors are reduced.

Acetabulum↗

PubMed2000

The Bisurface total knee replacement: a unique design for flexion. Four-to-nine-year follow-up study.

BACKGROUND: The Bisurface knee prosthesis was designed in 1989 to improve knee flexion without affecting the durability of the prosthesis. The prosthesis has a unique ball-and-socket joint in the midposterior portion of the femoral and tibial components, which functions as a posterior stabilizing cam mechanism and causes femoral rollback. The femoral component was made of alumina ceramic. The purpose of this study was to review the clinical results of the first 223 arthroplasties performed with this prosthesis in order to assess whether this new implant had achieved its design objectives. METHODS: From December 1989 to May 1994, all patients who were scheduled for primary total knee arthroplasty were enrolled in a prospective study of the Bisurface knee. The patients were evaluated clinically according to The Hospital for Special Surgery knee-rating system and with a self-administered questionnaire, and they were evaluated radiographically according to the system of the Knee Society. Kaplan-Meier survivorship analysis was performed with revision of the knee or recommendation for revision as the end point. RESULTS: One hundred and sixty-six patients treated with a total of 223 consecutive primary total knee arthroplasties were enrolled in the study, and 182 knees were followed for 3.9 to 9.0 years (mean, 5.8 years). Preoperatively, the mean Hospital for Special Surgery knee score was 44.5 points. At the time of latest follow-up, the mean knee score was 86.3 points. The mean preoperative and postoperative ranges of flexion were 119 and 124 degrees, respectively. The patients, even those with a good preoperative range of motion, rarely lost deep flexion of the knee after the procedure. A revision operation was performed in eight knees (because of infection in five, instability in two, and breakage of the peg of the patellar component in one). Two knees had recurrent medial-lateral subluxations of the femorotibial articulation, which were treated nonoperatively. No prosthesis had loosened aseptically and no alumina ceramic femoral component had broken by the time of latest follow-up. The rate of survival of the implant was 94 percent (95 percent confidence interval, 90 to 98 percent) at six years. According to the patient questionnaires, 20 percent of the knees sometimes felt loose in daily living activities, which prompted us to improve the intrinsic stability of the prosthesis by improving the congruity of the ball-and-socket joint. CONCLUSIONS: Total knee arthroplasty with the Bisurface prosthesis resulted in an excellent range of motion and a high level of satisfaction with the operation; the durability of the prosthesis is promising.

Aged↗

PubMed1999

Inflammatory cytokines induced down-regulation of m-calpain mRNA expression in fibroblastic synoviocytes from patients with osteoarthritis and rheumatoid arthritis.

Our previous reports revealed that calpain has proteoglycanase activity and exists in synovial fluid in osteoarthritis and rheumatoid arthritis. We examined the effects of cytokines on expression of the calpain-calpastatin system in fibroblastic synoviocytes (FLS). Primary cultures of human FLS from osteoarthritis (OA) and rheumatoid arthritis (RA) patients were stimulated with inflammatory cytokines and the amounts of m-calpain and calpastatin mRNAs expressed were determined by Northern blotting. Northern blots were subjected to computerized densitometer and band intensities were determined. Interleukin-1 (IL-1) down-regulated m-calpain and tissue-type calpastatin mRNA expression in OA and RA FLS. In RA FLS, although IL-6 did not alter m-calpain mRNA expression, IL-1 + tumor necrosis factor (TNF) and IL-1 + transforming growth factor (TGF) down-regulated m-calpain mRNA expression. These results provide new information about the effects of inflammatory cytokines on calpain and calpastatin system in OA and RA pathology.

Arthritis, Rheumatoid↗

PubMed1999

Bonding behavior of ultrahigh strength unsintered hydroxyapatite particles/poly(L-lactide) composites to surface of tibial cortex in rabbits.

Unsintered hydroxyapatite particles/poly(L-lactide) (u-HA/PLLA) composites with an initial bending strength of up to 270 MPa were developed based on the hypothesis that inclusion of u-HA particles in a PLLA matrix might enhance bone bonding. The purpose of this study was to examine the bonding strength and behavior of these u-HA/PLLA composites on the surface of the bone cortex. Composites containing 30 (u-HA30), 40 (u-HA40), or 50 wt % (u-HA50) of fine u-HA particles (3-microm average particle size) were prepared. Semicolumnar plates of these composites and control PLLA plates were fixed with metal screws to the surface of both proximal tibial cortices in 45 rabbits. The loads required to detach the plates from the bone cortex surface, defined as the bonding strengths, were measured at 4, 8, and 25 weeks after implantation. Bonding strengths in the u-HA30 group at 8 weeks and in the u-HA40 and u-HA50 groups at each postimplantation time were significantly greater than in the PLLA group (post hoc test using Fisher's protected least significant difference method). At each postimplantation time histological examinations revealed direct contact between the bone and the u-HA/PLLA composite plates without any intervening fibrous tissue. There was no evidence of any inflammatory or foreign-body response in any group throughout the follow-up periods. The results of this study suggest that the biodegradable PLLA fixation plates amended with u-HA particles could be functionally superior to PLLA plates without particles.

Animals↗

PubMed1999

Effect of rotational alignment on patellar tracking in total knee arthroplasty.

Forty-four consecutive patients (65 knees) who underwent identical condylar type total knee arthroplasty were evaluated retrospectively. In 22 of the patients (32 knees), the femoral component was set parallel to the posterior condylar axis (neutrally aligned group). In the remaining 22 patients (33 knees), it was set in an external rotation position of 3 degrees to 5 degrees relative to the axis (externally aligned group). Of the total knee arthroplasties in the neutrally aligned group, 34% required lateral release, compared with only 6% in the externally aligned group; patellar tracking in the externally aligned group was significantly better than that in the neutrally aligned group. Postoperative measurements performed using computed tomography scans showed that the mean angle between the prosthetic posterior condylar axis and the transepicondylar axis was 7.9 degrees in the neutrally aligned group and 3.2 degrees in the externally aligned group. The external rotation setting of the femoral component diminished the need for lateral retinacular release and may decrease the rate of patellofemoral complications that occur after total knee arthroplasty.

Adult↗

PubMed1999

Osteonecrosis of the resurfaced patella following bilateral total knee arthroplasty. A case report and review of the literature.

A 77-year-old woman with severe varus and flexion deformity of both knee joints, hypertension, and arteriosclerosis underwent bilateral total knee arthroplasty. Six weeks after the operation on the right knee and four months after the operation on the left knee, osteolysis of the patellas was seen on the radiographs. Three years after the operations, the lateral and inferior poles of both patellas were sclerotic and displaced. There was no knee pain and no extension lag throughout the follow-up period. This case suggests that the prognosis of patellar osteonecrosis after total knee arthroplasty is good if the continuity of the retinaculum and the extensor mechanism are preserved, and if instability of the knee does not occur.

Aged↗

PubMed1998

Treatment of osteomyelitis with antibiotic-soaked porous glass ceramic.

We have developed a new drug delivery system using porous apatite-wollastonite glass ceramic (A-W GC) to treat osteomyelitis. A-W GC (porosity, 70% and 20% to 30%), or porous hydroxyapatite (HA) blocks (porosity 35% to 48%) used as controls, were soaked in mixtures of two antibiotics, isepamicin sulphate (ISP) and cefmetazole (CMZ) under high vacuum. We evaluated the release concentrations of the antibiotics from the blocks. The bactericidal concentration of ISP from A-W GC was maintained for more than 42 days, but that from HA decreased to below the detection limit after 28 days. The concentrations of CMZ from both materials were lower than those of ISP. An in vivo study using rabbit femora showed that an osseous concentration of ISP was maintained at eight weeks after implantation. Osteoconduction of the A-W GC block was good. Four patients with infected hip arthroplasties and one with osteomyelitis of the tibia have been treated with the new delivery system with excellent results.

Adult↗

PubMed1998

A-W glass ceramic as a bone substitute in cemented hip arthroplasty: 15 hips followed 2-10 years.

We retrospectively reviewed hip arthroplasties in 13 patients (15 hips), in whom we had used apatite-wollastonite (A-W) glass ceramic together with auto- or allograft for augmentation of severe bone deficiency. 11 cemented sockets and 4 stem revisions were included and followed for 2-9.6 years. There were no radiolucent lines between A-W glass ceramic and surrounding bone, and remodeling of the bone graft containing A-W glass ceramic was observed. No migration of cemented sockets was seen except in 1 case, which was revised. In this case, direct bonding between bone and A-W glass ceramic granules was present histologically. In 4 stem revisions, 5 mm subsidence occurred in 1 case. However, the stem became stable and remodeling of the grafted bone occurred. An artificial bone material, such as A-W glass ceramic, can be used under high-load conditions, because of its good mechanical properties.

Adult↗