PubMed · 8887405
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A S Greenwald. 1996. Current concepts in joint replacement.. https://doi.org/10.3928/0147-7447-19960901-03
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In Europe and the USA combined, over half a million people had a hip joint replaced in 2005, contributing to the increasing number of radiotherapy patients with metallic hip prostheses. The treatment plan for external beam radiation therapy is based on the delineation of the anatomy in the planning CT scan. When implanted objects of high atomic number (Z) material are present, however, severe image artefacts are generated in conventional CT, strongly hindering the ability to delineate some organs. This is particularly the case for the planning of prostate patients with hip prostheses. This short communication presents the use of a new imaging modality, megavoltage cone-beam CT, to complement the regular CT for target definition of prostate cancer treatment of patients with hip replacements.
Modular hip prostheses are commonly used today. Dedicated surgical auxiliary instrumentation is indispensable. A correct coupling between the prosthesis and the instrument is necessary to avoid damage. Based on a specific commercial design (AnCAFit, Wright Cremascoli Ortho, Toulon, France), the aim of this work was to assess if stem holders of modular prostheses can induce any stem damage, and if so, to identify the features that provide minimal damage. Two different stem holder connector designs were investigated. The surface of the stem cavity was inspected to identify the damage caused by the use of the two connectors after a simulated surgical handling. Both connectors induced some damage, with significantly more damage being caused by a supposedly improved design. Scars due to contact with the stem holder were observed on the stem cavity surface. This may be sufficient to trigger increased fretting damage during service life, causing the production of fretting debris.