Published in The Journal of Post-Acute and Long-Term Care Medicine.
Article published in Clincal Orthopaedics and Related Research.
The AJRR report has been released.
Published in The Bone and Joint Jourmal.
The National Joint Registry 2018 has been released.
A reminder of an article published in the Bone and Joint Journal in 2017.
Clinical Orthopaedics and Related Research article.
Research article published by PLoS ONE.
Article published in Acta Orthopaedica.
Clinical Orthopaedics and Related Research article.
Journal of Biomedical Materials Research Part B: Applied Biomaterials.
Paper published in Clinical Orthopaedics and Related Research.
The use of XLPE has resulted in a significant reduction in the rate of revision at 16 years following THA for osteoarthritis according to an article published in JBJS.
The author analysed registry data involving more than 240,000 total hip arthroplasty (THA) patients and found markedly lower revision rates in those who received XPLE rather than conventional PE acetabular components. Published in JBJS.
Clinical Orthopaedics and Related Research Article.
Paper published in The Bone and Joint Journal.
36-mm metal-on-metal Pinnacle total hip arthroplasties have an unacceptably high ten-year failure rate, especially if implanted from 2006 onwards. Published in The Bone and Joint Journal.
This analysis from the National Joint Registry for England and Wales was published in The Bone and Joint Journal.
Clinical Orthopaedics and Related Research article.
Our latest (open access) paper in Bone & Joint Research
Cementless femoral stem fixation in patients 75 years or older is associated with a higher early rate of revision, even when only the best-performing prostheses used in patients in this age group were compared. Clinical Orthopaedics and Related Research article.
Clinical Orthopaedics and Related Research article.
Very interesting article published in Clinical Orthopaedics and Related Research.
Findings from the Global Burden of Disease Study 2015 published in Acta Orthopaedica.
Article published in Acta Orthopaedica discussing the diffent material combinations used as the bearing surfaces in total hip joint replacements.
Interesting article punlished in Clincal Orthopaedics and Related Research.
Paper published in Acta Orthopaedica.
Higher risk for revision compared with other uncemented cup designs in a collaborative register study including 93,709 hips (published in Acta Orthopaedica).
A retrospective single-centre cohort study published in The Bone and Joint Journal.
Article published in The Bone and Joint Journal.
Drugs used to treat rleumatoid arthritis and their cardiovascular risk. Paper published in The BMJ.
Ware the Research Priorities in Childrens Orthopaedics? BJJ article.
Article published in The Bone and Joint Journal.
A research article published in PLoS ONE.
This article concluded that the length of stay for joint replacement fell substantially from 1997 to 2014. These reductions have translated into substantial savings. While patient characteristics affect length of stay and reimbursement, patient profiles have remained broadly stable over time. The observed reductions appear to be mostly explained by improved efficiency. Published in BMJ Open.
A Clinical Orthopaedics and Related Research article. The results showed that the majority of estimated material loss from the head bore-stem cone junctions resulting from taper fretting and corrosion was from the CoCr head bore tapers as opposed to the stem cone tapers. Additionally, the total material loss from the ceramic cohort showed a reduction in the amount of metal released by an order of magnitude compared with the CoCr cohort.
A Clinical Orthopaedics and Related Research article. The authors state that the revision rate for all large-diameter head MoM THAs studied in the Finnish Arthroplasty Register is unacceptably high.
The general shortage of evidence regarding benefits and harms of medical devices has been highlighted following the serious safety concerns with metal-on-metal hip replacements and silicone breast implants and was again pointed out in a recent survey of European Health Technology Assessment institutions. This is a paper published in Health Policy.
Article on shoulder replacements published in Clinical Orthopaedics and Related Research.
Article published in Clinical Orthopaedics and Related Research.
The intervention resulted in sustained significant improvements in pain severity and interference in patients with hip/knee osteoarthritis, awaiting arthroplasty compared with a control group. Article published in BMC Musculoskeletal Disorders.
Paper published in the Bone & Joint Journal exploring data published in the National Joint Registry reports.
Indicators of quality of care improved from 2005 to 2014 with the exception of the rates of lower respiratory tract infection and renal failure. Article published in JBJS.
Article published in JBJS discussing the failures of metal-on-metal hip prostheses.
This article provides information regarding ARMD revision surgery in metal-on-metal hip arthroplasties. Published in Acta Orthopaedica.
A paper published in Clinial Orthopaedics and Related Research in 2016.
An analysis of data from the National Joint Registry published in The Bone and Joint Journal. There is good evidence that the latest generation of ceramic has greatly reduced the odds of head fracture but not of liner fracture. Small head size and high patient BMI are associated with an increased risk of ceramic bearing fracture.
This randomized study with followup into the second decade demonstrated reductions in revision, wear, and osteolysis associated with the use of XLPE. Article published in Clincal Ortthopaedics and Related Research.
Our recent paper concerning laboratory wear testing of artificial shoulder joints published in Biotribology.
A Clincal Summary in JBJS discussing the fixation of hip replacements since the 1960s.
BMJ Open article. Length of stay for joint replacement fell substantially from 1997 to 2014.
A paper published in Clincal Orthopaedics and Related Research discussing the wear of ASRs.
Article published in Acta Orthopaedica.
Original article published in Accountability and Research examines internal company documents relating to the “Multi-center, Prospective, Clinical Evaluation of Pinnacle Acetabular Implants in Total Hip Arthroplasty” PIN Study
Interesting article in Clinical Orthopaedics and Related Research.
Male and female patients who had hip resurfacing arthroplasty with implantation of the ASRTMprosthesis should be followed with equal vigilance as both are at similar risk of revision surgery and adverse local tissue reaction. Paper published in Clinical Orthopaedics and Related Research.
Editorial published in the Bone and Joint Journal on metal-on-metal joints.
Article published in the Bone and Joint Journal.
Are we over-servicing or under-caring? Article published in the Bone and Joint Journal.
This case report presents a 46-year-old male who underwent bilateral metal-on-metal total hip arthroplasty and subsequently developed cardiomyopathy requiring left ventricular assist device implantatio. Article published in Arthroplasty Today.
The 2017 Australian Joint Registry is now available. Lots of excellent data on how implants are performing.
This article sought to determine whether cobalt-chromium alloy (CoCr) femoral stem tapers (trunnions) wear more than titanium (Ti) alloy stem tapers (trunnions) when used in a large diameter (LD) metal-on-metal (MoM) hip arthroplasty system. Article published in the Bone and Joint Journal.
Outcomes research in THA has focused largely on long-term implant survivorship as a primary outcome and emphasized the development of new implant technologies. In contrast, strategies to improve short-term outcomes, such as the frequencies of periprosthetic joint infections and unplanned readmissions, have received less attention. Article published in Clinical Orthopaedics and Related Research.
Article discussing published randomised controlled trials comparing different implant combinations (BMJ).
The serious adverse events associated with metal on metal hip replacements have highlighted the importance of improving methods for monitoring surgical implants. Article published in BMC Musculoskeletal Disorders.
Brief article published in JBJS Orthobuzz.
This study shows that a 13-year median followup has not yet indicated any long-term deleterious effects related to dissemination of metallic ions with the cementless Metasul prosthesis. Longer followup with a more sophisticated imaging study is necessary to confirm this so far positive report. Article published in Clinical Orthopaedics and Related Research.
In this study a unique collection of autopsy-retrieved TKR and THR components that were well-functioning at the time of retrieval was used to compare volumetric wear differences between hip and knee polyethylene components made from identical material. Article published in CORR.
Article published in Journal of Clinical Nursing on both hips and knees.
Another Newcastle study publishe in the BJJ.
A patient-engagement and pathway-management program for patients undergoing primary total hip and knee replacement was evaluated in this study published in JBJS.
Work conducted by the Newcastle group and published in the Journal of Biomechanics.
Open-access paper published in BioResearch.
Our paper published in BJJ. The differences in debris arising from the taper and the articulating surfaces may provide some understanding of the increased incidence of soft-tissue reactions reported in patients implanted with MoM total hip arthroplasties compared with patients with hip resurfacings.
BJJ article discussing the determination of the volumetric polyethylene wear on explanted material.
Increased failure rates due to metallic wear particle-associated adverse local tissue reactions (ALTR) is a significant clinical problem in resurfacing and total hip arthroplasty. Distinct differences in size, shape, and element composition of the metallic particles were detected in each implant class which correlate with the histological features of severity of ALTR and variability in implant performance. Article published in Nanomedicine.
Another article from Journal of Biomedical Materials Research.
Article from Journal of Biomedical Materials Research.
The aim of this BJJ article was to determine whether there is any association between glomerular filtration rate (GFR) and blood cobalt (Co) and chromium (Cr) levels in patients with metal-on-metal (MoM) hip arthroplasty.
This BMJ article aims to describe the methods and sample size required to conduct a one-sample non-inferiority study of a medical device for the purposes of benchmarking.
Improvements in physical function and pain sustained for up to 10 years after knee or hip arthroplasty irrespective of mental health status before surgery
Acta Orthopaedica article on 9,737 middle-aged and 9,292 older women from the Australian Longitudinal Study on Women’s Health and National Joint Replacement Registry
Comparison of metal ion concentrations and implant survival after total hip arthroplasty with metal-on-metal versus metal-on-polyethylene articulations
A 16-year follow-up of a prospective randomized study published in Acta Orthopaedica
Lack of evidence—the anti-stepwise introduction of metal-on-metal hip replacements
A systematic review and a comparative assessment of the literature and registry data published in Acta Orthopaedica
Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris?
This is an analysis from the National Joint Registry for England and Wales published in BJJ.
Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity
This is a presentation of ten cases (mean age 60 years) where the authors evaluated neuropsychiatric morbidity following metal-on-metal hip implant failure and revision. Published in BMC Psychiatry.
Metal-on-Metal Hip Prostheses and Systemic Health: A Cross-Sectional Association Study 8 Years after Implantation
This paper discusses a detailed cross-sectional health screen at a mean of 8 years after surgery in 35 asymptomatic patients who had previously received a metal-on-metal hip resurfacing (MoMHR) versus 35 individually age and sex matched asymptomatic patients who had received a conventional hip replacement. Open-access article published in PLoS One.
Outcome in design-specific comparisons between highly crosslinked and conventional polyethylene in total hip arthroplasty
Article published in Acta Orthopaedica discussing the risk of cup and/or liner revision for specific cup and liner designs made of either XLPE or conventional polyethylene.
Magnetically controlled growing rods in the treatment of early-onset scoliosis - a note of caution
Our paper published in The Bone and Joint Journal. Good results have been published, but there have been recent reports identifying implant failures that may be associated with significant metallosis surrounding the implants. This article aims to present the current knowledge regarding the performance of this implant, and the potential implications and strategies that may be employed to identify and limit any problems.
The role of metabolism in the pathogenesis of osteoarthritis
In the past few years, several studies have demonstrated that metabolism has a key role in inflammatory joint diseases. This review focuses on aberrant metabolism in the pathogenesis of OA, summarizing the current state of knowledge on the role of impaired metabolism in the cells of the osteoarthritic joint.
Analysis of Explanted Magnetically Controlled Growing Rods from 7 UK Spinal Centers
Prof. Joyce's paper, published in Spine, in which the team analysed explanted Magnetically Controlled Growing Rods (MAGEC) for early onset scoliosis of the spine.
Surrogate markers of long-term outcome in primary total hip arthroplasty
High failure rates of metal-on-metal hip arthroplasty implants have highlighted the need for more careful introduction and monitoring of new implants and for the evaluation of the safety of medical devices.
Investigation of Taper Failure in a Contemporary Metal-on-Metal Hip Arthroplasty System Through Examination of Unused and Explanted Prostheses.
A paper published in JBJS.
Explant analysis of the Biomet Magnum/ReCap metal-on-metal hip joint
Our paper open-access paper published in BJR.
The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study
An article published in The Lancet. This study used novel methodology to investigate and offer new insight into the importance of young age and risk of revision after total hip or knee replacement. The evidence challenges the increasing trend for more total hip replacements and total knee replacements to be done in the younger patient group, and these data should be offered to patients as part of the shared decision making process.
Early Lessons From a Worldwide, Multicenter, Followup Study of the Recalled Articular Surface Replacement Hip System
Adverse local tissue reactions (ALTRs) around hip arthroplasties are an important reason for failure of metal-on-metal (MoM) hip implants. Little is known about capsular dehiscence patterns as ALTRs decompress from the hip into the surrounding tissue planes; these patterns may also influence the onset and severity of patient symptoms. Published in Clinical Orthopaedics and Related Research.
Poor 10-year survivorship of hip resurfacing arthroplasty
This study on 5,098 replacements from the Finnish Arthroplasty Register was published in Acta Orthopaedica.
Potential Synthetic Biolubricant as an Alternative to Bovine Serum
Our latest open-access paper published in Lubricants.
Heart failure after conventional metal-on-metal hip replacements
It is unclear whether metal particles and ions produced by mechanical wear and corrosion of hip prostheses with metal-on-metal (MoM) bearings have systemic adverse effects on health. In this Acta Orthopaedica article the risk of heart failure in patients with conventional MoM total hip arthroplasty (THA) and in those with metal-on-polyethylene (MoP) THA was compared.
Effects of Cobalt and Chromium Levels Following Modular Hip Stem Total Hip Arthroplasty
This paper, published in Orthopedics, attempts to correlate objective findings of serum cobalt (Co) levels, serum chromium (Cr) levels, and/or reactive tissue seen on metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) with a patient's need for revision THA.
Prevalence of and Risk Factors for Hip Resurfacing Revision
Article published in the Journal of Bone and Joint Surgery investigating prevalence of, and risk factors for, all-cause and pseudotumor-related revision at up to 15 years following ,etal-on-metal hip replacement and whether risk factors were sex-specific.
Worse health-related quality of life and hip function in female patients with elevated chromium levels
In this Acta Orthopaedica article the authore compared unilateral patients and bilateral patients with either an ASR hip resurfacing (HR) or an ASR XL total hip replacement (THR) and investigated whether cobalt or chromium was associated with a broad spectrum of patient outcomes.
The clinical implications of metal debris release from the taper junctions and bearing surfaces of metal-on-metal hip arthroplasty
Our research at Newcastle published in The Bone and Joint Journal discussing the influence of metal debris exposure on the subsequent immune response and resulting soft-tissue injury following metal-on-metal (MoM) hip arthroplasty.
The manufacture of generic replicas of implants for arthroplasty of the hip and knee
Paper published in the July issue of The Bone and Joint Journal. Recently, the patents on many well established and successful implants have expired. Companies have started producing and distributing implants that purport to replicate existing implants with good long-term results. The aims of this paper are to assess the legality, the monitoring and cost saving implications of such generic implants.
The era of phased introduction of new implants
This paper published in Bone and Joint Research discusses the need for a phased evidence-based introduction of implants, as is common for pharmaceuticals, to regulate the introduction of new total knee prostheses and total hip prostheses to the market.
Surrogate markers of long-term outcome in primary total hip arthroplasty
High failure rates of metal-on-metal hip arthroplasty implants have highlighted the need for more careful introduction and monitoring of new implants and for the evaluation of the safety of medical devices. This article discusses surrogate markers to identify outcomes of THA. Article published in Bone and Joint Research.
The manufacture of generic replicas of implants for arthroplasty of the hip and knee
Paper published in The Bone and Joint Journal discussing the legality, monitoring and cost-saving of replicating existing implants with good long-term results.
A Tribological Assessment of Ultra High Molecular Weight Polyethylene Types GUR 1020 and GUR 1050 for Orthopedic Applications
A study conducted at Newcastle University investigating the wear properties of biomaterials. Published in Lubricants.
The clinical implications of metal debris release from the taper junctions and bearing surfaces of metal-on-metal hip arthroplasty
One of our papers published in The Bone and Joint Journal investigating the influence of metal debris exposure on the subsequent immune response and resulting soft-tissue injury following metal-on-metal (MoM) hip arthroplasty.
Hip resurfacing for osteonecrosis
This article published in The Bone and Joint Journal reports the long-term outcome (mean 10.8 years follow-up) of hip resurfacings for patients with osteonecrosis.
Comparison of rates of safety issues and reporting of trial outcomes for medical devices approved in the European Union and United States: cohort study
Article published in BMJ.
Cementless Total Hip Arthroplasty With Metasul Bearings Provides Good Results in Active Young Patients: A Concise Followup
This paper published in Clincal Orthopaedics and Related Research discusses the suvivorship after 15 years of cementless 28 mm diameter metal-on-metal bearings.
Pseudotumour formation and subsequent resolution in metal-on-metal total hip arthroplasty following revision
Paper published in JBJS.
Eighty-six Percent Failure Rate of a Modular-Neck Femoral Stem Design at 3 to 5 Years
The article discussing the failure rate of Rejuvenate modular-neck stem was published in JBJS.
The Inflammatory Phenotype in Failed Metal-On-Metal Hip Arthroplasty Correlates with Blood Metal Concentrations
Open-access article published in PLOS One.
The design and development of a finger joint simulator
A paper authored by Prof. Joyce just published in Journal Engineering in Medicine.
Our paper just published in Journal of Engineering in Medicine "Engineering of a multi-station shoulder simulator"
This work aimed to engineer a multi-station shoulder simulator in order to wear test shoulder prostheses using recognized shoulder activities of daily living.
India's just got its first joint replacement registry
Data on joint replacements will help surgeons select better implants for their patients. But it's unclear if patients will be able to use registry data.
Analysis of FDA-Approved Orthopaedic Devices and Their Recalls
A JBJS article. The U.S. Food and Drug Administration (FDA) evaluates medical devices by two main pathways. The more stringent Premarket Approval (PMA) review requires clinical trials, and the Premarket Notification 510(k) process generally exempts devices from clinical trials if they prove to be substantially equivalent to existing devices. The authors of this article concluded that it is concerning that most orthopaedic devices are cleared through the 510(k) process with limited clinical trials
Modular to Monoblock: Difficulties of Detaching the M2a-MagnumTM Head Are Common in Metal-on-metal Revisions
Clinical Orthopaedics and Related Research article. The titanium–titanium taper junction (femoral head/trunnion junction) can be very difficult to separate during revision THAs, and if not anticipated, this problem can result in larger and more complicated revision procedures in patients who have the M2a-MagnumTM implant.
Humeral Tray-Taper Failure in Modular Reverse Total Shoulder Arthroplasty
Paper published in the HSS Journal. This case series illustrates a previously unpublished complication of humeral tray-taper junction failure following modular RTSA.
Joint issues: conflicts of interest, ASR hip, surgical conflicts of interest
Open access paper published in BMC Medical Ethics
Alternative bearings and modularity have not reduced revision rates in total hip arthroplasty
There was no evidence in the literature that alternative bearings (either metal-on-metal or ceramic-on-ceramic) in THA have decreased revision rates. Article published in Clinical Orthopaedics and related research.