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Disassociation of a Cold-Welded Bimodular Titanium Femoral Stem by Intraoperative Ice Cooling.

ABSTRACT: Modularity in total hip arthroplasty allows a surgeon to have intraoperative versatility, allowing for fine adjustments of the femoral offset, leg length, and version. However, modularity can be a source of multiple complications. This case report describes a novel intraoperative solution for the problem of cold welding of a neck-stem junction using sterile ice to cryogenically disengage the modular components.

SUBMITTER: Frandsen J

PROVIDER: S-EPMC7329910 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Disassociation of a Cold-Welded Bimodular Titanium Femoral Stem by Intraoperative Ice Cooling.

Frandsen Jeff J Duensing Ian I Anderson Lucas L Gililland Jeremy J

Arthroplasty today 20200628 3

Modularity in total hip arthroplasty allows a surgeon to have intraoperative versatility, allowing for fine adjustments of the femoral offset, leg length, and version. However, modularity can be a source of multiple complications. This case report describes a novel intraoperative solution for the problem of cold welding of a neck-stem junction using sterile ice to cryogenically disengage the modular components. ...[more]

PMID: 32637516

Similar Datasets

Letter to the Editor on "Disassociation of a Cold-Welded Bimodular Titanium Femoral Stem by Intraoperative Ice Cooling".

Project description: Not available

| S-EPMC7772441 | biostudies-literature

Fracture of the Neck of a Modern Cementless, Titanium Femoral Stem.

Project description:Intraprosthetic fracture of a femoral component is a rare but devastating complication after total hip arthroplasty (THA). We present the case of a 68-year-old man who presented with acute hip pain approximately 8 years after a left THA with a modern cementless, titanium femoral component. Radiographs revealed a fracture of the midportion of the neck of the stem, below the level of the trunnion. The patient underwent an isolated 1-component revision THA with a modular exchange. To our knowledge, this is the only reported case of a catastrophic failure fracture of this particular prosthesis.

| S-EPMC7218161 | biostudies-literature

Dual Modular Titanium Alloy Femoral Stem Failure Mechanisms and Suggested Clinical Approaches.

Project description:Titanium (Ti) alloys have been proven to be one of the most suitable materials for orthopaedic implants. Dual modular stems have been introduced to primary total hip arthroplasty (THA) to enable better control of the femoral offset, leg length, and hip stability. This systematic review highlights information acquired for dual modular Ti stem complications published in the last 12 years and offers a conclusive discussion of the gathered knowledge. Articles referring to dual modular stem usage, survivorship, and complications in English were searched from 2009 to the present day. A qualitative synthesis of literature was carried out, excluding articles referring solely to other types of junctions or problems with cobalt-chromium alloys in detail. In total, 515 records were identified through database searching and 78 journal articles or conference proceedings were found. The reasons for a modular neck fracture of a Ti alloy are multifactorial. Even though dual modular stems have not shown any clinical benefits for patients and have been associated with worse results regarding durability than monolithic stems, some designs are still marketed worldwide. Orthopaedic surgeons should use Ti6Al4V dual modular stem designs for primary THA in special cases only.

| S-EPMC8200202 | biostudies-literature

Innovative intraoral cooling device better tolerated and equally effective as ice cooling.

Project description:PurposeMost of the patients who receive myeloablative therapy prior to stem cell transplantation develop oral mucositis (OM). This adverse reaction manifests as oral mucosal erythema and ulcerations and may require high doses of morphine for pain alleviation. OM may also interfere with food intake and result in weight loss, a need for parenteral nutrition, and impaired quality of life. To date, there have been very few studies of evidence-based interventions for the prevention of OM. Cryotherapy, using ice chips, has been shown to reduce in an efficient manner the severity and extent of OM, although clinical applications are still limited due to several shortcomings, such as adverse tooth sensations, problems with infectious organisms in the water, nausea, and uneven cooling of the oral mucosa. The present proof-of-concept study was conducted to compare the tolerability, temperature reduction, and cooling distribution profiles of an intra-oral cooling device and ice chips in healthy volunteers who did not receive myeloablative treatment, and therefore, did not experience the symptoms of OM.MethodsTwenty healthy volunteers used the cooling device and ice chips for a maximum of 60 min each, using a cross-over design. The baseline and final temperatures were measured at eight intra-oral locations using an infra-red thermographic camera. The thermographic images were analysed using two digital software packages. A questionnaire was used to assess the tolerability levels of the two interventions.ResultsThe intra-oral cooling device was significantly better tolerated than the ice-chips (p = 0.0118). The two interventions were equally effective regarding temperature reduction and cooling distribution.ConclusionsThe intra-oral cooling device shows superior tolerability in healthy volunteers. Furthermore, this study shows that temperature reduction and cooling distribution are achieved equally well using either method.

| S-EPMC5676821 | biostudies-literature

Protecting ice from melting under sunlight via radiative cooling.

Project description:As ice plays a critical role in various aspects of life, from food preservation to ice sports and ecosystem, it is desirable to protect ice from melting, especially under sunlight. The fundamental reason for ice melt under sunlight is related to the imbalanced energy flows of the incoming sunlight and outgoing thermal radiation. Therefore, radiative cooling, which can balance the energy flows without energy consumption, offers a sustainable approach for ice protection. Here, we demonstrate that a hierarchically designed radiative cooling film based on abundant and eco-friendly cellulose acetate molecules versatilely provides effective and passive protection to various forms/scales of ice under sunlight. This work provides inspiration for developing an effective, scalable, and sustainable route for preserving ice and other critical elements of ecosystems.

| S-EPMC8836806 | biostudies-literature

Discrepancy of Trial Rasp and Femoral Stem Relative Position Within the Femoral Canal of a Coated Tapered System: An Intraoperative, Intrapatient Controlled Study.

Project description:BackgroundFor a successful total hip arthroplasty, the final position of the trial rasp should be adopted by the femoral stem to achieve correct positioning. This study aimed to characterize the discrepancy of the stem and rasp position in vivo of a widely used dual-tapered straight stem with rectangular cross section that is known to have an oversized stem with respect to the rasp.MethodsThe distances between the tip of the greater trochanter and the shoulder of the implant and rasp were measured on 39 intraoperatively acquired fluoroscopic image pairs. Leg-length discrepancy was also measured clinically before and after surgery.ResultsA paired t-test showed a significant average protrusion of the femoral stem with respect to the final rasp position of 2.63 mm (standard deviation = 2.3 mm, P < .001), while 88% of the cases had no leg-length discrepancy after surgery. The quantified stem protrusion was statistically significant but did not reach clinical relevance and was easily mitigated in our study.ConclusionsThe quantified stem protrusion appears to be clinically manageable, as only 2 cases required attenuation of stem positioning: in one case by the use of a femoral head with a shorter neck and in the other case by rerasping the femoral bed. Neither case was associated with the most extreme differences in position of the stem with respect to the final rasp. In addition, the used stem shows good overall outcomes in other studies. It appears that factors other than stem and rasp position play a critical role to the surgeon and for total hip arthroplasty success.

| S-EPMC7522528 | biostudies-literature

Heat Transfer Modeling of an Annular On-Line Spray Water Cooling Process for Electric-Resistance-Welded Steel Pipe.

Project description:On-line spray water cooling (OSWC) of electric-resistance-welded (ERW) steel pipes can replace the conventional off-line heat treatment process and become an important and critical procedure. The OSWC process improves production efficiency, decreases costs, and enhances the mechanical properties of ERW steel pipe, especially the impact properties of the weld joint. In this paper, an annular OSWC process is investigated based on an experimental simulation platform that can obtain precise real-time measurements of the temperature of the pipe, the water pressure and flux, etc. The effects of the modes of annular spray water cooling and related cooling parameters on the mechanical properties of the pipe are investigated. The temperature evolutions of the inner and outer walls of the pipe are measured during the spray water cooling process, and the uniformity of mechanical properties along the circumferential and longitudinal directions is investigated. A heat transfer coefficient model of spray water cooling is developed based on measured temperature data in conjunction with simulation using the finite element method. Industrial tests prove the validity of the heat transfer model of a steel pipe undergoing spray water cooling. The research results can provide a basis for the industrial application of the OSWC process in the production of ERW steel pipes.

| S-EPMC4511770 | biostudies-literature

Dynamic response of the Greenland ice sheet to recent cooling.

Project description:The subglacial hydrological system critically controls ice motion at the margins of the Greenland Ice Sheet. However, over multi-annual timescales, the net impact of hydro-dynamic coupling on ice motion remains poorly understood. Here, we present annual ice velocities from 1992-2019 across a ~10,600 km2 land-terminating area of southwest Greenland. From the early-2000s through to ~2012, we observe a slowdown in ice motion in response to increased surface melt, consistent with previous research. From 2013 to 2019 however, we observe an acceleration in ice motion coincident with atmospheric cooling and a ~15% reduction in mean surface melt production relative to 2003-2012. We find that ice velocity speed-up is greater in marginal areas, and is strongly correlated with ice thickness. We hypothesise that under thinner ice, increases in basal water pressure offset a larger proportion of the ice overburden pressure, leading to reduced effective pressure and thus greater acceleration when compared to thicker ice further inland. Our findings indicate that hydro-dynamic coupling provides the major control on changes in ice motion across the ablation zone of land terminating margins of the Greenland Ice Sheet over multi-annual timescales.

| S-EPMC6997348 | biostudies-literature

Titanium neck-titanium stem taper corrosion in a modular neck stem.

Project description:An 81-year-old woman presented with progressive groin pain after metal-on-polyethylene total hip arthroplasty with a modular neck stem and was found to have adverse local tissue reaction. As we report for the first time with this implant, we observed titanium neck-titanium stem taper corrosion intraoperatively. We also found head-neck taper corrosion. The patient underwent revision surgery to a modular fluted tapered stem with ceramic head and was asymptomatic at 3-year follow-up visit. In conclusion, consideration should be given to avoiding the routine use of this modular neck stem in total hip arthroplasty. Patients with this prosthesis should be closely monitored for adverse local tissue reaction.

| S-EPMC6588719 | biostudies-literature

The missing Northern European winter cooling response to Arctic sea ice loss.

Project description:Reductions in Arctic sea ice may promote the negative phase of the North Atlantic Oscillation (NAO-). It has been argued that NAO-related variability can be used an as analogue to predict the effects of Arctic sea ice loss on mid-latitude weather. As NAO- events are associated with colder winters over Northern Europe, a negatively shifted NAO has been proposed as a dynamical pathway for Arctic sea ice loss to cause Northern European cooling. This study uses large-ensemble atmospheric simulations with prescribed ocean surface conditions to examine how seasonal-scale NAO- events are affected by Arctic sea ice loss. Despite an intensification of NAO- events, reflected by more prevalent easterly flow, sea ice loss does not lead to Northern European winter cooling and daily cold extremes actually decrease. The dynamical cooling from the changed NAO is 'missing', because it is offset (or exceeded) by a thermodynamical effect owing to advection of warmer air masses.

| S-EPMC5343504 | biostudies-literature

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