This book addresses the background and significance of the factors potentially influencing the clinical and biological outcomes of metal-on-metal hip implants. Metal-on-metal bearings were introduced and evaluated as an alternative to other bearing couples, particularly metal-on-polyethylene, due to their enhanced wear resistance as determined in laboratory testing. Initially, reports of short-term clinical outcomes were favorable and an increasing number of metal-on-metal prostheses were implanted. Subsequently, isolated case findings describing adverse tissue responses around the articulation became the harbinger of an increasing number of reports describing pseudotumors and other significant lymphocytic-based responses associated with metal-on-metal prostheses. Questions have been raised as to whether this is an implant, design, or patient-specific response. The reasons why some patients have a negative biological response and pathology while others do not remain to be determined, but tens of thousands of patients in the US, the UK, and around the world are considered to be at risk. Leading researchers and clinicians describe the issues related to the nature of the biological and pathological responses and the protocols that should be followed to determine if an adverse response is occurring. This book is essential reading for researchers, engineers, and orthopaedic surgeons who are involved in the design, evaluation, and implantation of metal-on-metal prostheses.

During the 2011 EFORT Congress in Copenhagen, many interesting topics relating to tribology in total hip arthroplasty were discussed during a special day devoted entirely to the subject. EFORT decided that, given the wide interest in these discussions, publication of the presentations would be warmly welcomed by all fellow professionals who were unable to attend. This book is the result. It provides detailed information on currently used articulating materials and their wear performance. Clinical outcomes are discussed, and important new frontiers are carefully considered. The book will be of interest both to novices who want to learn more about the field and to experienced orthopaedic surgeons wishing to keep abreast of the latest developments.

Covering the fundamental principles of bearing selection, design, and tribology, this book discusses basic physical principles of bearing selection, lubrication, design computations, advanced bearings materials, arrangement, housing, and seals, as well as recent developments in bearings for high-speed aircraft engines. The author explores unique solutions to challenging design problems and presents rare case studies, such as hydrodynamic and rolling-element bearings in series and adjustable hydrostatic pads for large bearings. He focuses on the design considerations and calculations specific to hydrodynamic journal bearings, hydrostatic bearings, and rolling element bearings.

This open access book describes and illustrates the surgical techniques, implants, and technologies used for the purpose of personalized implantation of hip and knee components. This new and flourishing treatment philosophy offers important benefits over conventional systematic techniques, including component positioning appropriate to individual anatomy, improved surgical reproducibility and prosthetic performance, and a reduction in complications. The techniques described in the book aim to reproduce patients’ native anatomy and physiological joint laxity, thereby improving the prosthetic hip/knee kinematics and functional outcomes in the quest of the forgotten joint. They include kinematically aligned total knee/total hip arthroplasty, partial knee replacement, and hip resurfacing. The relevance of available and emerging technological tools for these personalized approaches is also explained, with coverage of, for example, robotics, computer-assisted surgery, and augmented reality. Contributions from surgeons who are considered world leaders in diverse fields of this novel surgical philosophy make this open access book will invaluable to a wide readership, from trainees at all levels to consultants practicing lower limb surgery

The purpose of this book was to offer an overview of recent insights into the current state of arthroplasty. The tremendous long term success of Sir Charnley's total hip arthroplasty has encouraged many researchers to treat pain, improve function and create solutions for higher quality of life. Indeed and as described in a special chapter of this book, arthroplasty is an emerging field in the joints of upper extremity and spine. However, there are inborn complications in any foreign design brought to the human body. First, in the chapter on infections we endeavor to provide a comprehensive, up-to-date analysis and description of the management of this difficult problem. Second, the immune system is faced with a strange material coming in huge amounts of micro-particles from the tribology code. Therefore, great attention to the problem of aseptic loosening has been addressed in special chapters on loosening and on materials currently available for arthroplasty.

Long Term Results of BHR and Lessons Learned, Effect of Patient Selection and Surgical Techniques on Outcome Results of Conserve Plus, Results and Use of Mono Block Cups (Thick vs Thin), Changes in High Activity After Resurfacing, Incidence and Prevention of Complications for Resurfacing, A Survey of Incidence of Pseudotumors with MOM Hip Resurfacing in Canadian Academic Centers, Effects of Component Orientation, Coverage, and Design on Ion Levels and ALTR After Hip Resurfacing: A Multi-Center Study, Imaging and In Vivo Validation of MARS MRI After Hip Resurfacing, Histological Features of Femoral Hip Resurfacing with Neck Narrowing, Risk Factors and Affects on Incidence on Pseudotumors, Promising New Techniques for Hip Resurfacing, Comparison of Functional Results of Hip Resurfacing and Total Hip Replacement, Indications, Techniques, and Results of Revision of Hip Resurfacing, Comparison of Cemented and Cementless Hip Resurfacing- A 2-5 year Follow-up