Can larger cemented femoral components reduce periprosthetic fractures?

Introduction The risk for late periprosthetic fractures is higher in patients treated for a neck of femur fracture compared to those treated for osteoarthritis. It has been hypothesised that osteopenia and consequent decreased stiffness of the proximal femur are responsible for this. We investigated if a femoral component with a bigger body would increase the torque to failure in a biaxially loaded composite sawbone model. Method A biomechanical composite sawbone model was used. Two different body sizes (Exeter 44-1 vs 44-4) of a polished tapered cemented stem were implanted by an experienced surgeon, in 7 sawbones each and loaded at 40 deg/s internal rotation until failure. Torque to fracture and fracture energy were measured using a biaxial materials testing device (Instron 8874). Data are non-parametric and tested with Mann-Whitney U-test. Results The mean torque load to fracture was 154.1 NM (SD 4.4) for the 44-1 stem and 229 NM (SD10.9) for the 44-4 stem (p = 0.01). The mean fracture energy was 9.6 J (SD1.2) for the 44-1 stem and 17.2 J (SD2.0) for the 44-4 stem (p = 0.14). Conclusion the use of a large body polished tapered cemented stem for neck of femur fractures increases the torque to failure in a biomechanical model and therefore is likely to reduce late periprosthetic fracture risk in this vulnerable cohort.

Fracture load for short versus standard cemented hip stems : an experimental in vitro study

Introduction: In an attempt to reduce stress shielding in the proximal femur multiple new shorter stem design have become available. We investigated the load to fracture of a new polished tapered cemented short stem in comparison to the conventional polished tapered Exeter stem. Method: A total of forty-two stems, twenty-one short stems and twenty-one conventional stems both with three different offsets were cemented in a composite sawbone model and loaded to fracture. Results: study showed that femurs will break at a significantly lower load to failure with a shorter compared to conventional length Exeter stem. Conclusion: This Both standard and short stem design are safe to use as the torque to failure is 7–10 times as much as the torques seen in activities of daily living.

Proximal femoral morphology in regions of hard and soft water

This study compared proximal femoral morphology in patients living in soft and hard water regions. The proximal femoral morphology of two groups of 70 patients living in hard and soft water regions with a mean age of 72.3 (range 50 to 87 years) were measured using an antero-posterior radiograph of the non-operated hip with magnification adjusted. The medullary canal diameter at the level of the lesser trochanter (LT) was significantly wider in patients living in the hard water region (mean width 1.9 mm wider; p= 0.003). No statistical significant difference was found in the medullary canal width at 10 cm below the level of LT, Dorr index, or Canal Bone Ratio (CBR). In conclusion, the proximal femoral morphology does differ in patients living in soft and hard water areas. These results may have an important clinical bearing in patients undergoing total hip replacement surgery. Further research is needed to determine whether implant survivorship is affected in patients living in hard and soft water regions.

Can larger-bodied cemented femoral components reduce periprosthetic fractures? A biomechanical study

Introduction: The risk for late periprosthetic femoral fractures is higher in patients treated for a neck of femur fracture compared to osteoarthritis. It has been hypothesised that osteopenia and consequent decreased stiffness of the proximal femur are responsible for this. We investigated whether a femoral component with a bigger body would increase the torque to failure in a biaxially loaded composite Sawbone model. Material and methods: A biomechanical bone analogue was used. Two different body sizes (Exeter 44-1 vs 44-4) of a polished tapered cemented femoral stem were implanted by an experienced surgeon in 7 bone analogues each and internally rotated at 40°/s until failure. Torque to fracture and fracture energy were measured using a biaxial materials testing device (Instron 8874, MI, USA). The data were non-parametric and therefore tested with the Mann-Whitney U-test. Results: The median torque to fracture was 156.7 Nm (IQR 19.7) for the 44-1 stem and 237.1 Nm (IQR 52.9) for the 44-4 stem (p=0.001). The median fracture energy was 8.5J (IQR 7.3) for the 44-1 stem and 19.5J (IQR 8.8) for the 44-4 stem (p=0.014). Conclusions: The use of a large body polished tapered cemented stems for neck of femur fractures increases the torque to failure in a biomechanical model and therefore is likely to reduce late periprosthetic fracture risk in this vulnerable cohort.

River Dart Scale Reading Investigation Report on the 1965 Season

This is the fourth River Dart Scale Reading Investigation Report on the 1965 season by the Devon River Board. The object of this investigation is to examine, by means of scale-reading, the general biology of the salmon population of the River Dart. It reviews the methods used for the collection of scales and examination of the materials. It shows the results of the survey and the number of scales studied from each of the various sea-age classes, time of running with distribution of the sea-age groups throughout the season, fish sizes and smolt ages at migration. All it summarized in tables, and figures are included plotting weight distributions for each age classes and frequency distributions.

River Dart Scale Reading Investigation Report on the 1966 Season

This is the fifth River Dart Scale Reading Investigation Report on the 1966 Season by the Devon River Board. The object of this investigation is to examine, by means of scale-reading, the general biology of the salmon population of the River Dart. It reviews the methods used for the collection of scales and examination of the materials. It shows the results of the survey and the number of scales studied from each of the various sea-age classes, time of running with distribution of the sea-age groups throughout the season, fish sizes and smolt ages at migration. All it summarized in tables, and figures are included plotting weight distributions for each age classes and frequency distributions. It also compares the results of previous reports.

River Dart Scale Reading Investigation Report on the 1967 Season

This is the sixth and final River Dart Scale Reading Investigation Report on the 1967 Season by the Devon River Board. The object of this investigation is to examine, by means of scale-reading, the general biology of the salmon population of the River Dart. It reviews the methods used for the collection of scales and examination of the materials. It shows the results of the survey and the number of scales studied from each of the various sea-age classes, time of running with distribution of the sea-age groups throughout the season, fish sizes and smolt ages at migration. All it summarized in tables, and figures are included plotting weight distributions for each age classes and frequency distributions. It also compares the results of previous reports and gives a full summary for the investigation (including previous reports).

River Dart Scale Reading Investigation Report on the 1962 Season

This is the first River Dart Scale Reading Investigation Report on the 1962 season by the Devon River Board. The object of this investigation is to examine, by means of scale-reading, the general biology of the salmon population of the River Dart. It reviews briefly the theory and mechanics of the scale-reading technique, the life history of the salmon, and the methods used for the collection of scales and the examination of the materials. It shows the results of the survey and the number of scales studied from each of the various sea-age classes, time of running with distribution of the sea-age groups throughout the season, fish sizes and smolt ages at migration. All are summarized in various tables and figures are also included, plotting weight distributions for each age classes and frequency distributions.

River Dart Scale Reading Investigation Report on the 1963 Season

This is the second River Dart Scale Reading Investigation Report on the 1963 season by the Devon River Board. The object of this investigation is to examine, by means of scale-reading, the general biology of the salmon population of the River Dart. It reviews the methods used for the collection of scales and examination of the materials. It shows the results of the survey and number of scales studied from each of the various sea-age classes, time of running with distribution of the sea-age groups throughout the season, fish sizes and smolt ages at migration. All are summarized in tables, and figures are alo included plotting weight distributions for each age classes and frequency distributions. The report also remarks the similarity of the results with those for 1962.

River Dart Scale Reading Investigation Report on the 1964 Season

This is the third River Dart Scale Reading Investigation Report on the 1964 season by the Devon River Board. The object of this investigation is to examine, by means of scale-reading, the general biology of the salmon population of the River Dart. It reviews the methods used for the collection of scales and examination of the materials. It shows the results of the survey and the number of scales studied from each of the various sea-age classes, time of running with distribution of the sea-age groups throughout the season, fish sizes and smolt ages at migration. All are summarized in tables, and figures are also included plotting weight distributions for each age classes and frequency distributions. After three years of the investigation a pattern is emerging which shows that the Dart salmon population is mainly composed of four year old fish, which have spent two years in the river and then two year or little longer at sea.

River Dart fisheries survey 1965

This is the first River Dart Fisheries Survey produced by the Devon River Authority; which was carried out from May to October 1965. The objective was to examine the distribution and relative abundance of salmonid fish in the River Dart, in order to assess the possibility or desirability, of increasing salmon smolt production of the river by artificial propagation or other means. Description, chemical, pollution and biological conditions of the River Dart along with fisheries catches, water extraction and spawning are briefly cited. The method includes the choice of sections and sampling techniques. The results go through the number/type/class of fishes counted while the survey took place, distribution patterns within the different transects/brooks, competition between salmon parr and trout and estimations of population. The section on the discussion and recommendations is introduced by a brief explanation of the bases for the Artificial Propagation Programme and the River Dart specific case-study. The annexes contains River Dart and tributaries maps, fish size distribution tables and figures, tables with totals of salmonid fish found and population density tables.

River Dart fisheries survey 1969

This is the second River Dart Fisheries Survey produced by the Devon River Authority; which was carried out from April to July, 1969. The objective was to examine the distribution and relative abundance of salmonid fish in the River Dart, in order to assess the possibility or desirability, of increasing salmon smolt production of the river by artificial propagation or other means. In addition to the tributaries examined in the 1965 survey, further sections were studied on the River Hems and Holy Brook and reference should be made to the River Survey Report, 1965 for introductory information. The method includes the choice of sections and sampling techniques. The results go through the number/type/class of fishes counted while the survey took place and distribution patterns within the different transects/brooks. The discussion tries to remark the importance of understanding the differences between 1965 and 1969 surveys. The Appendix contains tables with totals of salmonid fish found and distribution sizes for each section, population density tables and a map with new surveyed sections.