Matthias Honl Fachkonzept
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Fachkonzept Hüftendoprothetik Orthopädie LKH Klagenfurt
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Matthias Honl Fachkonzept
- 4. Anatomy—Hip
- 5. Implantate
- 8. Verfahren
- 9. Verfahren
- 10. Verfahren
- 11. Verfahren
- 14. Wiles 1938 Geschichte: erste Endoprothesen Ring 1964 McKee Farrar
- 16. - Historie -
- 18. EVIDENZ
- 19. EVIDENZ
- 20. EVIDENZ
- 24. Infektion
- 25. Verschleiß
- 26. Osteolysen
- 31. Tribologie ist die Wissenschaft und Technik von aufeinander einwirkenden Oberflächen in Relativbewegung. Sie umfasst das Gesamtgebiet von Reibung und Verschleiß , einschließlich Schmierung , und schließt entsprechende Grenzflächenwechselwirkungen sowohl zwischen Festkörpern als auch zwischen Festkörpern und Flüssigkeiten oder Gasen ein. - Tribologie -
- 32. BIOLOGIE - Tribologie -
- 34. Comparison of Wear Rates - Tribologie -
- 35. insgesamt betrachtet versagten die Metall-Metall Prothesen der 1. Generation WARUM? Material, Design, Verankerung, Herstellungs- und Implantationsprobleme -Tribologie am Beispiel Metall-Metall
- 36. - Tribologie -
- 37. Schmierung ist die Hypothese
- 43. MoM der 3. Generation -MoM 3. Generation - ACCIS Finsbury Int. Orthopaedics Bio-surf Wright BHR
- 44. - jede Paarung produziert Partikel - jeder Partikel kann Reaktionen erzeugen, Unterschiede: · Anzahl · Form · Material · Oberfläche · Lokation · Toxizität · Abbau · ….. -Tribologischer Imput -
- 45. Abriebpartikel Metall: - ca. 10 6 Metallpartikel / pro Schritt - Nebenwirkungen: Lmphozytische Reaktion Hypersensitivität in ca. 0,05 – 0,5% der Patienten (Willert / Park / Schmalzried/Jacobs) - Ionenkonzentration Blut / Serum - jede Paarung produziert Partikel - jeder Partikel kann Reaktionen erzeugen
- 46. - gross - rund - hart - geschmiert - passgenau - perfekt ausgerichtet Für Metall Metall: TAKE HOME
- 48. WAS tun- für unsere Patienten???
- 51. Survivorship – global results
- 52. Australian Orthopaedic Association National Joint Replacement Registry 2006 Report “ Unlike conventional total hips, the younger the resurfacing patient the lower the revision rate”
- 54. 2J 3J
- 55. Finite Elemente: Southampton - Andrew New:
- 56. Prosthese Knochen Methode Coordinate Systems:
- 58. CT0501 – Current Study Centre Status Centre Number Investigator Study Site No. / Approval Status 2 Dr J Sullivan Sydney Adventist Hospital, Australia 19 3 Dr C Waller Randwick Orthosports Clinic, Australia 10 4 Mr M Maheson Llandough Hospital, Wales 0 5 Prof N Pace Ospedali Riuniti di Jesi, Italy Approvals in progress 6 Prof E Masterson Midwestern Regional Orthopaedic Hospital, Ireland Approvals in progress 7 Dr R Verheul Royal Newcastle Hospital, Australia 4 9 Prof A Kurth Universitatsklinik Friedrichscheim, Germany Approvals in progress 10 Prof P Piriou Hôpital Raymond-Poincar é , France 9
- 62. Reinigung des Knochenbetts Ohne Pulse-Lavage Mit Pulse-Lavage Breusch, 2000
- 65. Pulse lavage Keine Puls Lavage Breusch, 2000
- 66. Aufsammeln unter Vakuum Vacuum Stop vacuum Vacuum mixing Collection without vacuum vacuum Collection with vacuum Wang et al. Acta Orthop Scand. 1993, 64:143-6 vacuum Collection with vacuum
- 69. Unser Lebensalter adaptiertes Therapiekonzept LKH Orthopädie: Wir verantworten Bewegung ! EVIDENZ?
- 70. Das Team sagt Danke:
Notas del editor
- In fact thin film lubrication depends on head diameter, surface finish, surface roundness, clearance and the material itself. The Depuy product will be better than all the competitors in all these...
- But there are limitations on this approach. Firstly of all, roughness depends on the manufacturing capabilities, bearing materials, and operating conditions, and may be difficult to control and is not easy to characterize. Secondly, the meaning of Ra is not very precise. Different surface roughness profiles may give the same Ra value.
- There are many ways which can be used to increase the lubricant film thickness. For example, to increase the contact area between the two bearing surfaces, which can generally lead to the increase in the lubricant film thickness. This can be achieved through modification of the geometries of the bearing surfaces. It is also possible to increase the elasticity of the bearing surfaces, through considerations of both the materials and the structural supports. It is also possible to alter the loading pattern to increase the squeeze-film action, or to inject an artificial lubricant with high viscosities, but these may not be easy to achieve. So the most widely adopted strategy is to modify the geometries of the bearings surfaces to increase the lubricant film thickness.
- There are two main parameters which governing the geometry of the bearing surfaces. The femoral head and the clearance The increase in the femoral head radius can increase the lubricant film thickness, since both the contact area and the sliding speed can be increased. But we should also realize that the sliding distance is also increased, which may not be a problem if the two surfaces are completely separated. The decrease in clearance also increases the contact area and hence lubrication. But we must be careful that the increase in the contact radius does not adversely affect lubrication, for example equatorial contact and blockage of lubricant entry.
- There are two main parameters which governing the geometry of the bearing surfaces. The femoral head and the clearance The increase in the femoral head radius can increase the lubricant film thickness, since both the contact area and the sliding speed can be increased. But we should also realize that the sliding distance is also increased, which may not be a problem if the two surfaces are completely separated. The decrease in clearance also increases the contact area and hence lubrication. But we must be careful that the increase in the contact radius does not adversely affect lubrication, for example equatorial contact and blockage of lubricant entry.