Analysing the optimum eburnated bone surface topology for bone cement fixation

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Table of Contents

CHAPTER 2: LITERATURE REVIEW1

Introduction1

Clinical Problem2

Ebournated bones2

Osteoarthritis3

Treatment- Bone Cement Fixation3

Bone Cement3

Pioneering work of Dr. John Charnley:4

PMMA bone Cements4

Mechanical Properties of Bone Cement4

Bone Cement in Aging6

Conclusion7

REFERENCES8

CHAPTER 2: LITERATURE REVIEW

Introduction

A comprehensive literature review has been conducted to establish a solid starting point to pursue the proposed study. The literature review focused on investigating and analyzing current practices as well as relevant research studies in bone cement fixation. Several studies have been conducted related to the two research areas of interest in this study: Total knee replacement and bone cement fixation in aging people (Danielsen, 2007, 723). As the number of total knee replacements has been increasing day by day, researchers are focusing on the bone cement fixation methods which are relatively new research topics. In this chapter, a summary of the findings of previous studies related to the topic are included. This chapter will review various studies represented in the field of science related to total knee replacement, which would help in explaining the knee replacement issue and its causes. Furthermore, this chapter supports the use of literature which has been presented by other researchers (Wang, 2002, 189).

The number of people getting total knee replacement has increased than ever before. During the year 2009, the number of surgeries for total knee replacement has topped up to 600,000 which is twice the number of surgeries carried in past decade. Knee replacement surgery is significantly increasing in people of older age, according to the new research presented by doctors working as physiotherapist in UK (Gourion-Arsiquaud & Faibish, 2009c, 1571). Similar results were observed in a study conducted by the team working at Helsinki University Central Hospital, Finland. The study stated that in past 27 years, there is a rapid increase in the number of people who have gone under the surgery to avoid one of the most problem related to old age. Although, there has been a substantial increase in the surgeries for people between the ages of 39 to 59, yet the biggest increase in the number fo surgeries was observed for people aged between 50 and 59 (Gourion-Arsiquaud & Faibish, 2009c, 1570).

Total knee replacement (TKR) was first proposed in the nineteenth century as a means to alleviate pain from osteoarthritis. Since that time, continual advance- ments have been made to the surgical procedures, designs, and materials that are associated with TKR. In modern TKR, knee joint surfaces that have suffered carti-ered cartilage degeneration are removed and replaced with metal and plastic implants. The diseased portion of the femur is replaced with a monolithic component that is composed of a metal alloy (e.g. cobalt-chrome). Rejected tibial bone is replaced with a metallic base-plate, which holds a plastic bearing made of ultra high molecular weight polyethylene (UHMWPE) (Burguera & Chow, 2005, 967). Finally, the diseased patellar bone is replaced with a UHMWPE implant. This design scheme relies upon soft tissues for constraint, and provides the tibiofemoral and patellofemoral joints the 6 degrees- ...