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  • 1 Department of Musculoskeletal Surgery, University of Pécs, Pecs, Hungary
  • 2 Department of Biophysics, Faculty of Medicine, Institute of Biophysics, University of Pécs, Szigeti Str. 12, 7624, Pecs, Hungary
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Abstract

Aseptic and septic periprosthetic osteolysis following total hip arthroplasty has become increasingly recognized as a major clinical problem. An aggressive granulomatous tissue, the interfacial membrane, develops at the interface between the bone and the prostheses or the bone and the cement. Our hypothesis was that during the septic and aseptic loosening of the total hip arthroplasty, there is a clear pathological abnormality in the tissue elements building up the interfacial membrane, which is responsible for the different aetiologies of the disease and could be monitored besides the classical methods by differential scanning calorimetry. In our study, the interfacial membrane pieces removed during operations of revision hip arthroplasties in the cases of aseptic loosening and during prosthesis removals in the cases of septic implant loosening. We investigated stem parts of cemented hip arthroplasties only. Our measurements were carried out on eight septic and 12 aseptic samples. With our investigations, we could demonstrate that DSC is a useful and well-applicable method for the investigation of the interfacial membrane that develops in septic and aseptic loosening of hip arthroplasty. DSC scans clearly demonstrated significant differences between the different types and conditions of samples (aseptic membrane: Tm = 62.2 °C and ΔHcal = 2.13 J/g, septic membrane: Tm = 60.2 °C and ΔHcal = 3.22 J/g,). These investigations can help us make a correct diagnosis in the problematic cases of loosened total hip arthroplasty. To decide the possible septic feature of a given sample, calorimetry could serve as one of the quickest procedures available.

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