The insidious risk of periprosthetic fracture in clinically functional total hip arthroplasties: A biomechanical study of willed joints.

Femoral bone quality is a major risk factor of periprosthetic fracture after total hip arthroplasty (THA), which has mortality similar to native hip fractures but higher short-term morbidity. The goal of this study was to quantify cortical strains at the site of expected Vancouver Type-B periprosthetic fracture as a function of bone mineral density, femoral stem material, and fixation method using a series of 29 autopsy-retrieved, clinically asymptomatic hip joints with THA. Periprosthetic bone mineral content and density was assessed using dual-energy X-ray absorptiometry by Gruen Zone. Specimens then underwent combined cyclic axial and torsional loading, increasing incrementally from 100 N and ±1 Nm to peaks of 700 N and ±5 Nm. All specimens experienced significantly higher strains on the lateral surface than on the anterior surface, indicating that the bending loads in the frontal plane, rather than axial/torsional loads, had the predominant effect. Multiple significant relationships (p = 0.04, p = 0.02) were found between predicted periprosthetic strains calculated from radiographic measurements and observed principal strains. Though THA in the present study were in successful clinical service, the produced results indicated that some femurs with rigid cemented or noncemented implants were potentially at high risk for Vancouver Type-B fractures, which may be predicted radiographically.

The distribution of 4-nonylphenol in marine organisms of North American Pacific Coast estuaries.

One of the chemical breakdown products of nonylphenol ethoxylates, 4-nonylphenol (4-NP), accumulates in organisms and is of concern as an environmental pollutant due to its endocrine disrupting effects. We measured 4-NP levels in the seawater, sediment, and twelve organisms within the California estuary, Morro Bay, and examined biomagnification of 4-NP using stable isotope abundances (δ(15)N and δ(13)C) to quantify trophic position. 4-NP concentrations in organisms from Morro Bay included 25000±8600 ng g(-1) lw in liver of California sea lion, 14000±5600 ng g(-1) lw in liver of harbor porpoise, 138000±55000 ng g(-1) lw in liver of sea otters, 15700±3600 ng g(-1) lw in liver of seabirds, 36100±6100 ng g(-1) lw in arrow goby fish, 62800±28400 ng g(-1) lw in oysters, and 12700±1300 ng g(-1) lw in mussels. 4-NP levels generally showed a pattern of trophic dilution among organisms in Morro Bay, with exceptions of biomagnification observed between three trophic links: mussel to sea otter (BMF 10.9), oyster to sea otter (BMF 2.2), and arrow goby to staghorn sculpin (BMF 2.7). Our examination of other west coast estuaries of USA and Canada revealed that mean 4-NP concentrations in gobies and mussels from Morro Bay were significantly higher than those from a more urbanized estuary, San Francisco Bay (goby: 11100±3800 ng g(-1) lw) and from a remote estuary, Bamfield Inlet, Canada (goby: 9000±900 ng g(-1) lw, mussel: 6100±700 ng g(-1) lw). Relative to other estuaries worldwide, 4-NP levels in seawater (0.42±0.16 µg L(-1)) and sediment (53±14 ng g(-1) dw) of Morro Bay are low, but gobies and oysters have higher 4-NP levels than comparable fauna.