873 publications from this institution
We report the ten-year results for three designs of stem in 240 total hip replacements, for which subsidence had been measured on plain radiographs at regular intervals. Accurate migration patterns could be determined by the method of Einzel-Bild-Roentgen-Analyse-femoral component analysis (EBRA-FCA) for 158 hips (66%). Of these, 108 stems (68%) remained stable throughout, and five (3%) started to migrate after a median of 54 months. Initial migration of at least 1 mm was seen in 45 stems (29%) during the first two years, but these then became stable. We revised 17 stems for aseptic loosening, and 12 for other reasons. Revision for aseptic loosening could be predicted by EBRA-FCA with a sensitivity of 69%, a specificity of 80%, and an accuracy of 79% by the use of a threshold of subsidence of 1.5 mm during the first two years. Similar observations over a five-year period allowed the long-term outcome to be predicted with an accuracy of 91%. We discuss the importance of four different patterns of subsidence and confirm that the early measurement of migration by a reasonably accurate method can help to predict long-term outcome. Such methods should be used to evaluate new and modified designs of prosthesis.
One of the most disputed issues raised by molten corium concrete interaction (MCCI) is how the 2D cavity ablation in an oxidic pool evolves: why is the ablation anisotropic with siliceous concretes and isotropic with carbonaceous concretes. The work performed in the frame of the SARNET2 WP6 group during the last 4years has enabled significant progress on this topic. This paper summarizes this progress using the analysis of recent 2D real material experiments in an oxidic pool and from analytical simulant experiments on 2D heat convection in a bubbling pool, including calculations and recalculations with MCCI codes available in Europe. Firstly, the effective heat transfer coefficients from the bulk pool to the bottom and lateral pool interfaces deduced from MCCI experiments lead to a range of a few 100W/m2/K. By contrast, a detailed review of possible 2D convection mechanisms shows that the individual heat convection mechanisms (without taking a crust into account) such as gas bubbling convection and solutal convection overestimates the overall heat transfer coefficient, and does not account for the main trends of 2D ablation deduced from MCCI tests, which are very dependent on the composition of concrete components and aggregates. This fact, in turn, points to the effect of more complex pool/concrete interface structures. On the basis of a thorough interpretation of the experimental database and of a detailed comparison of MCCI code predictions, a set of the most realistic and consistent assumptions are identified and major remaining uncertainties are listed.