Total Joint Replacement

Randall E. Marcus, MD, Professor and Chairman, Department of Orthopaedics

1. Aseptic Loosening of Orthopaedic Implants: Aseptic loosening occurs in the absence of clinical signs of infection. Nevertheless, bacterial endotoxin derived from subclinical infections, systemic sources, or the implant manufacturing process may contribute to aseptic loosening. The rate of implant infection is greater in patients with inflammatory arthritis than in patients with osteoarthritis. This is a long-term study regarding the effects of antibiotic-impregnated cement and its relationship to loosening in both osteoarthritis and inflammatory arthritis.
2. Subtrochanteric Femur Fracture After Screw Fixation of Femoral Neck Fracture: This is an ongoing study regarding the increased risk of subtrochanteric fracture after violation of the lateral cortex below the lateral trochanteric flare.
3. The Magnitude and Risk of Noise Exposure in Orthopaedic Surgery: This is an ongoing study regarding the increased risk of hearing deficits in orthopaedic surgeons, particularly in exposures of greater than 90 decibels.
4. Long-term Implant Survival Following Custom-Designed Uncemented Total Hip Femoral Implants: Total joint replacement specialists at University Hospitals Cleveland Medical Center have been utilizing a custom-designed hip protocol for younger patients with proximal femoral bony architecture that would be unlikely to fit current porous ingrowth prosthetic devices. Custom-made devices are implanted and followed prospectively regarding their hip function.