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The Journal of Bone and Joint Surgery 80:1710 (1998)
© 1998 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

J. Bellemans, M.D., Ph.D., Roy D. Bloebaum, Ph.D., Jennifer W. Jensen, B.S., Aaron A. Hofmann, M.D., Kent N. Bachus, Ph.D. and David F. Scott, M.D.

TO THE EDITOR:

I read with interest "Porous-Coated Metal-Backed Patellar Components in Total Knee Replacement. A Postmortem Retrieval Analysis" (80-A: 518–528, April 1998), by Bloebaum et al.

The authors reported a mean appositional bone index of 86 percent, as measured on contact radiographs of three-millimeter-thick sections.

However, this is probably a gross overestimation of the real amount of bone apposition because of the superposition effect of contact radiographs on such thick sections.

A realistic assessment of bone apposition is only possible on sections with a thickness of thirty micrometers or less9,10. This is 100 times thinner than the sections analyzed by Bloebaum et al. The techniques used to obtain and analyze sections of this thickness are readily available2. It is therefore very likely that the actual bone apposition for these patellar components was much smaller than that reported.

J. Bellemans, M.D., Ph.D.: Catholic University . . . [Full Text of this Article]


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