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https://www.readbyqxmd.com/read/28190644/what-are-normal-metal-ion-levels-after-total-hip-arthroplasty-a%C3%A2-serologic-analysis-of-four-bearing-surfaces
#1
Brian T Barlow, Philippe A Ortiz, John W Boles, Yuo-Yu Lee, Douglas E Padgett, Geoffrey H Westrich
BACKGROUND: The recent experiences with adverse local tissue reactions have highlighted the need to establish what are normal serum levels of cobalt (Co), chromium (Cr), and titanium (Ti) after hip arthroplasty. METHODS: Serum Co, Cr, and Ti levels were measured in 80 nonconsecutive patients with well-functioning unilateral total hip arthroplasty and compared among 4 bearing surfaces: ceramic-on-ceramic (CoC); ceramic-on-polyethylene (CoP); metal-on-polyethylene (MoP), and dual mobility (DM)...
December 3, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28167867/hip-resurfacing-international-perspectives-review-article
#2
REVIEW
Julien Girard
BACKGROUND: The hip resurfacing concept was developed for young and active patients, especially for femoral bone stock preservation. However, concerns about metal-on-metal bearings with adverse reactions to metal debris have led to a drop off in hip-resurfacing procedures. QUESTIONS/PURPOSES: The goal of this review is to evaluate our current knowledge of survivorship of second-generation hip resurfacing devices and elaborate international perspectives for product improvement...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28165599/cementing-a-polyethylene-cup-into-a-well-fixed-acetabular-metal-on-metal-resurfacing-component-an-experimental-investigation
#3
Matthias C M Klotz, Sebastian Jäger, Philippe Kretzer, Nicholas A Beckmann, Marc Thomsen, Rudi G Bitsch
INTRODUCTION: Adverse reactions to metal debris often indicate revision surgery in metal-on-metal (MoM) hip arthroplasty and an exchange of the MoM bearing into either a metal on polyethylene or a ceramic-on-polyethylene articulation. At the moment the removal of the entire implant system is the most reasonable method. In order to avoid bone loss caused by the removal of a well-fixed acetabular component, the purpose of this study was to measure the stability of a cemented polyethylene (PE) cup in an acetabular hip resurfacing component and to examine if such a method could be suitable for clinical use...
February 3, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28159422/fretting-and-corrosion-between-a-metal-shell-and-metal-liner-may-explain-the-high-rate-of-failure-of-r3-modular-metal-on-metal-hips
#4
Kevin C Ilo, Emma J Derby, Robert K Whittaker, Gordon W Blunn, John A Skinner, Alister J Hart
BACKGROUND: The R3 acetabular system used with its metal liner has higher revision rates when compared to its ceramic and polyethylene liner. In June 2012, the medical and healthcare products regulatory agency issued an alert regarding the metal liner of the R3 acetabular system. METHODS: Six retrieved R3 acetabular systems with metal liners underwent detailed visual analysis using macroscopic and microscopic techniques. RESULTS: Visual analysis discovered corrosion on the backside of the metal liners...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28131541/cobalt-toxicity-after-revision-total-hip-replacement-due-to-fracture-of-a-ceramic-head
#5
J M Pelayo-de Tomás, C Novoa-Parra, P Gómez-Barbero
Symptomatic cobalt toxicity from a failed total hip replacement is a rare, but devastating complication. Potential clinical findings include cardiomyopathy, hypothyroidism, skin rash, visual and hearing impairment, polycythaemia, weakness, fatigue, cognitive impairment, and neuropathy. The case is presented of a 74year-old man in whom, after a ceramic-ceramic replacement and two episodes of prosthetic dislocation, it was decided to replace it with a polyethylene-metal total hip arthroplasty (THA). At 6months after the revision he developed symptoms of cobalt toxicity, confirmed by analytical determination (serum cobalt level=651...
January 25, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28115797/osteolysis-in-total-hip-arthroplasty-after-head-and-inlay-revision-surgery
#6
Lorenz Pisecky, Günter Hipmair, Bernhard Schauer, Nikolaus Böhler
Wear debris seems to be the most likely reason for osteolysis in THA. The aim was to show the influence of head and acetabular liner revision surgery on osteolytic zones around the femoral component. Can head and inlay revision surgery reduce the size of the osteolytic zones around the femoral component? Which patients could benefit? 47 patients (51 hips), who had undergone THA head and inlay revision surgery between 1999 and 2011, were reviewed. The mean lifetime for the prosthesis was 15.1 years (8-26, standard deviation 4...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28106229/the-rm-pressfit-vitamys-5-year-swiss-experience-of-the-first-100-cups
#7
Michael Wyatt, Jan Weidner, Dominik Pfluger, Martin Beck
BACKGROUND: The RM Pressfit vitamys is a titanium particle-coated monoblock cup with vitamin E stabilised highly cross-linked polyethylene. Initial fixation is achieved via press-fit with subsequent stability by bone on-growth. This is the first study to report the 5-year results of this design. METHODS: We performed a prospective cohort study according to STROBE guidelines of 100 consecutive total hip replacements (THRs) in 92 patients all with ceramic heads. Demographic data, pre/postoperative visual analogue scale (VAS) for pain and satisfaction, Harris Hip Scores (HHS) and complications were recorded...
January 20, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28097117/cobalt-intoxication-heart-failure-after-revision-total-hip-replacement-for-ceramic-head-fracture-a-case-report
#8
Chul-Ho Kim, Young Hyun Choi, Mi Yeon Jeong, Jae Suk Chang, Pil Whan Yoon
In 1960s, toxic heart failure due to cobalt poisoning was firstly reported from Canadian industrial worker. Following development of bearing materials in hip arthroplasties, using cobalt-chrome alloy in bearing surface, there were rarely reported of systemic affect toxic cobaltism include toxic heart failure due to articulation wear in Western countries. It could be happened more easily by third body wear from ceramic particle especially revision total hip replacement (THR) surgery using cobalt-chrome alloy following ceramic articulation breakage which index surgery performed by ceramic on ceramic bearing...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28097115/granulomatous-lung-disease-a-novel-complication-following-metallosis-from-hip-arthroplasty
#9
Theodoros Balbouzis, Thomas Georgiadis, Peter Grigoris
A case of a female patient with local and systemic complications of metallosis, following catastrophic wear of a revised hip arthroplasty, is presented. The patient had a history of a fractured ceramic-on-ceramic implant, exchanged with a metal-on-polyethylene prosthesis. Systemic complications included sarcoidosis-like reactions, presenting as granulomatous lung disease, along with chorioretinitis, erythema nodosum, and cardiomyopathy. High local and circulating cobalt and chromium levels established the diagnosis...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28065626/choosing-a-femoral-head-a-survey-study-of-academic-adult-reconstructive-surgeons
#10
Sumon Nandi, Matthew S Austin
BACKGROUND: Our aim was to examine how academic adult reconstructive surgeons have interpreted evidence on femoral head material in total hip arthroplasty (THA). METHODS: A 16-question survey to evaluate attitudes toward ceramic and cobalt-chrome head use was emailed to 274 faculty at 42 US adult reconstruction fellowship programs. RESULTS: With 116 respondents, the response rate was 42.2%. Faculty use ceramic heads 72.9% of the time. The most common reason why respondents do not use ceramic heads is cost (44...
December 18, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28057394/metal-ion-levels-in-young-active-patients-receiving-a-modular-dual-mobility-total-hip-arthroplasty
#11
Denis Nam, Rondek Salih, Katherine M Brown, Ryan M Nunley, Robert L Barrack
BACKGROUND: Dual mobility total hip arthroplasty (THA) components improve stability, yet use of a modular cobalt alloy acetabular liner may be associated with metal ion release. This study's purpose was to measure blood metal ion levels in young, active patients receiving a dual mobility THA prosthesis. METHODS: This is a prospective study of young, active patients undergoing primary THA. Twenty-six patients received a 22-mm cobalt alloy (n = 10) or a 28-mm ceramic (n = 16) femoral head, a modular cobalt chrome acetabular liner, with a highly cross-linked polyethylene insert (dual mobility)...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28053256/high-prevalence-of-noise-following-delta-ceramic-on-ceramic-total-hip-arthroplasty
#12
P P Salo, P B Honkanen, I Ivanova, A Reito, J Pajamäki, A Eskelinen
AIMS: We evaluated the short-term functional outcome and prevalence of bearing-specific generation of audible noise in 301 patients (336 hips) operated on with fourth generation (Delta) medium diameter head, ceramic-on-ceramic (CoC) total hip arthroplasties (THAs). PATIENTS AND METHODS: There were 191 female (63%) and 110 male patients (37%) with a mean age of 61 years (29 to 78) and mean follow-up of 2.1 years (1.3 to 3.4). Patients completed three questionnaires: Oxford Hip Score (OHS), Research and Development 36-item health survey (RAND-36) and a noise-specific symptom questionnaire...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28043037/stem-taper-mismatch-has-a-critical-effect-on-ceramic-head-fracture-risk-in-modular-hip-arthroplasty
#13
Julian Gührs, Mandy Körner, Maren Bechstedt, Annika Krull, Michael M Morlock
BACKGROUND: Modular total hip prostheses with ceramic heads are well established in orthopedic surgery and widely used. With the variety of different manufacturers and available designs, components are at risk for mismatch. Several case studies show the potentially devastating effects of mismatch. METHODS: The aim of this study was to investigate the outcome of one arbitrary component mismatch with commercially available components that appear to provide a stable fixation during assembly...
December 16, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/28040609/in-situ-observation-of-lubricant-film-formation-in-thr-considering-real-conformity-the-effect-of-diameter-clearance-and-material
#14
D Nečas, M Vrbka, F Urban, J Gallo, I Křupka, M Hartl
The aim of the present study is to provide an analysis of protein film formation in hip joint replacements considering real conformity based on in situ observation of the contact zone. The main attention is focused on the effect of implant nominal diameter, diametric clearance and material. For this purpose, a pendulum hip joint simulator equipped with electromagnetic motors enabling to apply continuous swinging flexion-extension motion was employed. The experimental configuration consists of femoral component (CoCrMo, BIOLOX®forte, BIOLOX®delta) and acetabular cup from optical glass fabricated according to the dimensions of real cups...
December 23, 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28012723/incidence-of-ceramic-liner-malseating-after-ceramic-on-ceramic-total-hip-arthroplasty-associated-with-osteolysis-a-5-to-15-year-follow-up-study
#15
Yoshitoshi Higuchi, Yukiharu Hasegawa, Daigo Komatsu, Taisuke Seki, Naoki Ishiguro
BACKGROUND: The aim of our study was to evaluate the clinical and radiographic outcomes of malseating of the acetabular liner in ceramic-on-ceramic total hip arthroplasty (THA). METHODS: Outcomes for 160 ceramic-on-ceramic THAs, contributed by 116 women and 39 men, were evaluated. Clinical and radiographic measurements were obtained over a 5- to 15-year follow-up for analysis. RESULTS: Liner malseating was identified in 20% of cases. Outcomes for 32 cases with liner malseating (group A) were compared to outcomes for 128 joints with correct liner seating (group B)...
December 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28009420/clinical-outcomes-of-ceramicized-ball-heads-in-total-hip-replacement-bearings-a-literature-review
#16
Corrado Piconi, Vincenzo De Santis, Giulio Maccauro
BACKGROUND: Metallic ball heads for total hip replacement (THR) bearings with ceramicized surfaces were introduced in orthopedics during the second half of the 1980s, with the aim of decreasing the wear of polyethylene cups. METHODS: An analysis was made of the literature regarding outcomes for metallic ball heads with ceramicized surfaces now in clinical use (TiN, TiNbN, ZrN, monoclinic ZrO2), as well as carbon coatings (pyrolytic carbon, diamond-like carbon) and silicon nitride as coatings in ball heads for THR bearings...
December 6, 2016: Journal of Applied Biomaterials & Functional Materials
https://www.readbyqxmd.com/read/27966180/-endoprostheses-in-the-elderly-biomaterials-implant-selection-and-fixation-technique
#17
M M Morlock, M Jäger
The replacement of hip and knee joints is one of the greatest success stories in orthopedics. Due to continuous improvement of biomaterials and implant design, patient-associated problems are now mostly multifactorial and only rarely caused by the implant. Abrasion was significantly reduced by the introduction of highly cross-linked polyethylene (PE), antioxidant stabilized PE, new ceramics and the development of ceramic and protective surfaces. It is assumed that further reduction of frictional resistance will not lead to a significantly better clinical result: however, the problem of periprosthetic infections and implant-related incompatibility is still unsolved and remains challenging for biomaterial research...
January 2017: Der Orthopäde
https://www.readbyqxmd.com/read/27955657/adverse-reactions-to-metal-debris-occur-with-all-types-of-hip-replacement-not-just-metal-on-metal-hips-a-retrospective-observational-study-of-3340-revisions-for-adverse-reactions-to-metal-debris-from-the-national-joint-registry-for-england-wales-northern-ireland
#18
Gulraj S Matharu, Hemant G Pandit, David W Murray, Andrew Judge
BACKGROUND: Adverse reactions to metal debris (ARMD) have resulted in the high short-term failure rates observed with metal-on-metal hip replacements. ARMD has recently been reported in non-metal-on-metal total hip replacements (non-MoM THRs) in a number of small cohort studies. However the true magnitude of this complication in non-MoM THRs remains unknown. We used a nationwide database to determine the risk of ARMD revision in all non-MoM THRs, and compared patient and surgical factors associated with ARMD revision between non-MoM and MoM hips...
December 13, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27919579/alumina-delta-on-alumina-delta-bearing-in-cementless-total-hip-arthroplasty-in-patients-aged-50-years
#19
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
BACKGROUND: There are limited studies to evaluate long-term clinical and radiographic outcomes of alumina delta ceramic-on-ceramic bearings in cementless total hip arthroplasty (THA). The purpose of this study was to evaluate the clinical and radiographic results, prevalence of osteolysis, squeaking, and fracture of ceramic material associated with the use of the alumina delta ceramic-on-alumina delta ceramic bearing in cementless THA in patients aged <50 years. METHODS: We reviewed the cases of 277 patients (334 hips) who underwent a cementless THA using alumina delta ceramic-on-alumina delta ceramic when they were 50 years or younger at the time of surgery...
December 2, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27912168/tensor-resolved-raman-spectroscopic-analysis-of-wear-induced-residual-stress-fields-in-long-term-alumina-hip-joint-retrievals
#20
Wenliang Zhu, Elia Marin, Nobuhiko Sugano, Giuseppe Pezzotti
Polarized Raman spectroscopy was applied to evaluate the full set of stress tensor components in the wear-induced residual stress fields on two long-term (>20 y) (monolithic) alumina (Al2O3) femoral head retrievals coupled to polyethylene liners. The tensor-resolved residual stress state stored onto the Al2O3 ceramic head surface was found to retain "memory" of the sliding conditions in vivo and of the wear-induced consumption of the polyethylene counterpart. The evolution of tensor-resolved residual stress motifs in the three-dimensional space was examined, and key features, including exceptionally high shear stresses in one case, were uncovered...
February 2017: Journal of the Mechanical Behavior of Biomedical Materials
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