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https://www.readbyqxmd.com/read/28217831/blood-metal-ion-concentrations-in-metal-on-metal-total-hip-arthroplasty
#1
Tadahiko Ohtsuru, Yuji Morita, Yasuaki Murata, Shuji Shimamoto, Yutaro Munakata, Yoshiharu Kato
INTRODUCTION: The hip placement with a metal-on-metal (MOM) bearing has been used for both surface replacement and total hip arthroplasty (THA). Use of MOM bearing for hip replacement reduces the wear compared to conventional bearings. METHODS: We prospectively assessed 30 patients who underwent unilateral MOM THA. A control group of 30 patients who underwent metal-on-polyethylene THA using the implants as the other group, except for bearing, were accessed. Blood samples were collected preoperatively and at 3- , 6- , 9- , 12- , 15- , 18- , and 24-month intervals...
February 20, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28204856/ultrasound-findings-in-asymptomatic-patients-with-modular-metal-on-metal-total-hip-arthroplasty
#2
Nicholas B Frisch, Nolan M Wessell, Kevin Taliaferro, Marnix Van Holsbeeck, Craig D Silverton
OBJECTIVE: The use of metal-on-metal and modular total hip arthroplasty is associated with potentially serious local and systemic complications. The primary aim of this study was to identify the prevalence of a pseudotumor in asymptomatic patients with a particular metal-on-metal hip prosthesis after a minimum follow-up of 5 years using ultrasound evaluation. A secondary purpose was to identify associations between the presence of pseudotumor and serum metal ion levels following implantation...
February 15, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28196445/chrome-nitride-coating-reduces-wear-of-small-spherical-crcomo-metal-on-metal-articulations-in-a-joint-simulator
#3
R Thorkildsen, O Reigstad, M Røkkum
Metal-on-metal articulations have fallen out of favour in larger joint replacements, but are still used in smaller joints. Coating the articulation has been suggested as one way of reducing wear. We compared a standard 6 mm CrCoMo articulation designed for the carpometacarpal joint of the thumb with a chromium nitride-coated version after 512,000 cycles in a joint simulator. A total of 6 articulations in each group were tested with a unidirectional load of 5 kg in Ringer's solution. We found a statistically significant reduction in weight loss, amount of metallic wear produced and volumetric wear for the chromium nitride-coated articulation...
March 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28195859/metallosis-identified-via-intraoperative-cell-salvage-a-case-report
#4
Lauren M Parker, Mark H Yazer, Jonathan H Waters
Intraoperative cell salvage, whereby shed surgical blood is recovered for autologous reinfusion, is frequently used during hip arthroplasty because of the potential for significant blood loss. The following cases describe 2 instances in which chromium and cobalt particles from patients' metal-on-metal hip implants were identified within the blood recovery system. Results of heavy metal testing during the second case suggest that the use of a leukocyte reduction filter effectively reduces metal concentrations to below normal circulating levels...
February 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28167874/design-considerations-for-the-next-generation-hip-resurfacing-implant-commentary
#5
Edwin P Su
The current generation of hip resurfacing consists of a metal-on-metal ball and monoblock socket of minimal thickness. Although results in certain patient subgroups have been excellent at up to 15 years of follow-up, other subgroups have had poor results. The hard-on-hard bearing is susceptible to edge-loading conditions and may produce excessive metallic debris; furthermore, other patients have had allergic reactions to the metal byproducts. In both situations, there can be clinical failures from adverse local tissue reactions...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167873/corrosion-of-the-head-stem-taper-junction-are-we-on-the-verge-of-an-epidemic-review-article
#6
REVIEW
Michael Morlock, Dennis Bünte, Julian Gührs, Nicholas Bishop
BACKGROUND: The modular head taper junction has contributed to the success of total hip arthroplasty (THA) greatly. Taper corrosion and wear problems reported for large and extra-large metal-on-metal bearings as well as for bi-modular THA stems have cast doubt on the benefit of the taper interface. Presently, corrosion problems are being reported for nearly all kinds of artificial hip joints incorporating metal heads, questioning taper connections in general. QUESTIONS/PURPOSES: This study aimed to review the mechanical and electrochemical relationships that may lead to taper corrosion, which have been reported more commonly in recent literature, and to also review the contribution of patient characteristics and surgical techniques involved in taper assembly that may contribute to the problem...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167869/bearings-in-hip-arthroplasty-joint-registries-vs-precision-medicine-review-article
#7
REVIEW
Mark J Pearson, Liam M Grover, Janet M Lord, Simon W Jones, Edward T Davis
BACKGROUND: Precision medicine has been adopted in a range of clinical settings where omics data have led to greater characterisation of disease and stratification of patients into subcategories of phenotypes and pathologies. However, in orthopaedics, precision medicine lags behind other disciplines such as cancer. Joint registries have now amassed a huge body of data pertaining to implant performance which can be broken down into performance statistics for different material types in different cohorts of patients...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167867/hip-resurfacing-international-perspectives-review-article
#8
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/28167866/the-role-of-metal-on-metal-bearings-in-total-hip-arthroplasty-and-hip-resurfacing-review-article
#9
David Sands, Emil H Schemitsch
BACKGROUND: The current role of metal-on-metal (MoM) bearings in hip arthroplasty remains controversial. The low wear offered by MoM bearings compared to metal-on-polyethylene and the possibility of a lower risk of dislocation with larger head sizes, encouraged a trend towards the re-introduction of the MoM bearing couple. However, recent evidence has shown that not all designs of the MoM bearing have been successful. QUESTIONS/PURPOSES: The purpose of this paper is to provide an update on the use of MoM bearings and address the following issues: (1) the reintroduction of metal-on-metal bearings in total hip arthroplasty, (2) the failure of metal-on-metal bearings in stemmed total hip arthroplasty, (3) the role of metal-on-metal hip resurfacing in modern orthopaedics and (4) metal-on-metal hip resurfacing versus total hip arthroplasty...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28165602/outcome-of-revision-arthroplasty-for-failed-metal-on-metal-total-hip-replacements-is-there-a-relation-with-metal-ions
#10
Hafiz J Iqbal, Waheeb A K Al-Azzani, Esther Jackson-Taylor, Elizabeth Clatworthy, Alun John
PURPOSE: We aimed to assess the early outcome following revision arthroplasty for failed metal-on-metal (MoM) total hip replacements (THR) due to adverse reaction to metal debris (ARMD). METHODS: We reviewed 106 consecutive revision arthroplasties. Case notes and radiological investigations were reviewed to assess the complications. Oxford Hip Score (OHS) and Euroqol (EQ-5D-3L) scores were used to assess the functional outcome and improvement of quality of life...
February 3, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28165599/cementing-a-polyethylene-cup-into-a-well-fixed-acetabular-metal-on-metal-resurfacing-component-an-experimental-investigation
#11
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/28165598/correlation-between-serum-metal-ion-levels-and-adverse-local-tissue-reactions-after-conserve%C3%A2-plus-hip-resurfacing-arthroplasty
#12
Harlan C Amstutz, Michel J Le Duff
BACKGROUND: Adverse local tissue reactions (ALTR) have been associated with the use of metal-on-metal (MoM) bearings and the monitoring of cobalt (Co) and chromium (Cr) ion levels in blood or serum may be the best way to evaluate in vivo the wear of these bearings. However, the relationship between Co and Cr ion concentrations and the formation of ALTR remains unclear. METHODS: We investigated the relationship between ALTR and serum Co and Cr ion levels and identified the clinical factors influencing the formation of ALTR in patients treated with MoM hip resurfacing arthroplasties...
February 6, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28161662/release-of-metal-ions-from-nano-cocrmo-wear-debris-generated-from-tribo-corrosion-processes-in-artificial-hip-implants
#13
Yang Wang, Yu Yan, Yanjing Su, Lijie Qiao
CoCrMo alloys have been widely used in metal-on-metal (MoM) hip replacements due to their superior wear and corrosion resistance properties. However, metal ions like Co(2+) and Cr(3+), or even Cr(6+) released from CoCrMo hip prostheses can induce macrophage apoptotic vs. necrotic mortality and damage the surrounding tissues. Simultaneously, osteolysis induced by the wear debris can be a cause of failure. Nano wear debris is more active than the bulk material, due to its small size. In this study, to accurately analyse the fresh wear debris retrieved from the hip simulator and the interaction between the particles and tribocorrosion of CoCrMo, wear debris was observed without protein digest, using a combined experimental approach involving the employment of TEM and ICP-MS...
January 30, 2017: Journal of the Mechanical Behavior of Biomedical Materials
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
#14
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/28145952/patient-and-radiographic-factors-help-to-predict-metal-on-metal-hip-resurfacings-with-evidence-of-a-pseudotumor
#15
Gulraj S Matharu, Oliver Blanshard, Kawaljit Dhaliwal, Andrew Judge, David W Murray, Hemant G Pandit
BACKGROUND: The role of radiographs in the follow-up of patients with metal-on-metal hip resurfacing (MoMHR) implants is unclear. We investigated whether a combination of patient and radiographic factors predicted MoMHRs with evidence of a pseudotumor. METHODS: We performed a retrospective single-center case-control study of 384 MoMHRs. The pseudotumor group of 130 hips all had evidence of a symptomatic pseudotumor on cross-sectional imaging, with the diagnosis confirmed at revision...
February 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28122467/high-blood-metal-ion-levels-in-19-of-22-patients-with-metal-on-metal-hinge-knee-replacements
#16
Minna Laitinen, Jyrki Nieminen, Aleksi Reito, Toni-Karri Pakarinen, Piia Suomalainen, Konsta Pamilo, Jyrki Parkkinen, Tonis Lont, Antti Eskelinen
Background and purpose - There has been increasing alarm regarding metal-on-metal (MoM) joint replacements leading to elevated levels of metal ions and adverse reactions to metal debris (ARMDs). There is little information available concerning the prevalence of and risk factors for these adverse reactions, except with MoM hip joint replacements. We determined the levels of metal ions in blood and the rate of revision due to ARMDs in patients treated with MoM hinge total knee arthroplasty (TKA). Patients and methods - 22 patients with TKAs and MoM hinge connecting mechanisms were studied for whole-blood chromium and cobalt levels at 6 months, 1 year, and/or ≥2 years after surgery...
January 26, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28114963/neuropsychiatric-symptoms-following-metal-on-metal-implant-failure-with-cobalt-and-chromium-toxicity
#17
Ben Green, Emily Griffiths, Solomon Almond
BACKGROUND: There were at least 31,171 metal-on-metal (MoM) hip implants in the UK between 2003 and 2011. Some of these were subject to failure and widescale recalls and revisions followed. METHOD: This is a presentation of ten cases (mean age 60 years) where we evaluated neuropsychiatric morbidity following metal-on-metal hip implant failure and revision. Implants were ASR total hip replacement (acetabular implant, taper sleeve adaptor and unipolar femoral implants) performed between 2005 and 2009...
January 24, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28108481/clinically-insignificant-trunnionosis-in-large-diameter-metal-on-polyethylene-total-hip-arthroplasty
#18
H S Hothi, D Kendoff, C Lausmann, J Henckel, T Gehrke, J Skinner, A Hart
OBJECTIVES: Mechanical wear and corrosion at the head-stem junction of total hip arthroplasties (THAs) (trunnionosis) have been implicated in their early revision, most commonly in metal-on-metal (MOM) hips. We can isolate the role of the head-stem junction as the predominant source of metal release by investigating non-MOM hips; this can help to identify clinically significant volumes of material loss and corrosion from these surfaces. METHODS: In this study we examined a series of 94 retrieved metal-on-polyethylene (MOP) hips for evidence of corrosion and material loss at the taper junction using a well published visual grading method and an established roundness-measuring machine protocol...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28106230/the-value-of-serial-metal-ion-levels-in-following-up-patients-with-metal-on-metal-hip-arthroplasty
#19
Gavin McHugh, Rajiv Merchant, Gabrielle E Kelly, Karen M Bergin, Gerald F McCoy, Andrew P Wozniak, John F Quinlan
BACKGROUND: The sensitivity of cobalt (Co) and chromium (Cr) ion-levels in detecting poorly performing metal-on-metal hip implants is low. This study proposes that serial changes in ion-levels are a more accurate marker of arthroplasties at risk. METHODS: Serial metal ion-levels and implant data of 285 patients with ASR resurfacing or replacement were studied. Patient and implant characteristics were analysed using univariate and multivariate analyses. RESULTS: 111 (39%) had revision surgery...
January 20, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28098396/effects-of-chronic-cobalt-and-chromium-exposure-after-metal-on-metal-hip-resurfacing-an-epigenome-wide-association-pilot-study
#20
Julia Steinberg, Karan M Shah, Alison Gartland, Eleftheria Zeggini, Jeremy Mark Wilkinson
Metal-on-metal (MOM) hip resurfacing has recently been a popular prosthesis choice for the treatment of symptomatic arthritis, but results in the release of cobalt and chromium ions into the circulation that can be associated with adverse clinical effects. The mechanism underlying these effects remains unclear. While chromosomal aneuploidy and translocations are associated with this exposure, the presence of subtle structural epigenetic modifications in patients with MOM joint replacements remains unexplored...
January 18, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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