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ARMD adverse reaction to metal debris

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https://www.readbyqxmd.com/read/29773173/gene-expression-in-adverse-reaction-to-metal-debris-around-metal-on-metal-arthroplasty-an-rna-seq-based-study
#1
Antti Pemmari, Tiina Leppänen, Erja-Leena Paukkeri, Antti Eskelinen, Teemu Moilanen, Eeva Moilanen
Joint replacement surgery is a standard treatment of advanced osteoarthritis (OA). Since 2000, cobalt-chromium (CoCr) metal-on-metal (MoM) implants were widely used in hip arthroplasties. Some patients developed "adverse reaction to metal debris" (ARMD) around the prosthesis, resulting in a need for revision surgery. In the present study, we addressed the pathogenesis of ARMD by genome-wide expression analysis. Pseudosynovial ARMD tissue was obtained from revision surgery of Articular Surface Replacement (ASR, DePuy, Warsaw, IN, USA) hip arthroplasties...
July 2018: Journal of Trace Elements in Medicine and Biology
https://www.readbyqxmd.com/read/29768492/association-between-periprosthetic-tissue-metal-content-whole-blood-and-synovial-fluid-metal-ion-levels-and-histopathological-findings-in-patients-with-failed-metal-on-metal-hip-replacement
#2
Lari Lehtovirta, Aleksi Reito, Jyrki Parkkinen, Sirpa Peräniemi, Jouko Vepsäläinen, Antti Eskelinen
Adverse Reaction to Metal Debris (ARMD) is a major cause of implant failure leading to revision surgery in patients with metal-on-metal (MoM) hip arthroplasties. However, the pathogenesis and its association to implant wear are poorly understood and previous studies have yielded discrepant results. We sought to investigate the associations between histological findings, whole blood and synovial fluid metal ion concentrations and periprosthetic tissue metal concentrations in patients with MoM total hip replacements and hip resurfacings revised for ARMD...
2018: PloS One
https://www.readbyqxmd.com/read/29649639/cobalt-ii-ions-and-nanoparticles-induce-macrophage-retention-by-ros-mediated-down-regulation-of-rhoa-expression
#3
Jing Xu, Junyao Yang, Agata Nyga, Mazdak Ehteramyan, Ana Moraga, Yuanhao Wu, Lingfang Zeng, Martin M Knight, Julia C Shelton
Histological assessments of synovial tissues from patients with failed CoCr alloy hip prostheses demonstrate extensive infiltration and accumulation of macrophages, often loaded with large quantities of particulate debris. The resulting adverse reaction to metal debris (ARMD) frequently leads to early joint revision. Inflammatory response starts with the recruitment of immune cells and requires the egress of macrophages from the inflamed site for resolution of the reaction. Metal ions (Co2+ and Cr3+ ) have been shown to stimulate the migration of T lymphocytes but their effects on macrophages motility are still poorly understood...
April 9, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29529653/outcomes-after-metal-on-metal-hip-revision-surgery-depend-on-the-reason-for-failure-a-propensity-score-matched-study
#4
Gulraj S Matharu, Andrew Judge, David W Murray, Hemant G Pandit
BACKGROUND: Metal-on-metal hip replacement (MoMHR) revision surgery for adverse reactions to metal debris (ARMD) has been associated with an increased risk of early complications and reoperation and inferior patient-reported outcome scores compared with non-ARMD revisions. As a result, early revision specifically for ARMD with adoption of a lower surgical threshold has been widely recommended with the goal of improving the subsequent prognosis after ARMD revisions. However, no large cohorts have compared the risk of complications and reoperation after MoMHR revision surgery for ARMD (an unanticipated revision indication) with those after non-ARMD revisions (which represent conventional modes of arthroplasty revision)...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29516273/implant-failure-in-bilateral-metal-on-metal-hip-resurfacing-arthroplasties-a-clinical-and-pathological-study
#5
Yoshinubo Uchihara, George Grammatopoulos, Mitsuru Munemoto, Gulraj Matharu, Yusuke Inagaki, Hemant Pandit, Yasuhito Tanaka, Nick A Athanasou
Metal-on-metal hip resurfacing arthroplasties (MoMHRAs) have a high failure rate due to pseudotumour formation. It is not certain whether pseudotumours in bilateral MoMHRAs form on the basis of an adverse reaction to metal debris (ARMD) that is entirely due to a local innate and adaptive immune response to Cobalt-Chrome (Co-Cr) wear particles. To determine if there is a systemic component to ARMD in bilateral MoMHRAs, we examined the histology of ARMD in unilateral and bilateral MoMHRAs revised for pseudotumour and determined whether implant survival differed between these two groups...
March 7, 2018: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/29493348/revision-surgery-of-metal-on-metal-hip-arthroplasties-for-adverse-reactions-to-metal-debris
#6
Gulraj S Matharu, Antti Eskelinen, Andrew Judge, Hemant G Pandit, David W Murray
Background and purpose - The initial outcomes following metal-on-metal hip arthroplasty (MoMHA) revision surgery performed for adverse reactions to metal debris (ARMD) were poor. Furthermore, robust thresholds for performing ARMD revision are lacking. This article is the second of 2. The first article considered the various investigative modalities used during MoMHA patient surveillance (Matharu et al. 2018a ). The present article aims to provide a clinical update regarding ARMD revision surgery in MoMHA patients (hip resurfacing and large-diameter MoM total hip arthroplasty), with specific focus on the threshold for performing ARMD revision, the surgical strategy, and the outcomes following revision...
June 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29455347/a-prospective-comparative-study-of-hip-resurfacing-arthroplasty-and-large-diameter-head-metal-on-metal-total-hip-arthroplasty-in-younger-patients-a-minimum-of-five-year-follow-up
#7
Ran Tao, Fan Liu, Ya-Ke Liu, Yue Lu, Hua Xu, Yi Cao, Zhen-Yu Zhou, Wei Wang
INTRODUCTION: Both hip resurfacing arthroplasty (HRA) and large-diameter head metal-on-metal total hip arthroplasty (LDH MoM THA) are generally used for young and active patients. A number of comparative studies of HRA and total hip arthroplasty have been published in the literature. However, studies that have compared HRA with LDH MoM THA are rare. The purpose of this study is to compare the mid-term results of HRA with those of LDH MoM THA in young patients. PATIENTS AND METHODS: Between 2007 and 2011, 68 patients were enrolled in the study and randomized into two groups: HRA group (28 hips) and LDH MoM THA group (40 hips)...
February 18, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29432270/what-is-the-long-term-survival-for-primary-tha-with-small-head-metal-on-metal-bearings
#8
Richard de Steiger, Andrea Peng, Peter Lewis, Stephen Graves
BACKGROUND: Large-head metal-on-metal (MoM) bearing hip replacements have been shown to have a much higher rate of revision than other bearing surfaces. However, small-head (≤ 32 mm) MoM bearing surfaces have been in use for many years with several reports of satisfactory mid- to long-term survivorship. It is unclear whether the long-term survival of small-head MoM devices will continue to be satisfactory or whether the same concerns seen with the large-head MoM devices will ultimately become more prevalent...
February 8, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29280283/pet-ct-to-detect-adverse-reactions-to-metal-debris-in-patients-with-metal-on-metal-hip-arthroplasty-an-exploratory-prospective-study
#9
Erik Aro, Marko Seppänen, Keijo T Mäkelä, Pauliina Luoto, Anne Roivainen, Hannu T Aro
Metal-on-metal (MoM) bearings in total hip arthroplasties and hip resurfacing arthroplasties have recently shown a new type of complication: adverse reactions to metal debris (ARMD). ARMD is characterized by local severe inflammation and tissue necrosis leading to implant failures. The gluteal muscle region is important for the patient outcome after revision surgery. This prospective positron emission tomography/computed tomography (PET/CT) study was undertaken to evaluate the characteristics of 2-deoxy-2-[18 F]fluoro-d-glucose ([18 F]FDG) and [68 Ga]Gallium citrate ([68 Ga]Citrate) PET/CT in ARMD patients...
December 27, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/29228956/analysis-of-bearing-wear-whole-blood-and-synovial-fluid-metal-ion-concentrations-and-histopathological-findings-in-patients-with-failed-asr-hip-resurfacings
#10
Lari Lehtovirta, Aleksi Reito, Jyrki Parkkinen, Harry Hothi, Johann Henckel, Alister Hart, Antti Eskelinen
BACKGROUND: Adverse Reaction to Metal Debris (ARMD) is still a major reason for revision surgeries in patients with metal-on-metal (MoM) hip replacements. ARMD consists of a wide range of alterations in periprosthetic tissues, most important of which are metallosis, inflammation, pseudotumors and necrosis. Studies investigating histopathological findings and their association to implant wear or indirect measures of wear have yielded inconsistent results. Therefore, we aimed to investigate bearing surface wear volume, whole blood and synovial fluid metal ion concentrations, histopathological findings in periprosthetic tissues and their associations...
December 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29130357/biological-effects-of-metal-degradation-in-hip-arthroplasties
#11
Donatella Granchi, Lucia Maria Savarino, Gabriela Ciapetti, Nicola Baldini
Metals and metal alloys are the most used materials in orthopedic implants. The focus is on total hip arthroplasty (THA) that, though well tolerated, may be associated with local and remote adverse effects in the medium-long term. This review aims to summarize data on the biological consequences of the metal implant degradation that have been attributed predominantly to metal-on-metal (MoM) THA. Local responses to metals consist of a broad clinical spectrum ranging from small asymptomatic tissue lesions to severe destruction of bone and soft tissues, which are designated as metallosis, adverse reactions to metal debris (ARMD), aseptic lymphocytic vasculitis associated lesion (ALVAL), and pseudotumors...
February 2018: Critical Reviews in Toxicology
https://www.readbyqxmd.com/read/29105547/what-is-appropriate-surveillance-for-metal-on-metal-hip-arthroplasty-patients
#12
Gulraj S Matharu, Andrew Judge, Antti Eskelinen, David W Murray, Hemant G Pandit
The unexpected high revision rates of large-diameter (femoral head sizes of 36 mm or greater) metal-on-metal hip arthroplasties (MoMHAs) have led to worldwide regulatory authorities recommending regular surveillance, even for asymptomatic individuals. However, these recommendations are not evidence-based and are very costly. The rapidly evolving evidence base requires an update regarding the investigation and management of MoMHA patients. This article is the first of 2 (the second article in this series will consider the threshold for performing revision, and the outcomes following ARMD revision surgery: Matharu et al...
February 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29048694/effect-of-sleeved-ceramic-femoral-heads-on-titanium-ion-release
#13
Anthony Deny, Janie Barry, Jonathan R B Hutt, Martin Lavigne, Vincent Massé, Pascal-André Vendittoli
INTRODUCTION: Metal ion release from wear and corrosion at the femoral head-stem taper junction can evoke local adverse reactions to metal debris (ARMD). In a specific large-diameter head (LDH) total hip arthroplasty (THA) system, ceramic femoral heads of 44 to 48 mm are available with a titanium (Ti) adaptor sleeve, while heads of 36- to 40-mm come without sleeves. The hypothesis of this study is that the Ti adaptor sleeve with LDH ceramic-on-ceramic (CoC) bearings will not cause wear or corrosion at the taper junction and, thus, will not generate high whole blood Ti ion levels...
October 16, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28926394/armd-and-presumed-dangerous-commentary-on-an-article-by-gulraj-s-matharu-bsc-hons-mrcs-mres-et-al-blood-metal-ion-thresholds-to-identify-patients-with-metal-on-metal-hip-implants-at-risk-of-adverse-reactions-to-metal-debris-an-external-multicenter-validation
#14
COMMENT
https://www.readbyqxmd.com/read/28926383/mri-findings-in-patients-after-small-head-metal-on-metal-total-hip-arthroplasty-with-a-minimum-follow-up-of-10-years
#15
Tobias Reiner, Thuy D Do, Matthias C Klot, Fabian Hertzsch, Kirsten Seelmann, Matthias M Gaida, Marc-André Weber, Tobias Gotterbarm
BACKGROUND: Concern has been raised about the late onset of adverse reactions to metal debris (ARMD) in patients with a small-head metal-on-metal total hip replacement. The aims of this study were to assess the frequency and characteristic appearance of ARMD in patients with a small-head (28-mm) metal-on-metal total hip replacement and elevated blood ion levels (>1 μg/L) after a minimum follow-up of 10 years and to analyze the possible risk factors associated with the prevalence of these lesions...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28926382/blood-metal-ion-thresholds-to-identify-patients-with-metal-on-metal-hip-implants-at-risk-of-adverse-reactions-to-metal-debris-an-external-multicenter-validation-study-of-birmingham-hip-resurfacing-and-corail-pinnacle-implants
#16
MULTICENTER STUDY
Gulraj S Matharu, Fiona Berryman, Andrew Judge, Aleksi Reito, Jamie McConnell, Olli Lainiala, Stephen Young, Antti Eskelinen, Hemant G Pandit, David W Murray
BACKGROUND: The authors of recent studies have reported newly devised implant-specific blood metal ion thresholds to predict adverse reactions to metal debris (ARMD) in patients who have undergone unilateral or bilateral metal-on-metal (MoM) hip arthroplasty. These thresholds were most effective for identifying patients at low risk of ARMD. We investigated whether these newly devised blood metal ion thresholds could effectively identify patients at risk of ARMD after MoM hip arthroplasty in an external cohort of patients...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28887488/the-chemical-form-of-metal-species-released-from-corroded-taper-junctions-of-hip-implants-synchrotron-analysis-of-patient-tissue
#17
Anna Di Laura, Paul D Quinn, Vasiliki C Panagiotopoulou, Harry S Hothi, Johann Henckel, Jonathan J Powell, Fitim Berisha, Fernanda Amary, J Fred W Mosselmans, John A Skinner, Alister J Hart
The mechanisms of metal release from the articulation at the head cup bearing and the tapered junctions of orthopaedic hip implants are known to differ and the debris generated varies in size, shape and volume. Significantly less metal is lost from the taper junction between Cobalt-Chromium-Molybdenum (CoCrMo) and Titanium (Ti) components (fretting-corrosion dominant mechanism), when compared to the CoCrMo bearing surfaces (wear-corrosion dominant mechanism). Corrosion particles from the taper junction can lead to Adverse Reactions to Metal Debris (ARMD) similar to those seen with CoCrMo bearings...
September 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28790470/management-guidelines-for-metal-on-metal-hip-resurfacing-arthroplasty-a-strategy-on-followup
#18
Naoki Nakano, Andrea Volpin, Jonathan Bartlett, Vikas Khanduja
Despite the initial promise of metal-on-metal (MoM) implants as the ideal bearing surface for hip replacements and resurfacings, high short term failure rates due to an adverse reaction to metal debris (ARMD) have led to a dramatic reduction in the number of MoM implants used in the modern era. With over one million patients worldwide having undergone hip operations utilizing a MoM bearing surface, the long term outcomes for such patients remains unknown, and there is much debate as to the most effective management of these patients...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28781016/blood-metal-ion-levels-have-limited-utility-in-the-surveillance-of-asymptomatic-large-head-metal-on-metal-total-hip-arthroplasties
#19
Manish Kiran, Catherine Armstrong, Deepak Shivarathre, Viju K Peter
BACKGROUND: Blood cobalt (Co) and chromium (Cr) ion levels have been used as surveillance tools for adverse reaction to metal debris (ARMD) in metal-on-metal (MoM) articulations with varying thresholds in different countries. The aim of our study is to present the serial 12-year blood Co and Cr levels in a cohort of MoM total hip arthroplasties (THAs) with femoral head size ≥36 mm and analyze their utility in asymptomatic patients at current thresholds. METHODS: A total of 256 patients with unilateral MoM THA with femoral head size ≥36 mm were included in this study with data collected prospectively...
December 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28768778/which-factors-influence-the-rate-of-failure-following-metal-on-metal-hip-arthroplasty-revision-surgery-performed-for-adverse-reactions-to-metal-debris-an-analysis-from-the-national-joint-registry-for-england-and-wales
#20
MULTICENTER STUDY
G S Matharu, A Judge, H G Pandit, D W Murray
AIMS: To determine the outcomes following revision surgery of metal-on-metal hip arthroplasties (MoMHA) performed for adverse reactions to metal debris (ARMD), and to identify factors predictive of re-revision. PATIENTS AND METHODS: We performed a retrospective observational study using National Joint Registry (NJR) data on 2535 MoMHAs undergoing revision surgery for ARMD between 2008 and 2014. The outcomes studied following revision were intra-operative complications, mortality and re-revision surgery...
August 2017: Bone & Joint Journal
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