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ARMD adverse reaction to metal debris

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https://www.readbyqxmd.com/read/29130357/biological-effects-of-metal-degradation-in-hip-arthroplasties
#1
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...
November 13, 2017: Critical Reviews in Toxicology
https://www.readbyqxmd.com/read/29105547/what-is-appropriate-surveillance-for-metal-on-metal-hip-arthroplasty-patients
#2
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...
November 6, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29048694/effect-of-sleeved-ceramic-femoral-heads-on-titanium-ion-release
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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...
July 20, 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
#10
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
https://www.readbyqxmd.com/read/28710154/outcomes-following-revision-surgery-performed-for-adverse-reactions-to-metal-debris-in-non-metal-on-metal-hip-arthroplasty-patients-analysis-of-185-revisions-from-the-national-joint-registry-for-england-and-wales
#11
G S Matharu, A Judge, D W Murray, H G Pandit
OBJECTIVES: Few studies have assessed outcomes following non-metal-on-metal hip arthroplasty (non-MoMHA) revision surgery performed for adverse reactions to metal debris (ARMD). We assessed outcomes following non-MoMHA revision surgery performed for ARMD, and identified predictors of re-revision. METHODS: We performed a retrospective observational study using data from the National Joint Registry for England and Wales. All non-MoMHAs undergoing revision surgery for ARMD between 2008 and 2014 were included (185 hips in 185 patients)...
July 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28707830/-patients-with-metal-on-metal-hip-arthroplasty-evaluation-and-management-of-complications
#12
Olivier Guyen, Christophe Tissot
The potentially severe complications related to metal-on-metal (MoM) hip replacements have led to a dramatic decrease of their use. Large diameter heads are more likely to fail than smaller diameters, but complications have been described even with « small » diameters. Therefore, monitoring of MoM arthroplasties is mandatory. This includes physical examination, X-Rays, metal ion levels, and potentially cross-sectional imaging. Despite pathophysiology of adverse reactions to metal debris (ARMD) is better understood, their evolution and the potential systemic complications remain unclear...
December 14, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28378001/adverse-reaction-to-metal-debris-with-concomitant-incidental-crystalline-arthropathy-in-hip-arthroplasty
#13
Edward J Testa, Brian J McGrory
Adverse reaction to metal debris (ARMD) is a known cause of failed metal in hip arthroplasty. Diagnosis of this type of prosthesis failure may be difficult, and the hallmark is an abnormally elevated serum cobalt level. Concomitant diagnoses may also be present, such as infection, instability, and loosening, and this may confuse interpretation of abnormal laboratories. We present here, for the first time, 2 patients with ARMD and crystalline arthropathy. In each case, the patient chose surgery for ARMD, with resolution of symptoms and no recurrence of the crystalline arthropathy...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28246095/explant-analysis-of-the-biomet-magnum-recap-metal-on-metal-hip-joint
#14
S C Scholes, B J Hunt, V M Richardson, D J Langton, E Smith, T J Joyce
OBJECTIVES: The high revision rates of the DePuy Articular Surface Replacement (ASR) and the DePuy ASR XL (the total hip arthroplasty (THA) version) have led to questions over the viability of metal-on-metal (MoM) hip joints. Some designs of MoM hip joint do, however, have reasonable mid-term performance when implanted in appropriate patients. Investigations into the reasons for implant failure are important to offer help with the choice of implants and direction for future implant designs...
February 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28218371/adverse-reaction-to-metal-debris-in-a-consecutive-series-of-durom%C3%A2-hip-resurfacing-pseudotumour-incidence-and-metal-ion-concentration
#15
Albrecht Hartmann, Jan-Dirk Kieback, Jörg Lützner, Klaus-Peter Günther, Jens Goronzy
INTRODUCTION: The aim of this study was to evaluate the incidence of adverse reactions to metal debris (ARMD) in a consecutive series of DUROM™ Hip Resurfacing Arthroplasty (HRA) at mid-term follow-up. METHODS: Between October 2003 and March 2007 a total of 134 consecutive DUROM™ HRA in 121 patients were performed at our institution. Follow-up could be obtained in 101 unrevised patients (83%) at a mean time of 8.51 ± 0.97 years postoperatively and included patient-related outcome measurement, plain radiographs, MARS-MRI as well as whole blood metal ion assessment...
July 25, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
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
#16
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/28122467/high-blood-metal-ion-levels-in-19-of-22-patients-with-metal-on-metal-hinge-knee-replacements
#17
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...
June 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/27992643/recall-of-the-asr-xl-head-and-hip-resurfacing-systems
#18
Werner Maurer-Ertl, Joerg Friesenbichler, Lukas A Holzer, Lukas Leitner, Kathrin Ogris, Michael Maier, Andreas Leithner
At the beginning of the 21st century, use of large-diameter, metal-on-metal devices was a popular procedure for hip replacement in young and physically active patients; however, within a few years, the number of revisions increased, resulting in a worldwide recall for the articular surface replacement (ASR) system. Complication rates for the ASR devices implanted at the authors' department are reported, with revision rates of 32% and 30% in the ASR XL Head and ASR Resurfacing groups, respectively. Reasons for revision surgery were serum metal ion elevation, luxation or subluxation, aseptic loosening, soft tissue compromise (adverse reactions to metal debris [ARMD]), and infection...
March 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/27988181/incidence-of-adverse-reactions-to-metal-debris-from-28-mm-metal-on-metal-total-hip-arthroplasties-with-minimum-10-years-of%C3%A2-follow-up-clinical-laboratory-and-ultrasound-assessment-of-44%C3%A2-cases
#19
Béchir Ayoub, Sophie Putman, Pierre Cholewinski, Amandine Paris, Henri Migaud, Julien Girard
BACKGROUND: Total hip arthroplasty with metal-on-metal (MoM) bearings has been suspected to cause adverse reactions to metal debris (ARMD), with the incidence varying greatly by implant type and patient gender. The prevalence of ARMD from small-diameter MoM bearings in women is unknown, especially after 10 years of follow-up (FU). METHODS: Cementless 28-mm MoM total hip arthroplasty bearings (Metasul) were implanted consecutively in 42 active women between 1996 and 2002...
April 2017: Journal of Arthroplasty
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
#20
COMPARATIVE STUDY
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
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