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ARMD adverse reaction to metal debris

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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
#1
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
#2
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
#3
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
#4
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
#5
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...
February 8, 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
#6
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
#7
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
#8
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
#9
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...
November 15, 2016: 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
#10
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/27835611/effect-of-cobalt-mediated-toll-like-receptor-4-activation-on-inflammatory-responses-in-endothelial-cells
#11
Sami A Anjum, Helen Lawrence, James P Holland, John A Kirby, David J Deehan, Alison J Tyson-Capper
Cobalt-containing metal-on-metal hip replacements are associated with adverse reactions to metal debris (ARMD), including inflammatory pseudotumours, osteolysis, and aseptic implant loosening. The exact cellular and molecular mechanisms leading to these responses are unknown. Cobaltions (Co2+) activate human Toll-like receptor 4 (TLR4), an innate immune receptor responsible for inflammatory responses to Gram negative bacterial lipopolysaccharide (LPS).We investigated the effect of Co2+-mediated TLR4 activation on human microvascular endothelial cells (HMEC-1), focusing on the secretion of key inflammatory cytokines and expression of adhesion molecules...
November 22, 2016: Oncotarget
https://www.readbyqxmd.com/read/27829734/601-metal-on-metal-total-hip-replacements-with-36%C3%A2-mm-heads-a-5-minimum-year-follow-up-levels-of-armd-remain-low-despite-a-comprehensive-screening-program
#12
Amit Atrey, Alister Hart, Nasir Hussain, Jonathon Waite, Andrew J Shepherd, Steve Young
BACKGROUND: We conducted a retrospective study to assess the clinical outcome, failure rate, and reason for failure of a large consecutive series of 36 mm MoM Corail/Pinnacle total hip replacements (THRs). METHODS: Between 2006 and 2011, 601 consecutive 36 mm MoM THRs were performed (585 patients). Patients were followed according to the UK Medicines and Healthcare Products Regulatory Agency (MHRA) guidelines. All patients were accounted for and 469 patients (78%) were clinically and radiographically assessed...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27803220/can-blood-metal-ion-levels-be-used-to-identify-patients-with-bilateral-birmingham-hip-resurfacings-who-are-at-risk-of-adverse-reactions-to-metal-debris
#13
G S Matharu, F Berryman, L Brash, P B Pynsent, D J Dunlop, R B C Treacy
AIMS: We investigated whether blood metal ion levels could effectively identify patients with bilateral Birmingham Hip Resurfacing (BHR) implants who have adverse reactions to metal debris (ARMD). PATIENTS AND METHODS: Metal ion levels in whole blood were measured in 185 patients with bilateral BHRs. Patients were divided into those with ARMD who either had undergone a revision for ARMD or had ARMD on imaging (n = 30), and those without ARMD (n = 155). Receiver operating characteristic analysis was used to determine the optimal thresholds of blood metal ion levels for identifying patients with ARMD...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27759474/poor-10-year-survivorship-of-hip-resurfacing-arthroplasty
#14
MULTICENTER STUDY
Matti Seppänen, Mikko Karvonen, Petri Virolainen, Ville Remes, Pekka Pulkkinen, Antti Eskelinen, Antti Liukas, Keijo T Mäkelä
Background and purpose - In a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associated with HRA, not only with large-diameter head metal-on-metal THA. The aim of the study was to assess medium- to long-term survivorship of HRA based on the Finnish Arthroplasty Register (FAR). Patients and methods - 5,068 HRAs performed during the period 2001-2013 in Finland were included...
December 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27704611/variation-in-taper-surface-roughness-for-a-single-design-effects-the-wear-rate-in-total-hip-arthroplasty
#15
Robert K Whittaker, Harry S Hothi, Antti Eskelinen, Gordon W Blunn, John A Skinner, Alister J Hart
Material loss from the head-stem taper junction of total hip arthroplasty (THA) is implicated in adverse reactions to metal debris (ARMD); the mechanisms for this are multi-factorial. We investigated the relationship between the roughness of the "as manufactured" taper surface and the wear rate from this junction. Fifty retrieved Pinnacle metal-on-metal (MOM) bearings paired with a Corail stem were included in the study. Multivariable statistical analysis was performed to determine the influence of taper roughness on material loss rate after controlling for other confounding surgical, implant, and patient factors...
October 5, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27612918/blood-metal-ion-levels-are-not-a-useful-test-for-adverse-reactions-to-metal-debris-a-systematic-review-and-meta-analysis
#16
M Pahuta, J M Smolders, J L van Susante, J Peck, P R Kim, P E Beaule
OBJECTIVES: Alarm over the reported high failure rates for metal-on-metal (MoM) hip implants as well as their potential for locally aggressive Adverse Reactions to Metal Debris (ARMDs) has prompted government agencies, internationally, to recommend the monitoring of patients with MoM hip implants. Some have advised that a blood ion level >7 µg/L indicates potential for ARMDs. We report a systematic review and meta-analysis of the performance of metal ion testing for ARMDs. METHODS: We searched MEDLINE and EMBASE to identify articles from which it was possible to reconstruct a 2 × 2 table...
September 2016: Bone & Joint Research
https://www.readbyqxmd.com/read/27580527/failure-rates-of-asian-type-anatomic-medullary-locking-stemmed-metal-on-metal-total-hip-replacement-a-cause-for-adverse-tissue-reactions-to-metal-debris-armd
#17
Masaru Nakamura, Tateaki Shimakawa, Shunji Nakano, Takashi Chikawa, Shinji Yoshioka, Masahiro Kashima, Shunichi Toki, Hidehisa Horiguchi, Koichi Sairyo
BACKGROUND: Adverse tissue reaction to metal debris (ARMD) as a secondary complication of Metal-on-metal total hip replacement (MoM THR) has been of concern. We have been performing cementless MoM THR using an Asian-type anatomic medullary locking (AML) stem. The purpose of this study is to examine the incident rate of ARMD, and the implant survival rate. METHODS: The study included 187 patients (211 hip joints) who underwent MoM THR between February 2007 and November 2009 at our hospital and who were followed up for a minimum of 6 years...
November 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27293285/midterm-results-of-36-mm-metal-on-metal-total-hip-arthroplasty
#18
Hawar Akrawi, Fahad S Hossain, Stefan Niculescu, Zaid Hashim, Arron Biing Ng, Ajit Shetty
BACKGROUND: Despite the many perceived benefits of metal-on-metal (MoM) articulation in total hip arthroplasty (THA), there have been growing concerns about metallosis and adverse reaction to metal debris (ARMD). Analysis of size 36 mm MoM articulation THAs is presented. These patients were evaluated for patient characteristics, relationship between blood metal ions levels and the inclination as well as the version of acetabular component, cumulative survival probability at final followup and functional outcome at final followup...
May 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27235513/pseudotumour-formation-and-subsequent-resolution-in-metal-on-metal-total-hip-arthroplasty-following-revision-instructional-review-and-an-illustrative-case-report-with-revision-using-a-dual-mobility-design
#19
REVIEW
A A Sassoon, R L Barrack
The use of large-diameter metal-on-metal (MoM) components in total hip arthroplasty (THA) is associated with an increased risk of early failure due to adverse local tissue reaction to metal debris (ARMD) in response to the release of metal ions from the bearing couple and/or head-neck taper corrosion. The aim of this paper was to present a review of the incidence and natural history of ARMD and the forms of treatment, with a focus on the need for and extent of resection or debulking of the pseudotumour. An illustrative case report is presented of a patient with an intra-pelvic pseudotumour associated with a large diameter MoM THA, which was treated successfully with revision of the bearing surface to a dual mobility couple and retention of the well-fixed acetabular and femoral components...
June 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27227536/the-inflammatory-phenotype-in-failed-metal-on-metal-hip-arthroplasty-correlates-with-blood-metal-concentrations
#20
Erja-Leena Paukkeri, Riku Korhonen, Mari Hämäläinen, Marko Pesu, Antti Eskelinen, Teemu Moilanen, Eeva Moilanen
INTRODUCTION: Hip arthroplasty is the standard treatment of a painful hip destruction. The use of modern metal-on-metal (MOM) bearing surfaces gained popularity in total hip arthroplasties during the last decade. Recently, worrisome failures due to adverse reaction to metal debris (ARMD), including pseudotumor response, have been widely reported. However, the pathogenesis of this reaction remains poorly understood. The aim of the present study was to investigate the ARMD response by flow cytometry approach...
2016: PloS One
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