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Nicholas Greco, Keith Berend
The case of an atraumatic dislocation of a fixed bearing in a medial unicompartmental arthroplasty with an oxinium femoral component is presented. A review of the literature pertaining to knee arthroplasty locking mechanisms is discussed. Potential modes of locking mechanisms failure are reviewed including the recognition of such failures in the clinical setting. This is the first report of a dislocated fixed-bearing medial oxinium unicompartmental arthroplasty and consequent metal arthrogram.
March 7, 2018: Knee
A Saleh, J George, M Faour, A K Klika, C A Higuera
OBJECTIVES: The diagnosis of periprosthetic joint infection (PJI) is difficult and requires a battery of tests and clinical findings. The purpose of this review is to summarize all current evidence for common and new serum biomarkers utilized in the diagnosis of PJI. METHODS: We searched two literature databases, using terms that encompass all hip and knee arthroplasty procedures, as well as PJI and statistical terms reflecting diagnostic parameters. The findings are summarized as a narrative review...
January 2018: Bone & Joint Research
Sreekanth Kashayi-Chowdojirao, Aashish Vallurupalli, Vijay Krishna Chilakamarri, Chandrasekhar Patnala, Lalith Mohan Chodavarapu, Nageswara Rao Kancherla, Asif Hussain Khazi Syed
Background: Non-union humeral shaft fractures are seen frequently in clinical practice at about 2-10% in conservative management and 30% in surgically operated patients. Osteosynthesis using dynamic compression plate (DCP), intramedullary nailing, locking compression plate (LCP), Ilizarov technique along with bone grafting have been reported previously. In cases of prior failed plate-screw osteosynthesis the resultant osteopenia, cortical defect, bone loss, scalloping around screws and metallosis, make the management of non-union more complicated...
November 2017: Journal of Clinical Orthopaedics and Trauma
Justin J Mitchell, Dimitri S Tahal, J Christoph Katthagen, Alexander R Vap, Peter J Millett
CASE: Hemiarthroplasty of the shoulder is commonly indicated for younger patients with osteoarthritis who desire to continue recreational and employment activities. In patients who have undergone prior shoulder surgery, metallic suture anchors may be present in the glenoid. We present a case of bilateral shoulder metallosis following bilateral resurfacing hemiarthroplasty for arthropathy in the setting of previous shoulder instability; the prostheses caused eventual glenoid erosion, leading to contact with the retained metal anchors...
April 2017: JBJS Case Connector
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
Gavin J Heyes, Harriet S Julian, Ian Mawhinney
No abstract text is available yet for this article.
January 1, 2017: Journal of Hand Surgery, European Volume
Jae Hyuk Yang, Chang Hwa Ham, Yeok Gu Hwang, Seung Woo Suh
Soft tissue reaction following metallic debris formation with the use of guided growing rod system has not been previously reported in human. The purpose of this study is to report complications caused by metallosis in a guided growing rod system. A 9-year-old female patient, who underwent treatment for the progressive idiopathic scoliosis (with Cobb's angle of 71°) with the guided growing rod system. Her Cobb's angle was corrected to 13° with the index surgery. During the 5 years postoperative period, she manifested recurrent episodes of skin irritation and progressive worsening of lateral curvature of the spine to an angle of 57°...
November 2017: Indian Journal of Orthopaedics
Reed Ayers, Mackenzie Miller, Jeffery Schowinsky, Evalina Burger, Vikas Patel, Christopher Kleck
The characteristic trait of metallosis is the presence of tissue staining. Analyzing explanted revision hardware from spine surgeries and performing ICPMS/AES analysis on removed tissue samples, a clinically relevant definition for metallosis may be developed. Results of the analysis identified hardware fretting wear and corrosion, and ICP-MS/AES analysis identified elevated metal ion concentrations in all cases. This supports the hypothesis that corrosion may be linked to poor health outcomes and potential need for revision surgery...
December 1, 2017: Journal of Materials Science. Materials in Medicine
Chih-Chan Yang, Chien-Lun Tang, Chung-Yuh Tzeng, Hsi-Kai Tsou
PURPOSE: Cervical disc arthroplasty has been a popular alternative to traditional arthrodesis treatment for maintaining postoperative cervical spine mobility. However, certain adverse reactions to cervical disc arthroplasty have emerged during the last few decades. METHODS: Metallosis or metalloma is a rarely reported complication after spinal fusion or spinal arthroplasty surgery. We report on the first metallosis case occurring in a patient who received Bryan Disc implantation approximately 8 years earlier...
November 21, 2017: European Spine Journal
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
Himanshu Sahasrabudhe, Susmita Bose, Amit Bandyopadhyay
To mitigate shortcomings in current biomedical CoCrMo alloy, composites of CoCrMo with calcium phosphate (CaP) were envisioned. CoCrMo alloy was reinforced with CaP to enhance the wear resistance of the alloy. A powder based direct energy additive manufacturing technique of Laser Engineered Net Shaping (LENS™) was used for processing of CoCrMo alloy with 1% and 3% (by weight) of CaP in the form of hydroxyapaptite. Addition of CaP was found to stabilize the ε (HCP) phase along with the more common γ (FCC) phase of the CoCrMo alloy, and the microstructure showed discontinuous chromium carbide phase...
November 8, 2017: Acta Biomaterialia
Matthias Wolff, Carl Haasper, Akos Zahar, Christian Gauck, Thorsten Gehrke, Mustafa Citak
In recent years, the minimally invasive joint-preserving implant system has been developed. The main goal of this device is to unload the medial knee compartment without affecting the lateral compartment. The current authors describe a severe metallosis and elevated chromium in serum following implantation of the joint unloading implant system of a 50-year-old male patient, presented to our hospital 3 years after implantation of a KineSpring System into his left knee due to unicompartmental medial osteoarthritis (OA) in an external hospital...
October 4, 2017: Archives of Orthopaedic and Trauma Surgery
G Perumal, A Ayyagari, A Chakrabarti, D Kannan, S Pati, H S Grewal, S Mukherjee, S Singh, H S Arora
Substrate-cell interactions for a bioimplant are driven by substrate's surface characteristics. In addition, the performance of an implant and resistance to degradation are primarily governed by its surface properties. A bioimplant typically degrades by wear and corrosion in the physiological environment, resulting in metallosis. Surface engineering strategies for limiting degradation of implants and enhancing their performance may reduce or eliminate the need for implant removal surgeries and the associated cost...
October 13, 2017: ACS Applied Materials & Interfaces
W Guicherd, N Bonin, T Gicquel, J E Gedouin, X Flecher, M Wettstein, M Thaunat, N Prevost, E Ollier, O May
INTRODUCTION: Impingement between the acetabular component and the iliopsoas tendon is a cause of anterior pain after total hip replacement (THR). Treatment can be non-operative, endoscopic or arthroscopic, or by open revision of the acetabular component. Few studies have assessed these options. The present study hypothesis was that endo/arthroscopic treatment provides rapid pain relief with a low rate of complications. METHODS: A prospective multicenter study included 64 endoscopic or arthroscopic tenotomies for impingement between the acetabular component and the iliopsoas tendon, performed in 8 centers...
December 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Sheldon Moniz, Sean Hodgkinson, Piers Yates
Concerns regarding metal-on-metal (MoM) bearing couples in total hip arthroplasty are well documented in the literature with cobalt (Co) and chromium (Cr) toxicity causing a range of both local and systemic adverse reactions. We describe the case of a patient undergoing cardiac transplantation as a direct result of Co and Cr toxicity following a MoM hip replacement. Poor implant positioning led to catastrophic wear generating abundant wear particles leading to Co and Cr toxicity, metallosis, bony destruction, elevated metal ion levels, and adverse biological responses...
September 2017: Arthroplasty Today
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
Thomas J Christensen, Shefali A Samant, Alexander Y Shin
All metals implanted into a biological system undergo some degree of corrosion depending upon its composition. The electrochemical process of corrosion produces free metal ions, which may activate the host's immune system through a variety of mechanisms. Whereas dermal metal hypersensitivity is common, affecting 10% to 15% of the population, the immune reaction from implanted metals is much less common (< 0.1%), but has been associated with metal allergy and hypersensitivity producing a multitude of patient symptoms...
September 2017: Journal of Hand Surgery
Benjamin A Winston, Ryland P Kagan, Thomas W Huff
With newer-generation ceramic components used in total hip arthroplasty, component fracture is a rare complication. However rare, when ceramic component fracture does occur, prompt identification and revision is necessary as delay can lead to dramatic failure with resultant metallosis as the extremely hard ceramic debris abrades remaining components. We present a case of a 70-year-old woman with ceramic liner fracture and an estimated 10-year delay in intervention with failure resulting in pelvic discontinuity and massive metallosis with associated cutaneous manifestation...
June 2017: Arthroplasty Today
Robert P Runner, Briggs M Ahearn, George N Guild
Metal-on-metal (MoM) total hip arthroplasty (THA) is associated with increased incidence of failure from metallosis, adverse tissue reactions, and the formation of pseudotumors. This case highlights a 53-year-old female with an enlarging painful thigh mass 12 years status post MoM THA. Radiographs and advanced imaging revealed an atypical mass with cortical bone destruction and spiculation, concerning for periprosthetic malignancy. Open frozen section biopsy was performed before undergoing revision THA in a single episode of care...
June 2017: Arthroplasty Today
Mallory J DiVincenzo, Galit H Frydman, Michael P Kowaleski, Charles R Vanderburg, Barry Lai, Trisha J Oura, Samuel H Jennings
Metallosis is the accumulation of metallic debris in soft tissues resulting from wear following total joint replacement. A dog was evaluated for lameness 4 years after total hip arthroplasty using a titanium alloy and cobalt chromium total hip system. Radiographs revealed severe acetabular component wear, implant-bone interface deterioration, and peri-acetabular osteolysis. During surgical revision, black periarticular tissue surrounded the implants. Histologically, there was fibrosis and granulomatous inflammation with abundant, intra- and extracellular, black, granular material and smaller amounts of clear punctate to acicular material...
January 1, 2017: Veterinary Pathology
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