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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
#1
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/29754187/nationwide-multicenter-follow-up-cohort-study-of-hip-arthroplasties-performed-for-osteonecrosis-of-the-femoral-head
#2
Seneki Kobayashi, Toshikazu Kubo, Yukihide Iwamoto, Wakaba Fukushima, Nobuhiko Sugano
PURPOSE: To identify modifiable factors related to post-operative dislocation and reoperation in patients with osteonecrosis of the femoral head (ONFH) in a large cohort. METHODS: We studied 4995 hip arthroplasties: total hip arthroplasty (THA) was performed in 79% of patients; bipolar hemiarthroplasty (BP), 17%; total resurfacing arthroplasty (tRS), 3%; and hemi-resurfacing arthroplasty (hRS), 1%. A new type of BP (accounting for 49% of BPs) comprised a femoral component with a polished or smooth, small-diameter (approximately 10 mm) neck with a round or oval axial cut surface and no sharp corners...
May 12, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29734816/hip-resurfacing-with-a-highly-cross-linked-polyethylene-acetabular-liner-and-a-titanium-nitride-coated-femoral-component
#3
James W Pritchett
AIMS: This study evaluated a specific hip resurfacing system to determine the: (1) function and complications, (2) implant survivorship, (3) acetabular bone conservation and joint biomechanics and (4) osteolysis and polyethylene wear. METHODS: I performed 234 resurfacing procedures (192 patients) using a two-piece titanium acetabular component with a 4 mm highly cross-linked polyethylene liner and a cementless titanium nitride-coated titanium femoral component. Function was assessed with Harris Hip, WOMAC, SF-12, and UCLA scores...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29716769/the-cobalt-chromium-ratio-provides-similar-diagnostic-value-to-a-low-cobalt-threshold-in-predicting-adverse-local-tissue-reactions-in-patients-with-metal-on-metal-hip-arthroplasty
#4
Inari Laaksonen, Vincent P Galea, Gabrielle S Donahue, Sean J Matuszak, Orhun Muratoglu, Henrik Malchau
BACKGROUND: A higher cobalt/chromium (Co/Cr) ratio is thought to be associated with corrosion of the trunnion and increased adverse local tissue reaction (ALTR) risk in patients treated with metal-on-metal (MoM) hip arthroplasty. The main aim of this study was to investigate the diagnostic value of Co/Cr ratio in identifying ALTR in patients treated with MoM hip resurfacing arthroplasty and total hip arthroplasty (THA). METHODS: A total of 310 unilateral patients were included...
April 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29708567/relationship-of-blood-metal-ion-levels-and-leukocyte-profiles-in-patients-with-articular-surface-replacement-metal-on-metal-hip-replacement
#5
David C Markel, Christopher Bergum, Jeffrey Flynn, Nancy Jackson, Therese Bou-Akl, Weiping Ren
The purpose of this study was to compare blood leukocyte profiles and metal ion concentrations between hip resurfacing arthroplasty (articular surface replacement) patients with and without revision. A total of 25 articular surface replacement patients were recruited (10 with stable implants and 15 undergoing revision). Blood concentrations of chromium (Cr) and cobalt (Co) were measured. Flow cytometry was used to quantify the subpopulations of leukocytes, including CD14+ monocytes, CD16+ monocytes, CD3+ T-lymphocytes, CD19+ B-lymphocytes, CD4+ helper T-cells, and CD45+ RA memory vs naïve T-cells...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29657851/kinematic-alignment-technique-for-total-hip-and-knee-arthroplasty-the-personalized-implant-positioning-surgery
#6
Charles Rivière, Stefan Lazic, Loïc Villet, Yann Wiart, Sarah Muirhead Allwood, Justin Cobb
Conventional techniques for hip and knee arthroplasty have led to good long-term clinical outcomes, but complications remain despite better surgical precision and improvements in implant design and quality.Technological improvements and a better understanding of joint kinematics have facilitated the progression to 'personalized' implant positioning (kinematic alignment) for total hip (THA) and knee (TKA) arthroplasty, the true value of which remains to be determined.By achieving a true knee resurfacing, the kinematic alignment (KA) technique for TKA aims at aligning the components with the physiological kinematic axes of the knee and restoring the constitutional tibio-femoral joint line frontal and axial orientation and soft-tissue laxity...
March 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29606289/indications-for-mars-mri-in-patients-treated-with-metal-on-metal-hip-resurfacing-arthroplasty
#7
James W Connelly, Vincent P Galea, Sean J Matuszak, Rami Madanat, Orhun Muratoglu, Henrik Malchau
BACKGROUND: Currently, there are no universally accepted guidelines on when to obtain metal artifact reduction sequence magnetic resonance imaging (MARS-MRI) in metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) patients. Our primary aims were to identify which patient and clinical factors are predictive of adverse local tissue reaction (ALTR) and create an algorithm for indicating MARS-MRI in patients with Articular Surface Replacement (ASR) HRA. The secondary aim was to compare our algorithm to existing guidelines on when to perform MARS-MRI in MoM HRA patients...
February 2, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29587148/posterior-or-anterolateral-approach-in-hip-joint-arthroplasty-impact-on-frontal-plane-moment
#8
Marianne Tjur, Asger R Pedersen, William Sloth, Kjeld Søballe, Nina D Lorenzen, Maiken Stilling
BACKGROUND: Anterolateral surgical approach in hip joint arthroplasty necessitates division of the hip abductor muscle complex, which may compromise postoperative gait observed in the frontal plane. The aim of the study was to compare frontal plane moment after hip joint arthroplasty by anterolateral or posterior approach and to explore which compensatory strategies patients use to decrease frontal plane moment. METHODS: Twenty-eight patients were randomized by sealed envelopes to hip resurfacing arthroplasty surgery by anterolateral (ad modum Watson) or posterior (ad modum Moore) approach, performed by two senior surgeons...
May 2018: Clinical Biomechanics
https://www.readbyqxmd.com/read/29549305/trends-and-economic-impact-of-hip-and-knee-arthroplasty-in-central-europe-findings-from-the-austrian-national-database
#9
Lukas Leitner, Silvia Türk, Martin Heidinger, Bernd Stöckl, Florian Posch, Werner Maurer-Ertl, Andreas Leithner, Patrick Sadoghi
Arthroplasty registers were originally established in Scandinavia to receive clinically relevant information from pooled data, to improve quality and reduce revision surgeries, with socioeconomic benefit. In Austria, where the highest rate of total knee arthroplasties (TKA) per inhabitant of all OECD countries was reached in 2014, arthroplasties are centrally reported since 2009. Study purpose was to perform the first analysis of the Austrian database, aiming to obtain data on trends in arthroplasty in Austria over time in relation to demographic development...
March 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29544970/the-effect-of-prior-hip-arthroscopy-on-patient-reported-outcomes-after-total-hip-arthroplasty-an-institutional-registry-based-matched-cohort-study
#10
Joseph F Konopka, Robert L Buly, Bryan T Kelly, Edwin P Su, Alexander S McLawhorn
BACKGROUND: A significant number of patients who undergo hip arthroscopy will subsequently undergo total hip arthroplasty (THA) or hip resurfacing arthroplasty (HRA), although limited evidence exists regarding effects of prior hip arthroscopy on the outcomes of these procedures. METHODS: Of 5091 patients who underwent hip arthroscopy, we identified 69 patients who underwent subsequent THA (46) or HRA (23). Patients were matched to patients with no history of hip arthroscopy...
February 2, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29530907/comparison-of-hip-function-and-quality-of-life-of-total-hip-arthroplasty-and-resurfacing-arthroplasty-in-the-treatment-of-young-patients-with-arthritis-of-the-hip-joint-at-5-years
#11
Matthew L Costa, Juul Achten, Pedro Foguet, Nicholas R Parsons
OBJECTIVE: To compare the medium-term clinical effectiveness of total hip arthroplasty and resurfacing arthroplasty. DESIGN: Single centre, two-arm, parallel group, assessor blinded, randomised controlled trial with 1:1 treatment allocation. SETTING: A large teaching hospital in England. PARTICIPANTS: 122 patients older than 18 years with severe arthritis of the hip joint, suitable for resurfacing arthroplasty of the hip...
March 12, 2018: BMJ Open
https://www.readbyqxmd.com/read/29529655/five-hundred-fifty-five-retrieved-metal-on-metal-hip-replacements-of-a-single-design-show-a-wide-range-of-wear-surface-features-and-histopathologic-reactions
#12
Sang-Hyun Park, Zhen Lu, Robert S Hastings, Patricia A Campbell, Edward Ebramzadeh
BACKGROUND: In 2010, a widely used metal-on-metal hip implant design was voluntarily recalled by the manufacturer because of higher than anticipated failure rates at 5 years. Although there was a large published range of revision rates, numerous studies had reported a higher risk of revision for excessive wear and associated adverse tissue reactions when compared with other metal-on-metal total hips. The reasons for this were suggested by some to be related to cup design features. QUESTIONS/PURPOSES: From retrievals of ASR metal-on-metal implants and tissue samples obtained at revision surgery, we asked the following questions: (1) What were the common and uncommon surface features? (2) What were the common and uncommon linear and volumetric wear characteristics? (3) Were there common taper corrosion characteristics? (4) What aseptic lymphocytic vasculitis-associated lesion (ALVAL) features were present in the tissues? METHODS: Five hundred fifty-five ASRs, including 23 resurfacings, were studied at one academic research center...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29526334/higher-prevalence-of-mixed-or-solid-pseudotumors-in-metal-on-polyethylene-total-hip-arthroplasty-compared-with-metal-on-metal-total-hip-arthroplasty-and-resurfacing-hip-arthroplasty
#13
Mette Holm Hjorth, Inger Mechlenburg, Kjeld Soballe, Lone Roemer, Stig Storgaard Jakobsen, Maiken Stilling
BACKGROUND: Pseudotumors are a common finding in metal-on-metal (MoM) total hip arthroplasty (THA) and resurfacing hip arthroplasty (RHA). However, information on pseudotumors in metal-on-polyethylene (MoP) THA is limited. METHODS: One hundred eleven patients with 148 hip articulations-30 MoM THA, 47 MoM RHA, and 71 MoP THA-participated in a cross-sectional study at mean 7.1 (range: 0.2-21.5) years postoperatively. Patients were evaluated with metal artifact reducing sequence magnetic resonance imaging, measurements of metal ions, clinical scores of Harris Hip Score, Oxford Hip Score, the Copenhagen Hip and Groin Outcome Score, and conventional radiographs...
February 12, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29520467/outcomes-after-revision-of-metal-on-metal-hip-resurfacing-to-total-arthroplasty-using-the-direct-anterior-approach
#14
Victoire Bouveau, Thomas-Xavier Haen, Joel Poupon, Christophe Nich
BACKGROUND: Function after revision total hip arthroplasty (THA) in failed metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) is variable, but post-operative complication rates are reportedly high. We hypothesized HRA conversion to THA using the direct anterior approach (DAA) would be associated with optimal outcome. METHODS: Seventeen MoM-HRAs in 15 patients (seven males, eight females) were revised through the DAA. The mean age was 45 years (28-59 yrs)...
March 8, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29516273/implant-failure-in-bilateral-metal-on-metal-hip-resurfacing-arthroplasties-a-clinical-and-pathological-study
#15
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/29511363/application-of-a-causal-discovery-algorithm-to-the-analysis-of-arthroplasty-registry-data
#16
REVIEW
Camden Cheek, Huiyong Zheng, Brian R Hallstrom, Richard E Hughes
Improving the quality of care for hip arthroplasty (replacement) patients requires the systematic evaluation of clinical performance of implants and the identification of "outlier" devices that have an especially high risk of reoperation ("revision"). Postmarket surveillance of arthroplasty implants, which rests on the analysis of large patient registries, has been effective in identifying outlier implants such as the ASR metal-on-metal hip resurfacing device that was recalled. Although identifying an implant as an outlier implies a causal relationship between the implant and revision risk, traditional signal detection methods use classical biostatistical methods...
2018: Biomedical Engineering and Computational Biology
https://www.readbyqxmd.com/read/29493348/revision-surgery-of-metal-on-metal-hip-arthroplasties-for-adverse-reactions-to-metal-debris
#17
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/29469803/use-of-the-hemicap-partial-hip-resurfacing-technique-for-traumatic-femoral-head-osteochondral-defects-following-obturator-hip-dislocations
#18
Varun Arora, Pierre Navarre, Mathias Russ, Max Esser
Fracture of the femoral head (OTA 31-C1.3) following anterior obturator dislocations are a challenging problem as the fractures are often communited, impacted and with loose osteochondral fragments, making surgical fixation difficult. This can result in residual articular defects if the fragments cannot be internally fixed and need be excised, predisposing to secondary osteoarthritis. Treatment options for these defects are limited, have variable results and with limited literature to guide us on outcomes due to the rarity of these injuries...
2018: SICOT-J
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
#19
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/29452973/the-alpha-defensin-test-for-diagnosing-periprosthetic-joint-infection-in-the-setting-of-an-adverse-local-tissue-reaction-secondary-to-a-failed-metal-on-metal-bearing-or-corrosion-at-the-head-neck-junction
#20
Kamil T Okroj, Tyler E Calkins, Erdan Kayupov, Michael M Kheir, Joshua S Bingham, Christopher P Beauchamp, Javad Parvizi, Craig J Della Valle
BACKGROUND: In patients with adverse local tissue reaction (ALTR) secondary to a failed metal-on-metal (MoM) bearing or corrosion at the head-neck junction in a metal-on-polyethylene bearing, ruling in or out periprosthetic joint infection (PJI) can be challenging. Alpha-defensin has emerged as an accurate test for PJI. The purpose of this multicenter, retrospective study was to evaluate the accuracy of the alpha-defensin synovial fluid test in detecting PJI in patients with ALTR. METHODS: We reviewed medical records of 26 patients from 3 centers with ALTR that had an alpha-defensin test performed...
January 16, 2018: Journal of Arthroplasty
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