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https://www.readbyqxmd.com/read/28566326/retrieval-analysis-of-metal-and-ceramic-femoral-heads-on-a-single-cocr-stem-design
#1
A Di Laura, H Hothi, J Henckel, I Swiatkowska, M H L Liow, Y-M Kwon, J A Skinner, A J Hart
OBJECTIVES: The use of ceramic femoral heads in total hip arthroplasty (THA) has increased due to their proven low bearing wear characteristics. Ceramic femoral heads are also thought to reduce wear and corrosion at the head-stem junction with titanium (Ti) stems when compared with metal heads. We sought to evaluate taper damage of ceramic compared with metal heads when paired with cobalt chromium (CoCr) alloy stems in a single stem design. METHODS: This retrieval study involved 48 total hip arthroplasties (THAs) with CoCr V40 trunnions paired with either CoCr (n = 21) or ceramic (n = 27) heads...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28511949/serum-metal-levels-for-diagnosis-of-adverse-local-tissue-reactions%C3%A2-secondary-to-corrosion-in-metal-on-polyethylene-total%C3%A2-hip%C3%A2-arthroplasty
#2
Yale A Fillingham, Craig J Della Valle, Daniel D Bohl, Mick P Kelly, Deborah J Hall, Robin Pourzal, Joshua J Jacobs
BACKGROUND: Recently, corrosion at the head-neck junction in metal-on-polyethylene bearing surface total hip arthroplasty (THA) has been recognized as a cause of adverse local tissue reactions (ALTRs). Serum metal levels have been advocated as a tool for the diagnosis of ALTR; however, no prior studies have specifically examined their utility. The purpose of this study was to determine the optimal cutoff values for serum cobalt and chromium levels in diagnosing ALTR after metal-on-polyethylene bearing surface THA...
April 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28479059/comparison-of-pre-revision-magnetic-resonance-imaging-and-operative-findings-in-mechanically-assisted-crevice-corrosion-in-symptomatic-metal-on-polyethylene-total-hip-arthroplasties
#3
Pavel P Morozov, Munib Sana, Brian J McGrory, Steven W Farraher, Tod G Abrahams
BACKGROUND: Failed total hip arthroplasty (THA) caused by mechanically assisted crevice corrosion (MACC) has serious consequences-notably, adverse local tissue reactions. Metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) has been used to evaluate failed THA for other reasons but has not been assessed for the analysis of cases of MACC in the setting of metal-on-polyethylene arthroplasties. METHODS: We examined the correlation between preoperative MARS MRI and surgical findings in a cohort of 20 consecutive patients undergoing revision THA for symptomatic MACC without other associated orthopedic diagnoses...
March 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28457759/modular-neck-vs-nonmodular-femoral-stems-in-total-hip-arthroplasty-clinical-outcome-metal-ion-levels-and-radiologic-findings
#4
Rasmus T Mikkelsen, Marianne Fløjstrup, Christian Lund, Per Kjærsgaard-Andersen, Thomas Skjødt, Claus Varnum
BACKGROUND: Modular neck femoral stem (MNFS) for total hip arthroplasty (THA) was introduced to optimize the outcome, but created concerns about pain, elevated blood metal ion levels, and adverse reaction to metal debris such as pseudotumors (PTs), related to corrosion between femoral neck and stem. We compared these outcomes in patients with MNFS or nonmodular femoral stem (NFS) THA. METHODS: Thirty-three patients with unilateral MNFS THA were compared with 30 patients with unilateral NFS THA...
April 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28392135/ten-year-cross-sectional-study-of-mechanically-assisted-crevice-corrosion-in-1352-consecutive-patients-with-metal-on-polyethylene-total-hip-arthroplasty
#5
Daniel K Hussey, Brian J McGrory
BACKGROUND: Mechanically assisted crevice corrosion (MACC) in metal-on-polyethylene total hip arthroplasty (THA) is of concern, but its prevalence, etiology, and natural history are incompletely understood. METHODS: From January 2003 to December 2012, 1352 consecutive THA surgeries using a titanium stem, cobalt-chromium alloy femoral head, and highly cross-linked polyethylene liner from a single manufacturer were performed. Patients were followed at 1-year and 5-year intervals for surveillance, but also seen earlier if they had symptoms...
March 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28167873/corrosion-of-the-head-stem-taper-junction-are-we-on-the-verge-of-an-epidemic-review-article
#6
REVIEW
Michael Morlock, Dennis Bünte, Julian Gührs, Nicholas Bishop
BACKGROUND: The modular head taper junction has contributed to the success of total hip arthroplasty (THA) greatly. Taper corrosion and wear problems reported for large and extra-large metal-on-metal bearings as well as for bi-modular THA stems have cast doubt on the benefit of the taper interface. Presently, corrosion problems are being reported for nearly all kinds of artificial hip joints incorporating metal heads, questioning taper connections in general. QUESTIONS/PURPOSES: This study aimed to review the mechanical and electrochemical relationships that may lead to taper corrosion, which have been reported more commonly in recent literature, and to also review the contribution of patient characteristics and surgical techniques involved in taper assembly that may contribute to the problem...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28087160/mri-retrieval-analysis-and-histologic-evaluation-of-adverse-local-tissue-reaction-in-metal-on-polyethylene-total-hip-arthroplasty
#7
Scott R Nodzo, Christina I Esposito, Hollis G Potter, Chitranjan S Ranawat, Timothy M Wright, Douglas E Padgett
BACKGROUND: The severity and location of adverse local tissue reaction (ALTR) seen in metal-on-polyethylene total hip arthroplasty (THA) is not well described. METHODS: We retrospectively reviewed the records of patients who underwent a revision THA using our biomechanics database. We included all patients who underwent revision surgery for the diagnosis of ALTR with THA implants that had modularity solely at the head-neck junction and excluded patients with implant modularity at sites other than the head-neck junction...
May 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28065626/choosing-a-femoral-head-a-survey-study-of-academic-adult-reconstructive-surgeons
#8
Sumon Nandi, Matthew S Austin
BACKGROUND: Our aim was to examine how academic adult reconstructive surgeons have interpreted evidence on femoral head material in total hip arthroplasty (THA). METHODS: A 16-question survey to evaluate attitudes toward ceramic and cobalt-chrome head use was emailed to 274 faculty at 42 US adult reconstruction fellowship programs. RESULTS: With 116 respondents, the response rate was 42.2%. Faculty use ceramic heads 72.9% of the time. The most common reason why respondents do not use ceramic heads is cost (44...
May 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28064103/why-do-some-titanium-alloy-total-hip-arthroplasty-modular-necks-fail
#9
Samo K Fokter, Andrej Moličnik, Rajko Kavalar, Primož Pelicon, Rebeka Rudolf, Nenad Gubeljak
BACKGROUND: Increased modularity in total hip arthroplasty (THA) through extra junction between the neck and the femoral stem is gaining popularity among orthopaedic community. However, the advantage of the additional junction is shadowed by an increased risk of mechanical failure. The aim of this study was to describe the exact mechanism of fracture of the modular femoral neck in an uncemented stem. METHODS: Clinical, metallurgical, and mechanical analysis including finite-element modelling and elemental-sensitive tissue analysis with the micro-PIXE method was performed on two patients treated with fully modular primary THA made from Titanium alloy of the same oval taper-cone design...
December 27, 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28041772/elevated-intra-articular-cobalt-and-chromium-levels-in-mechanically-assisted-crevice-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty
#10
Brian J McGrory, Abigail M Payson, Johanna A MacKenzie
BACKGROUND: Failed total hip arthroplasty (THA) caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction (ALTR). Serum cobalt (Co) and chromium (Cr) ion levels have been used to diagnose taper corrosion, but have not been shown to be an accurate measure of the severity of MACC or associated ALTRs. Additionally, elevated serum ions are not specific in patients with multiple artificial joints. METHODS: We examined the relationship between serum and intra-articular (IA) Co and Cr levels in a cohort of 20 patients undergoing revision THA, 16 who had symptomatic MACC...
May 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28002921/restoring-the-femoral-offset-prevent-early-migration-of-the-stem-in-total-hip-arthroplasty-an-ebra-fca-study
#11
G Vicenti, G Solarino, A Spinarelli, M Carrozzo, G Picca, R Maddalena, F Rifino, B Moretti
The use of modular stems is still debated and controversial. Some authors have highlighted a number of disadvantages of modular prostheses including high costs, the tendency to fracture, the fretting and corrosion and the increased production of debris. Other authors have emphasized several advantages to adapt the prosthesis to the morphometric differences of patients, to allow better accuracy in restoring the anatomy and biomechanics of hip joint. The advantages of the modular devices appear to be more evident in patients with developmental dysplasia of the hip (DDH)...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/27923596/revision-hip-arthroplasty-using-a-modular-cementless-femoral-stem-intermediate-term-follow-up
#12
Sureshan Sivananthan, Chin-Tat Lim, Rapeepat Narkbunnam, Alex Sox-Harris, James I Huddleston, Stuart B Goodman
BACKGROUND: Modular femoral stem provides flexibility in femoral reconstruction, ensuring improved "fit and fill". However, there are risks of junction failure and corrosion, as well as cost concerns in the use of modular femoral stems. METHODS: We reviewed prospectively-gathered clinical and radiographic data on revision total hip arthroplasties (THAs) performed from 2001-2007 using modular, cementless femoral component performed by the 2 senior authors. Patients with a minimum follow-up of 7 years were included in this study...
November 2, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27776907/sensitivity-and-specificity-of-metal-ion-levels-in-predicting-pseudotumors-due-to-taper-corrosion-in-patients-with-dual-taper-modular-total-hip-arthroplasty
#13
Young-Min Kwon, Tsung-Yuan Tsai, William A Leone, Ming Han Lincoln Liow
BACKGROUND: Currently, no serum metal ion threshold exists to identify adverse tissue reactions in total hip arthroplasty (THA) patients with taper corrosion. Our study aims to investigate the sensitivity and specificity of serum metal ions in detecting taper corrosion related pseudotumors in patients with dual taper modular THA. METHODS: A total of 148 patients with dual taper modular THA were investigated: (1) 90 patients with pseudotumors detected with metal artifact reduction sequence-magnetic resonance imaging (MARS-MRI) and (2) 58 patients without pseudotumors on MARS-MRI...
September 28, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27768219/head-neck-taper-corrosion-following-total-hip-arthroplasty-with-stryker-meridian-stem
#14
Sonika Patel, Carl T Talmo, Sumon Nandi
BACKGROUND: Taper corrosion at the modular junctions of total hip arthroplasty (THA) femoral stems are known to cause locally destructive adverse local tissue reaction (ALTR). However, the implants at risk remain to be fully elucidated. CASE REVIEW: We report the case of a 76-year-old woman with hip pain, abductor weakness, and sciatic nerve symptoms 2 years following metal-on-polyethylene THA. Serum cobalt levels were elevated, while chromium levels were normal...
November 10, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27759468/heart-failure-after-conventional-metal-on-metal-hip-replacements
#15
MULTICENTER STUDY
Marianne H Gillam, Nicole L Pratt, Maria C S Inacio, Elizabeth E Roughead, Sepehr Shakib, Stephen J Nicholls, Stephen E Graves
Background and purpose - It is unclear whether metal particles and ions produced by mechanical wear and corrosion of hip prostheses with metal-on-metal (MoM) bearings have systemic adverse effects on health. We compared the risk of heart failure in patients with conventional MoM total hip arthroplasty (THA) and in those with metal-on-polyethylene (MoP) THA. Patients and methods - We conducted a retrospective cohort study using data from the Australian Government Department of Veterans' Affairs health claims database on patients who received conventional THA for osteoarthritis between 2004 and 2012...
February 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/27737298/ceramic-femoral-heads-for-all-patients-an-argument-for-cost-containment-in-hip-surgery
#16
Cody C Wyles, Benjamin A McArthur, Eric R Wagner, Matthew T Houdek, Jose H Jimenez-Almonte, Robert T Trousdale
Trunnionosis and taper corrosion have recently emerged as problems in total hip arthroplasty (THA). No longer restricted to metal-on-metal bearings, these phenomena now affect an increasing number of metal-on-polyethylene THAs and are exacerbated by modularity. Resulting increases in metal toxicity and patient morbidity, and the added costs of toxicity surveillance and revision surgery, will place a substantial economic burden on many health systems. Although they are more expensive than cobalt-chrome heads, ceramic femoral heads make metal toxicity a nonissue...
September 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27631309/do-cobalt-and-chromium-levels-predict-osteolysis-in-metal-on-metal-total-hip-arthroplasty
#17
Lisa Renner, Tom Schmidt-Braekling, Martin Faschingbauer, Friedrich Boettner
INTRODUCTION: Serum metal ions are part of the regular follow-up routine of patients with metal-on-metal total hip arthroplasties (MoM-THA). Increased cobalt levels have been suggested to indicate implant failure and corrosion. QUESTIONS: (1) Is there a correlation between the size of the osteolysis measured on a CT scan and metal ion levels? (2) Can metal ion levels predict the presence of osteolysis in MoM-THA? (3) Are cobalt and chromium serum levels or the cobalt-chromium-ratio diagnostic for osteolysis? MATERIALS AND METHODS: CT scans of patients (n = 75) with a unilateral MoM-THA (Birmingham Hip System, Smith & Nephew, TN, USA) implanted by a single surgeon were reviewed to determine the presence of osteolysis...
December 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27321963/corrosion-at-the-head-neck-junction-why-is-this-happening-now
#18
Joshua J Jacobs
While mechanically-assisted crevice corrosion (MACC) at the head/neck junction of modular total hip arthroplasty (THA) femoral components was first described over two decades ago, it is only within the last few years that investigators have observed that adverse local tissue reactions (ALTRs) associated with MACC are an increasingly prevalent mode of failure of contemporary THAs. As yet, the incidence, etiology and pathogenesis of MACC-associated ALTR are not well understood. In this review, possible implant-, patient-, and surgeon-related factors are considered in the context of a small but growing body of evidence from laboratory simulations, implant and tissue retrieval studies and clinical case series...
July 2016: Journal of Arthroplasty
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/27178012/medial-calcar-erosion-is-associated-with-synovial-thickness-in%C3%A2-patients-with-asr-xl-total-hip-arthroplasty
#20
Rami Madanat, Ola Rolfson, Gabrielle S Donahue, Daniel K Hussey, Hollis G Potter, Robert Wallace, Orhun K Muratoglu, Henrik Malchau
BACKGROUND: Medial calcar erosion is considered a late finding in patients with severe adverse local tissue reactions (ALTRs) after total hip arthroplasty (THA) with dual modular neck stems. Although calcar erosion has been associated with dual modular neck stems, one would expect similar findings in standard stems owing to analogous corrosion at the taper junction. The aim of this study was to evaluate whether medial calcar erosion is also associated with ALTR in patients with standard stems in metal-on-metal (MoM) THA...
April 13, 2016: Journal of Arthroplasty
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