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Particle disease hip replacement

Xiaodong Tang, Wei Guo, Rongli Yang, Taiqiang Yan, Shun Tang, Dasen Li
BACKGROUND: Pelvic reconstruction after periacetabular tumor resection is technically difficult and characterized by a high complication rate. Although endoprosthetic replacement can result in immediate postoperative functional recovery, biologic reconstructions with autograft may provide an enhanced prognosis in patients with long-term survival; however, little has been published regarding this approach. We therefore wished to evaluate whether whole-bulk femoral head autograft that is not contaminated by tumor can be used to reconstruct segmental bone defects after intraarticular resection of periacetabular tumors...
December 2017: Clinical Orthopaedics and related Research
Jason J Howard
Due to problems with wear particle generation and subsequent loosening using conventional metal-on-polyethylene total hip replacements, there has been a shift toward alternative bearing systems, including metal-on-metal (MoM), for younger, more active patients with degenerative joint disease. Based on positive results from early short-term clinical studies, MoM hip replacements were readily adopted by orthopedic surgeons with thousands being implanted worldwide over the past decade. Unacceptably high revision rates reported by two national joint registries called into question the rigorousness of the regulatory approval process for these implants, particularly with respect to premarket data requirements to prove safety, effectiveness, and the appropriateness of the regulatory pathway chosen...
2016: Medical Devices: Evidence and Research
Matthew F Gornet, Vaneet Singh, Francine W Schranck, Anastasia K Skipor, Joshua J Jacobs
STUDY DESIGN: Prospective longitudinal study. OBJECTIVE: The serum titanium (Ti) concentrations were examined in patients implanted with a PRESTIGE LP Cervical Disc System (Medtronic, Inc., Memphis, TN). The metal-on-metal disc with ball-in-trough articulation is made of titanium alloy/titanium carbide composite (Ti-6Al-4 V/TiC). SUMMARY OF BACKGROUND DATA: Cervical disc arthroplasty provides a motion-preserving treatment alternative to anterior cervical discectomy and fusion for degenerative cervical disc disease...
March 15, 2017: Spine
Marcin K Wasko, Stuart B Goodman
Aseptic loosening remains the most significant long-term complication of total hip replacement. The current paradigm points to an inflammatory response to wear particles as its main trigger. Recently, there have been increasing numbers of positive bacterial isolates reported among patients with clinically absent infection. This paper reviews existing evidence on possible involvement of bacteria and microbial-associated molecular patterns in the pathology of so-called "aseptic loosening." © 2016 Orthopaedic Research Society...
September 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Dong Fu, Wei Sun, Jiakang Shen, Xiaojun Ma, Zhengdong Cai, Yingqi Hua
Inflammatory pseudotumor has been commonly reported in patients undertaking total hip replacement (THR) for different reasons. The precise etiology of this biological reaction and whether the primary disease has an influence on pseudotumor formation remain unclear. There seems to be a consensus that metal ions and debris do play an important role during this process. Recently, however, compared to metal particles along, immune response induced by metal particles attracts more attention. We present two cases of pseudotumor who have accepted THR for ankylosing spondylitis (AS) and later required revision surgery and hindquarter amputation, respectively...
2015: World Journal of Surgical Oncology
Hong Suk Kwak, Jeong Joon Yoo, Young-Kyun Lee, Kyung-Hoi Koo, Kang Sup Yoon, Hee Joong Kim
BACKGROUND: Wear cannot be completely prevented after total hip arthroplasty. If severe polyethylene (PE) liner wear develops, the so-called catastrophic failure occurs and metallosis develops. We postulated that longevity of the new implant may be affected after revision surgery for metallosis following a catastrophic failure of a PE liner due to the substantial amount of PE wear particles and infiltration of the metal particles in this catastrophic condition. METHODS: Twenty-three hips of 23 patients were identified because they showed metallosis during revision total hip arthroplasties performed in Seoul National University Hospital between January 1996 and August 2004...
March 2015: Clinics in Orthopedic Surgery
Connie Y Chang, Ambrose J Huang, William E Palmer
Serial radiographs are the mainstay in the longitudinal assessment of hip implants. The prosthesis, periprosthetic bone, and juxta-articular soft tissues are inspected for fracture, periosteal reaction, stress shielding, calcar resorption, osteolysis, bony remodeling, metallic debris, and heterotopic ossification. Comparison radiographs best confirm implant migration, subsidence, and aseptic loosening. Infection, particle disease, reaction to metal, and mechanical impingement are important causes of postsurgical pain, but in their earliest stages they may be difficult to diagnose using radiographs...
February 2015: Seminars in Musculoskeletal Radiology
Lucas H B Walschot, René Aquarius, Nico Verdonschot, Pieter Buma, B Willem Schreurs
BACKGROUND AND PURPOSE: The bone impaction grafting technique restores bone defects in total hip replacement. Porous titanium particles (TiPs) are deformable, like bone particles, and offer better primary stability. We addressed the following questions in this animal study: are impacted TiPs osteoconductive under loaded conditions; do released micro-particles accelerate wear; and are systemic titanium blood levels elevated after implantation of TiPs? ANIMALS AND METHODS: An AAOS type-III defect was created in the right acetabulum of 10 goats weighing 63 (SD 6) kg, and reconstructed with calcium phosphate-coated TiPs and a cemented polyethylene cup...
December 2014: Acta Orthopaedica
R Lax-Pérez, J E Salinas-Gilabert, F Lajara-Marco, A Lax-Pérez, A Corraliza-Zamorano, A García-Gálvez, L Izquierdo-Plazas
Male, 76 year-old patient with a history of total hip arthroplasty who presents with a mass in the iliac fossa with swelling of the thigh and hip pain upon flexion and extension. Complementary ultrasound and computed tomography scan studies show a giant lobulated cystic mass in the left iliac fossa, 7 cm in diameter, near the prosthesis. Cyst formation caused by polyethylene disease after total hip arthroplasty is infrequent. We present a case of large psoas bursitis secondary to the release of polyethylene particles which caused superficial femoral vein compression and thrombosis...
September 2012: Acta Ortopédica Mexicana
John T Maltese, Myron M Laban, Krishnaj Gorab, John C Maltese
No abstract text is available yet for this article.
May 2014: American Journal of Physical Medicine & Rehabilitation
Stefan Landgraeber, S Putz, M Schlattjan, Lars P Bechmann, Martin Totsch, Florian Grabellus, Gero Hilken, M Jäger, A Canbay
Joint replacements have a longer durability in patients with high serum levels of adiponectin (APN) than in patients with low levels. We aimed to characterize the unknown pathophysiological effects of APN on wear particle-induced inflammation, apoptosis and osteolysis. Immunohistochemistry was performed to detect APN, its receptors and apoptosis in patients with and without aseptic loosening. Additionally, APN knockout mouse studies and pharmacological intervention of APN were performed in an established calvarial mouse model...
January 2014: Acta Biomaterialia
Christiaan P van Lingen, Harmen B Ettema, Jorik R Timmer, Gosse de Jong, Cees C P M Verheyen
Reports of adverse reactions to metal particle debris with metal-on-metal (MoM) hip arthroplasty have increased recently. Apart from the formation of pseudotumours and higher revision rates, another major cause for concern are the systemic effects of metal ions. Several effects of elevated systemic cobalt ions have been reported (e.g., myocardial and neurological effects, hypothyroidism). All 643 patients who underwent a stemmed large head MoM total hip replacement in our clinic were screened with repeated whole blood samples of metal ions (cobalt, chromium)...
September 2013: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Zachary D Post, Fabio R Orozco, Alvin C Ong
Recent problems with metal-on-metal bearings in total hip arthroplasty have highlighted a connection between metal particles and allergic responses. Metal sensitivity associated with total knee arthroplasty (TKA) is less understood and poorly characterized. However, metal sensitivity can lead to TKA failure. Accurate and reliable testing for this phenomenon is elusive; therefore, the diagnosis of metal sensitivity remains one of exclusion. Only skin testing and lymphocyte transformation testing are commonly available to assess hypersensitivity, and neither test is reliable...
April 2013: Orthopedics
Joseph G Craig
Imaging of the postoperative hip with ultrasound can be difficult and challenging. The primary role of ultrasound is to help determine whether or not there is infection. It is difficult at times to differentiate between complex fluid and synovium. Whether fluid is infected or not cannot be determined by ultrasound criteria and aspiration, and laboratory analysis is required. Particle disease and infection cannot be reliably differentiated by ultrasound criteria. In the setting of possible infection, any fluid collection/s around the hip should be treated with suspicion and, if possible, aspirated...
February 2013: Seminars in Musculoskeletal Radiology
Fernando Judas, Alexandre Marques, Luís Maximino, Francisco Lucas
We report a case of a severe bone loss of the proximal femur with a rapid progression, in a 72-year-old male patient with a stable total revision hip prosthesis. The patient had a persistent mechanical thigh pain. The blood laboratory values were normal. Infection disease and osteolytic bone tumor were excluded. A surgical procedure was performed. The native bone of the proximal femur was resorbed and replaced by a dense fibrous tissue with some sclerotic bone fragments. A large amount of a brownish fluid and a red-brown and friable tissue were found in the pseudojoint cavity...
April 2012: Acta Reumatológica Portuguesa
Hugo C van der Veen, Inge van den Akker-Scheek, Sjoerd K Bulstra, Jos Jam van Raay
BACKGROUND: Aseptic loosening of total hip arthroplasties is generally caused by periprosthetic bone resorption due to tissue reactions on polyethylene wear particles. In vitro testing of polyethylene cups incorporated with vitamin E shows increased wear resistance. The objective of this study is to compare vitamin E-stabilized highly cross-linked polyethylene with conventional cross-linked polyethylene in "reversed hybrid" total hip arthroplasties (cemented all-polyethylene cups combined with uncemented femoral stems)...
2012: BMC Musculoskeletal Disorders
J Špička, L Radová, J Gallo
PURPOSE OF THE STUDY: The aim of the study was to analyse the long-term clinical and radiographic results of total hip arthroplasty (THA) with the Bicontact-Plasmacup prosthesis, MATERIAL AND METHODS: In this retrospective observational study, 34 consecutive patients undergoing Bicontact-Plasmacup THA between August 1998 and July 2000 were evaluated. The group included 15 women and 19 men with an average age of 56 years (30 to 67 years). The mean ± SD of follow-up was 132 ± 9 months (122 to 149 months)...
2012: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Jiri Gallo, Stuart B Goodman, Yrjö T Konttinen, Milan Raska
Numerous studies provide detailed insight into the triggering and amplification mechanisms of the inflammatory response associated with prosthetic wear particles, promoting final dominance of bone resorption over bone formation in multiple bone multicellular units around an implant. In fact, inflammation is a highly regulated process tightly linked to simultaneous stimulation of tissue protective and regenerative mechanisms in order to prevent collateral damage of periprosthetic tissues. A variety of cytokines, chemokines, hormones and specific cell populations, including macrophages, dendritic and stem cells, attempt to balance tissue architecture and minimize inflammation...
2013: Innate Immunity
Dong-Kyu Shin, Mi-Hyung Kim, Sang-Han Lee, Tae-Ho Kim, Shin-Yoon Kim
Wear particles liberated from the surfaces of an implanted prosthesis are associated with peri-implant osteolysis and subsequent aseptic loosening. In the latter wear particle-induced inflammation and osteoclastogenesis have been identified as critical factors, and their inhibition as important steps in the treatment of affected patients, such as those undergoing total hip replacement. In this study the ability of luteolin to inhibit both titanium (Ti) particle-induced osteoclastogenesis in vitro and osteolysis in a murine calvaria Ti particle-induced model of osteolysis was examined...
September 2012: Acta Biomaterialia
R Lax-Pérez, J E Salinas-Gilabert, F Lajara-Marco, A Lax-Pérez, A Corraliza-Zamorano, A García-Gálvez, L Izquierdo-Plazas
The case of a male 76 year-old patient with a history of total hip replacement surgery is presented herein. The patient had tumors in the iliac fossa with swelling of the thigh and pain upon hip flexion and extension. The complementary ultrasound and computed tomography show a large lobed cystic tumor in the left iliac fossa, 7 cm in diameter, close to the prosthesis. The diagnosis was psoas bursitis secondary to the release of polyethylene particles that caused compression and thrombosis of the superficial femoral vein...
May 2011: Acta Ortopédica Mexicana
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