Delayed Fracture of a Ceramic Insert With Modern Ceramic Total Hip Replacement

2007 ◽  
Vol 22 (1) ◽  
pp. 136-139 ◽  
Author(s):  
Byung-Woo Min ◽  
Kwang-Soon Song ◽  
Chul-Hyung Kang ◽  
Ki-Cheol Bae ◽  
Ye-Yeon Won ◽  
...  
2012 ◽  
Vol 16 (6) ◽  
pp. 448-450 ◽  
Author(s):  
Fujio Higuchi ◽  
Daisuke Tsuruta ◽  
Yumiko Ishibashi ◽  
Kazuko Imamura ◽  
Tokiko Shimoyama ◽  
...  

Background: Ceramics are inorganic nonmetallic materials and are used as bioinert components in joint replacement surgeries. Ceramics are known to be low allergenic. We experienced a ceramic-induced psoriasis. Objective: We report a first case of possible ceramic-induced psoriasis caused by a ceramic insert. Methods: A 55-year-old female received an implanted ceramic-on-ceramic total hip replacement for osteoarthritis of the right hip joint. Following surgery, she developed psoriatic lesions, which continued for 10 years. We suspected that psoriasis was caused by a ceramic insert and removed it surgically. Results: When the ceramic insert was replaced with a polyethylene-on-metal hip joint, the psoriatic lesions completely disappeared. Conclusion: The pathogenesis of psoriasis is still an enigma, although deregulation of nuclear factor κB signaling and resulting abnormal cytokine secretion are speculated to be involved. Ceramics may affect these signaling events and cause the onset of psoriasis. Renseignements de base: Les céramiques sont des matériaux non métalliques inorganiques et sont utilisées comme composants bio-inertes dans les arthroplasties. Les céramiques sont reconnues pour être peu allergisantes. Nous avons observé un psoriasis provoqué par la céramique. Objectif: Nous exposons un premier cas possible de psoriasis provoqué par la céramique causé par un implant en céramique. Méthodes: Une femme de 55 ans a reçu une prothèse céramique-sur-céramique implantée lors d'une arthroplastie totale de la hanche pour traiter l'arthrose de l'articulation de la hanche droite. Après la chirurgie, elle a développé des lésions psoriasiques dont la manifestation s'est poursuivie pendant 10 ans. Nous avons soupçonné que le psoriasis était causé par l'implant en céramique, et nous l'avons enlevé chirurgicalement. Résultats: Une fois l'implant en céramique remplacé par une prothèse articulaire en polyéthylène-sur-métal, les lésions psoriasiques ont disparu complètement. Conclusion: La pathogenèse du psoriasis demeure une énigme, bien qu'on suppose que la dérégulation de la voie de signalisation NF-κB et que la sécrétion anormale de cytokines résultante soient impliquées. Les céramiques peuvent affecter ces événements de signalisation et provoquer l'apparition du psoriasis.


1992 ◽  
Vol 68 (04) ◽  
pp. 436-441 ◽  
Author(s):  
Nigel E Sharrock ◽  
George Go ◽  
Robert Mineo ◽  
Peter C Harpel

SummaryLower rates of deep vein thrombosis have been noted following total hip replacement under epidural anesthesia in patients receiving exogenous epinephrine throughout surgery. To determine whether this is due to enhanced fibrinolysis or to circulatory effects of epinephrine, 30 patients scheduled for primary total hip replacement under epidural anesthesia were randomly assigned to receive intravenous infusions of either low dose epinephrine or phenylephrine intraoperatively. All patients received lumbar epidural anesthesia with induced hypotension and were monitored with radial artery and pulmonary artery catheters.Patients receiving low dose epinephrine infusion had maintenance of heart rate and cardiac index whereas both heart rate and cardiac index declined significantly throughout surgery in patients receiving phenylephrine (p = 0.0001 and p = 0.0001, respectively). Tissue plasminogen activator (t-PA) activity increased significantly during surgery (p <0.0005) and declined below baseline postoperatively (p <0.005) in both groups. Low dose epinephrine was not associated with any additional augmentation of fibrinolytic activity perioperatively. There were no significant differences in changes in D-Dimer, t-PA antigen, α2-plasmin inhibitor-plasmin complexes or thrombin-antithrombin III complexes perioperatively between groups receiving low dose epinephrine or phenylephrine. The reduction in deep vein thrombosis rate with low dose epinephrine is more likely mediated by a circulatory mechanism than by augmentation of fibrinolysis.


1991 ◽  
Vol 66 (06) ◽  
pp. 652-656 ◽  
Author(s):  
Per Anders Flordal ◽  
Karl-Gösta Ljungström ◽  
Jan Svensson ◽  
Brenda Ekman ◽  
Gustaf Neander

SummaryTwelve patients undergoing total hip replacement, with regional anaesthesia and with dextran infusion for plasma expansion and thromboprophylaxis, were given the vasopressin analogue desmopressin (DDAVP) or placebo in a randomized, double-blind prospective study. In controls (n = 6) we found a prolongation of the bleeding time, low factor VIII (FVIII) and von Willebrand factor (vWF) and a decrease in antithrombin III to levels known to be at risk for venous thrombosis. Desmopressin shortened postoperative bleeding time, gave an early FVIII/vWF complex increase, prevented antithrombin III from falling to critically low values and appeared to activate the fibrinolytic system, both by tPA increase and PAI-1 decrease.Thus in the controls we found changes in both coagulation and fibrinolysis indicating a haemorrhagic diathesis as well as a risk for thromboembolism. Desmopressin induced factor changes that possibly reduce both risks.


1976 ◽  
Vol 36 (01) ◽  
pp. 157-164 ◽  
Author(s):  
P. M Mannucci ◽  
Luisa E. Citterio ◽  
N Panajotopoulos

SummaryThe effect of subcutaneous low-dose heparin on postoperative deep-vein thrombosis (D. V. T.) (diagnosed by the 125I-labelled fibrinogen test) has been investigated in a trial of 143 patients undergoing the operation of total hip replacement. Two randomized studies were carried out: in one the scanning for D.V.T. was carried out daily for 7 days post operatively and in the other for 15 days. In both, the incidence of D.V.T. was significantly lower in the heparin-treated patients (P<0.005). Bilateral D.V.T. was also prevented (P<0.05), through the extension of D.V.T. to the distal veins of the thigh was not significantly reduced. Heparin treatment was, however, followed by a higher incidence of severe postoperative bleeding (P< 0.02) and wound haematoma formation (P< 0.005), and the postoperative haemoglobin was significantly lower than in the control group (P<0.005). A higher number of transfused blood units was also needed by the heparin treated patients (P<0.001).


2019 ◽  
Vol 85 (3) ◽  
Author(s):  
Gianluca Cappelleri ◽  
Daniela Ghisi ◽  
Andrea L. Ambrosoli ◽  
Alice Ascari ◽  
Elisa Compagnino ◽  
...  

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