MARS MRI Characteristics of Adverse Local Tissue Reactions in Taper Corrosion of Metal-On-Polyethylene THA Differ From Metal-On-Metal THA

2020 ◽  
Vol 35 (11) ◽  
pp. 3338-3342
Author(s):  
John Mahajan ◽  
Bryant Bonner ◽  
Ruben Oganesyan ◽  
Ingwon Yeo ◽  
Christian Klemt ◽  
...  
Keyword(s):  
Local Tissue ◽  
Metal On Metal ◽  
Tissue Reactions ◽  
Mri Characteristics

scholarly journals High Frequency of Adverse Local Tissue Reactions in Asymptomatic Patients With Metal-on-Metal THA

2013 ◽  
Vol 472 (2) ◽  
pp. 517-522 ◽  
Author(s):  
Thomas K. Fehring ◽  
Susan Odum ◽  
Robert Sproul ◽  
Jessica Weathersbee
Keyword(s):  
High Frequency ◽  
Local Tissue ◽  
Asymptomatic Patients ◽  
Metal On Metal ◽  
Tissue Reactions

Cystic Adverse Local Tissue Reactions in Asymptomatic Modular Metal-on-Metal Total Hips May Decrease Over Time

2016 ◽  
Vol 31 (7) ◽  
pp. 1589-1594 ◽  
Author(s):  
Jeffrey M. Goldstein ◽  
Thomas K. Fehring ◽  
Keith A. Fehring
Keyword(s):  
Local Tissue ◽  
Metal On Metal ◽  
Tissue Reactions ◽  
Over Time

scholarly journals Failure of facet replacement system with metal-on-metal bearing surface and subsequent discovery of cobalt allergy: report of 2 cases

2018 ◽  
Vol 29 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Matthew L. Goodwin ◽  
William Ryan Spiker ◽  
Darrel S. Brodke ◽  
Brandon D. Lawrence
Keyword(s):  
Tissue Reaction ◽  
Adverse Outcomes ◽  
Low Grade ◽  
Bearing Surface ◽  
Allergy Testing ◽  
Local Tissue ◽  
Metal On Metal ◽  
Mobile Spine ◽  
Replacement System ◽  
Tissue Reactions

The aim of this study was to report on 2 patients in whom metal-on-metal (MOM) facet replacements failed, with subsequent positive findings on allergy testing. Motion-preserving devices have been used with limited success when instrumentation is indicated in the mobile spine. MOM-bearing surfaces in orthopedics were developed to increase implant longevity, yet have been associated with numerous adverse outcomes, including local tissue reactions, pseudotumors, metallosis, and the need for revision surgery. Five patients with spinal stenosis and low-grade spondylolisthesis were randomized to undergo facet replacement surgery with the ACADIA facet replacement system at the authors’ institution. Two patients experienced a return of neurological symptoms after a pain-free interval (< 2 years) with development of local tissue reaction and positive findings on allergy testing to cobalt, the metal in the MOM-bearing surface. Both patients underwent successful removal of the implant and revision to titanium posterior spinal fusion and interbody fusion without further complication.Motion-preserving devices have been designed and trialed for specific indications in the mobile spine. Given the adverse results from MOM devices in hip arthroplasty and now the early reports with MOM facet replacements, caution is warranted when moving forward with any MOM joint–bearing surface. Both patients presented here had an unusual tissue reaction locally and subsequent positive allergy testing results to cobalt. These 2 patients appear to have developed a delayed hypersensitivity reaction to the metal, likely from fine debris at the MOM interface.

Have newer bearing surfaces changed expectations regarding the longevity of total hip arthroplasty?

2020 ◽  
Vol 102-B (7_Supple_B) ◽  
pp. 105-111
Author(s):  
Charles A. Engh, Jr. ◽  
Craig J. McAsey ◽  
Agnes D. Cororaton ◽  
Henry Ho ◽  
Robert H. Hopper, Jr.
Keyword(s):  
Cobalt Chromium ◽  
Single Institution ◽  
Γ Irradiation ◽  
Local Tissue ◽  
Gas Plasma ◽  
Metal On Metal ◽  
The Mean ◽  
Tissue Reactions ◽  
Ceramic On Ceramic

Aims The purpose of this study is to examine six types of bearing surfaces implanted at a single institution over three decades to determine whether the reasons for revision vary among the groups and how long it takes to identify differences in survival. Methods We considered six cohorts that included a total of 1,707 primary hips done between 1982 and 2010. These included 223 conventional polyethylene sterilized with γ irradiation in air (CPE-GA), 114 conventional polyethylene sterilized with gas plasma (CPE-GP), 116 crosslinked polyethylene (XLPE), 1,083 metal-on-metal (MOM), 90 ceramic-on-ceramic (COC), and 81 surface arthroplasties (SAs). With the exception of the COC, all other groups used cobalt-chromium (CoCr) femoral heads. The mean follow-up was 10 (0.008 to 35) years. Descriptive statistics with revisions per 100 component years (re/100 yr) and survival analysis with revision for any reason as the endpoint were used to compare bearing surfaces. Results XLPE liners demonstrated a lower cumulative incidence of revision at 15 years compared to the CPE-GA and CPE-GP groups owing to the absence of wear-related revisions (4% for XLPE vs 18%, p = 0.02, and 15%, p = 0.003, respectively). Revisions for adverse local tissue reactions occurred exclusively among the MOM (0.8 re/100 year) and SA groups (0.1 re/100 year). The revision rate for instability was lower among hips with 36 mm and larger head sizes compared to smaller head sizes (0.2% vs 2%, p < 0.001). Conclusion The introduction of XLPE has eliminated wear-related revisions through 15-year follow-up compared to CPE-GP and CPE-GA. Dislocation incidence has been reduced with the introduction of larger diameter heads but remains a persistent concern. The potential for adverse local tissue reactions with MOM requires continued follow-up. Cite this article: Bone Joint J 2020;102-B(7 Supple B):105–111.

scholarly journals Diagnosis of adverse local tissue reactions following metal-on-metal hip arthroplasty

2016 ◽  
Vol 9 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Brian P. Chalmers ◽  
Kevin I. Perry ◽  
Michael J. Taunton ◽  
Tad M. Mabry ◽  
Matthew P. Abdel
Keyword(s):  
Hip Arthroplasty ◽  
Local Tissue ◽  
Metal On Metal ◽  
Tissue Reactions

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

2018 ◽  
Vol 33 (9) ◽  
pp. 3020-3024 ◽  
Author(s):  
Inari Laaksonen ◽  
Vincent P. Galea ◽  
Gabrielle S. Donahue ◽  
Sean J. Matuszak ◽  
Orhun Muratoglu ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Diagnostic Value ◽  
Cobalt Chromium ◽  
Local Tissue ◽  
Metal On Metal ◽  
Tissue Reactions

Correlation between Serum Metal Ion Levels and Adverse Local Tissue Reactions after Conserve® plus Hip Resurfacing Arthroplasty

2017 ◽  
Vol 27 (4) ◽  
pp. 336-342 ◽  
Author(s):  
Harlan C. Amstutz ◽  
Michel J. Le Duff
Keyword(s):  
Metal Ion ◽  
Strong Association ◽  
Hip Resurfacing ◽  
Local Tissue ◽  
Functional Coverage ◽  
Metal On Metal ◽  
Screening Protocol ◽  
Tissue Reactions ◽  
The Relationship

Background Adverse local tissue reactions (ALTR) have been associated with the use of metal-on-metal (MoM) bearings and the monitoring of cobalt (Co) and chromium (Cr) ion levels in blood or serum may be the best way to evaluate in vivo the wear of these bearings. However, the relationship between Co and Cr ion concentrations and the formation of ALTR remains unclear. Methods We investigated the relationship between ALTR and serum Co and Cr ion levels and identified the clinical factors influencing the formation of ALTR in patients treated with MoM hip resurfacing arthroplasties. 228 patients with unilateral Conserve® Plus MoM hip resurfacing had serum metal ion studies performed more than 1 year after surgery. Metal artifact reduction sequence magnetic resonance imaging (MARS MRI) was performed on subjects at risk for ALTR as determined by a screening protocol. Results 12 patients had ALTR. Logistic regression showed a strong association of ALTR with elevated ion levels and with low (<10 mm) contact patch to rim distance. Conclusions MoM bearings require enough functional coverage of the socket by design and then precise implantation to maximise functional coverage of the femoral ball, enhance lubrication, and avoid edge-loading wear.

scholarly journals Metal-on-metal total hip arthroplasty: does increasing modularity affect clinical outcome?

2020 ◽  
pp. 112070002097927
Author(s):  
Kevin C Ilo ◽  
Harry S Hothi ◽  
John A Skinner ◽  
Alister J Hart
Keyword(s):  
Metal Ion ◽  
Hip Prosthesis ◽  
Tissue Reaction ◽  
Bearing Surface ◽  
Adverse Local Tissue Reaction ◽  
Material Loss ◽  
Local Tissue ◽  
Local Tissue Reaction ◽  
Metal On Metal ◽  
Modular Implants

Background: Modularity of metal-on-metal (MoM) implants has come under scrutiny due to concerns regarding additional sources of metal debris. This study is a retrieval analysis of implants from the same manufacturer with the same MoM bearing surface. The difference between the implants was presence or absence of modular junctions. Methods: This is a retrospective study of 31 retrieved implants from 31 patients who received a Conserve Wright Medical MoM hip prosthesis. The 31 implants consisted of 16 resurfacings and 15 implants with modular junctions; 4 conventional THAs and 11 modular-neck THAs. Results: 43% of pre-revision MRI scans performed on resurfacing implants and 91% performed on the modular implants illustrated evidence of an adverse local tissue reaction. There was no difference in pre-revision blood metal ion levels or bearing surface wear between the resurfacings and modular implants. The neck-head tapers of the modular group showed low levels of material loss. However, the neck-stem tapers showed increased severity of corrosion and material loss Conclusions: The modular implants had an increased incidence of adverse local tissue reaction. This could be related to the presence of modular junctions, particular the neck-stem junction which showed increased susceptibly to corrosion

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