Unexpected varus deformity and concomitant metal ion release and MRI findings of modular-neck hip stems: descriptive RSA study in 75 hips with 8 years’ follow-up

Abstract Purpose Metal ion release may cause local and systemic effects and induce hypersensitivity reactions. The aim of our study is first to determine if implant-related hypersensitivity correlates to patient symptoms or not; second, to assess the rate of hypersensitivity and allergies in shoulder arthroplasty. Methods Forty patients with shoulder replacements performed between 2015 and 2017 were studied with minimum 2-year follow-up; no patient had prior metal implants. Each patient underwent radiographic and clinical evaluation using the Constant-Murley Score (CMS), 22 metal and cement haptens patch testing, serum and urine tests to evaluate 12 metals concentration, and a personal occupational medicine interview. Results At follow-up (average 45 ± 10.7 months), the mean CMS was 76 ± 15.9; no clinical complications or radiographic signs of loosening were detected; two nickel sulfate (5%), 1 benzoyl peroxide (2.5%) and 1 potassium dichromate (2.5%) positive findings were found, but all these patients were asymptomatic. There was an increase in serum aluminum, urinary aluminum and urinary chromium levels of 1.74, 3.40 and 1.83 times the baseline, respectively. No significant difference in metal ion concentrations were found when patients were stratified according to gender, date of surgery, type of surgery, and type of implant. Conclusions Shoulder arthroplasty is a source of metal ion release and might act as a sensitizing exposure. However, patch test positivity does not seem to correlate to hypersensitivity cutaneous manifestations or poor clinical results. Laboratory data showed small constant ion release over time, regardless of gender, type of shoulder replacement and implant used. Levels of evidence Level II.

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Effect of Femoral Stem Modular Neck’s Material on Metal Ion Release

The Open Orthopaedics Journal ◽

10.2174/1874325001711011337 ◽

2017 ◽

Vol 11 (1) ◽

pp. 1337-1344 ◽

Cited By ~ 1

Author(s):

Janie Barry ◽

Marc-Olivier Kiss ◽

Vincent Massé ◽

Martin Lavigne ◽

Jihad Matta ◽

...

Keyword(s):

Whole Blood ◽

Metal Ion ◽

Large Diameter ◽

Femoral Stem ◽

Complication Rates ◽

Modular Neck ◽

Metal Debris ◽

Metal Ion Release ◽

The Impact

Background: In recent decades, the popularity of modular necks in total hip arthroplasty (THA) has increased since modular necks offer the potential to restore the patient’s native anatomy, and thus improve stability. Unfortunately, modular necks are associated with higher complication rates, including implant fracture and modular junction corrosion with adverse local tissue reaction to metal debris. Objective: The objective of this study was to determine the impact of modular neck material on titanium (Ti), chrome (Cr), and cobalt (Co) metal ion levels in patients who underwent a THA with Ti femoral stem, Ti or CrCo modular neck, and ceramic-on-ceramic (CoC) bearing. Methods: Whole blood Ti, Cr, and Co levels were compared at a minimum 1-year follow-up in 36 patients who underwent unilateral, primary CoC large-diameter head THA with Profemur® Preserve modular femoral stems (MicroPort, Arlington, TX, USA). Results: Higher Co concentrations were observed in the CrCo modular neck group (0.46 versus 0.26 µg/l in the Ti neck group, P=0.004) and higher Ti concentrations were observed in the Ti modular neck group (1.98 vs 1.59 µg/l in the CrCo neck group, P=0.007). However, these differences were not clinically meaningful since the absolute values remained within what is considered the safe range of Ti, Cr, and Co ions in whole blood. No patients were re-operated or revised. Conclusion: Modular neck materials had an impact on whole blood metal ion levels but the concentrations measured remained within the safe range at 1-year follow-up. There were no indirect signs of modular junction corrosion with either CrCo or Ti femoral necks.

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Metal Ion Levels in Ceramic-on-Ceramic THR with Cobalt-Chrome Modular Necks: Analysis of Cobalt and Chromium Serum Levels in 23 Healthy Hip Patients

Hip International ◽

10.5301/hipint.5000430 ◽

2016 ◽

Vol 27 (1) ◽

pp. 21-25 ◽

Cited By ~ 8

Author(s):

Jan F.A. Somers ◽

Lieven Dedrye ◽

Sofie Goeminne

Keyword(s):

Detection Limit ◽

Hip Replacement ◽

Metal Ion ◽

Serum Levels ◽

Ion Release ◽

Modular Neck ◽

Stem Design ◽

Metal Ion Release ◽

Cobalt Chrome ◽

Ceramic On Ceramic

Background Modular necks in total hip replacement (THR) can be a source of metal ion release. Methods We measured the level of cobalt (Co) and chromium (Cr) ions in the serum of 23 healthy volunteers with a well-functioning ceramic-on-ceramic THR of a particular design, containing a cobalt-chrome (Co-Cr) stem and a Co-Cr modular neck. Results Average Co in serum was 1,71 μg/l; median Co was 1.50 μg/l. No patient had Co levels higher than 3.70 μg/l. Average Cr level was 0.49 μg/l; in all but one patient Cr was below the detection limit (≤0.50 μg/l). Co was higher for varus necks compared to all other subtypes: 2.14 μg/l vs 1.58 μg/l (p≤0.05). The same system with Titanium modular necks shows lower Co serum levels: 1.26 μg/l (p≤0.01). In conclusion, the hybrid THR Profemur Xm® – Procotyle L® with a Co-Cr modular neck on a Co-Cr stem design shows very low Cr ion serum levels in a randomly selected group of well-functioning hip patients. Conclusions Co ion serum levels are low, but significantly higher for 8° varus necks, and Co levels are significantly higher than values of this system with a Titanium modular neck.

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Faculty Opinions recommendation of Imperfect coordination chemistry facilitates metal ion release in the Psa permease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718170860.793499535 ◽

2014 ◽

Author(s):

Ian Roberts ◽

Helen Jesse

Keyword(s):

Coordination Chemistry ◽

Metal Ion ◽

Ion Release ◽

Metal Ion Release

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Bioactive Plasma Coatings on Orthodontic Brackets: In Vitro Metal Ion Release and Cytotoxicity

Coatings ◽

10.3390/coatings11070857 ◽

2021 ◽

Vol 11 (7) ◽

pp. 857

Author(s):

Lasni Samalka Kumarasinghe ◽

Neethu Ninan ◽

Panthihage Ruvini Lakshika Dabare ◽

Alex Cavallaro ◽

Esma J. Doğramacı ◽

...

Keyword(s):

Metal Ion ◽

Prolonged Exposure ◽

Orthodontic Brackets ◽

Plasma Polymer ◽

Functional Coatings ◽

Key Factors ◽

Ion Release ◽

Metal Ion Release ◽

Surface Functionalisation

The metal ion release characteristics and biocompatibility of meta-based materials are key factors that influence their use in orthodontics. Although stainless steel-based alloys have gained much interest and use due to their mechanical properties and cost, they are prone to localised attack after prolonged exposure to the hostile oral environment. Metal ions may induce cellular toxicity at high dosages. To circumvent these issues, orthodontic brackets were coated with a functional nano-thin layer of plasma polymer and further immobilised with enantiomers of tryptophan. Analysis of the physicochemical properties confirmed the presence of functional coatings on the surface of the brackets. The quantification of metal ion release using mass spectrometry proved that plasma functionalisation could minimise metal ion release from orthodontic brackets. Furthermore, the biocompatibility of the brackets has been improved after functionalisation. These findings demonstrate that plasma polymer facilitated surface functionalisation of orthodontic brackets is a promising approach to reducing metal toxicity without impacting their bulk properties.

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A New Nanocomposite Packaging Based on LASiS-Generated AgNPs for the Preservation of Apple Juice

Antibiotics ◽

10.3390/antibiotics10070760 ◽

2021 ◽

Vol 10 (7) ◽

pp. 760

Author(s):

Maria Chiara Sportelli ◽

Antonio Ancona ◽

Annalisa Volpe ◽

Caterina Gaudiuso ◽

Valentina Lavicita ◽

...

Keyword(s):

Metal Ion ◽

Chemical Characterization ◽

Average Diameter ◽

Biological Action ◽

Metal Species ◽

Ion Release ◽

Bioactive Materials ◽

Transmission Electron ◽

Metal Ion Release ◽

Bulk Chemical

Designing bioactive materials, with controlled metal ion release, exerting a significant biological action and associated to low toxicity for humans, is nowadays one of the most important challenges for our community. The most looked-for nanoantimicrobials are capable of releasing metal species with defined kinetic profiles, either by slowing down or inhibiting bacterial growth and pathogenic microorganism diffusion. In this study, laser ablation synthesis in solution (LASiS) has been used to produce bioactive Ag-based nanocolloids, in isopropyl alcohol, which can be used as water-insoluble nano-reservoirs in composite materials like poly(3-hydroxybutyrate-co-3-hydroxyvalerate). Infrared spectroscopy was used to evaluate the chemical state of pristine polymer and final composite material, thus providing useful information about synthesis processes, as well as storage and processing conditions. Transmission electron microscopy was exploited to study the morphology of nano-colloids, along with UV-Vis for bulk chemical characterization, highlighting the presence of spheroidal particles with average diameter around 12 nm. Electro-thermal atomic absorption spectroscopy was used to investigate metal ion release from Ag-modified products, showing a maximum release around 60 ppb, which ensures an efficient antimicrobial activity, being much lower than what recommended by health institutions. Analytical spectroscopy results were matched with bioactivity tests carried out on target microorganisms of food spoilage.

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