Activation of Periprosthetic Connective Tissue in Aseptic Loosening of Total Hip Replacements

1998 ◽  
Vol 352 ◽  
pp. 16???24 ◽  
Author(s):  
Santavirta ◽  
J-W. Xu ◽  
J. Hietanen ◽  
eponis ◽  
T. Sorsa ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Aseptic Loosening ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements

Total hip replacement: modes of failure

2011 ◽  
Author(s):  
Rob Pollock
Keyword(s):  
Aseptic Loosening ◽  
Success Rates ◽  
Total Hip ◽  
Reactive Protein ◽  
Modes Of Failure ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Simple Fixation

♦ Total hip replacements (THRs) may fail in various ways. They may become infected, they may be subject to aseptic loosening, they may dislocate, or a periprosthetic fracture may occur. The patient with a failed THR must be thoroughly assessed before treatment is contemplated♦ Infection may be acute or chronic. Assessment involves clinical assessment, plain radiographs, blood tests (C-reactive protein and erythrocyte sedimentation rate), hip aspiration, and, sometimes, nuclear medicine. The acutely infected hip may be treated with one-stage revision. This involves thorough lavage, debridement, and exchange of all modular components as well as long-term antibiotic therapy. The gold standard of treatment for a chronically infected THR is a two-stage revision. Success rates of 80–90% can be expected♦ Aseptic loosening typically occurs at the cement bone interface in hips where a metal-on-polyethylene bearing couple has been used. Bone resorption takes place as a result of an inflammatory response to small wear particles. After infection has been excluded the treatment of choice is a single-stage revision♦ Dislocation may be the result of patient factors, implant factors, or poor surgical technique. It is imperative for the clinician to minimize the risk by selecting patients carefully, using the correct combination of implants and performing surgery accurately♦ The management of periprosthetic fractures depends on how well the implants are fixed and quality of bone stock. Treatment ranges from simple fixation of the fracture through to revision augmented with strut allograft.

Ceramic-on-ceramic versus ceramic-on-polyethylene bearings in total hip arthroplasty: Results of a multicenter prospective randomized study and update of modern ceramic total hip trials in the United States

2005 ◽  
Vol 15 (3) ◽  
pp. 129-135 ◽  
Author(s):  
B. Sonny Bal ◽  
T.J. Aleto ◽  
J.P. Garino ◽  
A. Toni ◽  
K.J. Hendricks
Keyword(s):  
Aseptic Loosening ◽  
Randomized Study ◽  
The United States ◽  
Control Group ◽  
Time Interval ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Ceramic On Ceramic

One reason why otherwise well-functioning total hip replacements have a finite service life is eventual aseptic loosening of the implants because of osteolysis induced by wear particles from the artificial bearing. Pain and osteolysis from wear debris can manifest even in the absence of aseptic loosening. Total hip replacements with ceramic-on-ceramic articulations have shown less wear both in vitro and in vivo. A randomized prospective clinical trial was conducted to compare the outcomes of ceramic-on-ceramic articulations to ceramic-on-polyethylene articulations. Two-year data are of interest because premature failures of ceramic femoral heads usually occur by this time interval. Of 500 patients enrolled in this trial, half received total hip replacements with alumina-on-alumina bearings, while the other half had ceramic-on-polyethylene bearings. At the two-year follow-up, 444 patients (217 study group and 227 control group) were available for review. The clinical and radiographic outcomes between the groups were comparable, and reflected the typical results of primary total hip replacements. No complications related to spontaneous failures of the ceramic bearings were observed at this early follow-up period. Further follow-up is needed to confirm these findings over the long-term, but the short-term safety of alumina ceramic bearings in hip replacements reported in other recent reports is further validated by our findings.

Adiponectin attenuates osteolysis in aseptic loosening of total hip replacements

2014 ◽  
Vol 10 (1) ◽  
pp. 384-393 ◽  
Author(s):  
Stefan Landgraeber ◽  
S. Putz ◽  
M. Schlattjan ◽  
Lars P. Bechmann ◽  
Martin Totsch ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements

Aseptic Loosening of Total Hip Replacements - Acetabulum

2014 ◽  
pp. 2553-2572
Author(s):  
Hans Gollwitzer ◽  
Rüdiger von Eisenhart-Rothe ◽  
Reiner Gradinger
Keyword(s):  
Aseptic Loosening ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements

scholarly journals Characterization of macrophage polarizing cytokines in the aseptic loosening of total hip replacements

2014 ◽  
Vol 32 (9) ◽  
pp. 1241-1246 ◽  
Author(s):  
Eemeli Jämsen ◽  
Vesa-Petteri Kouri ◽  
Juri Olkkonen ◽  
Andrej Cör ◽  
Stuart B. Goodman ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements

FDG PET for Differentiation of Infection and Aseptic Loosening in Total Hip Replacements: Comparison with Conventional Radiography and Three-Phase Bone Scintigraphy

Radiology ◽  
2004 ◽  
Vol 231 (2) ◽  
pp. 333-341 ◽  
Author(s):  
Katrin D. M. Stumpe ◽  
Hubert P. Nötzli ◽  
Marco Zanetti ◽  
Ehab M. Kamel ◽  
Thomas F. Hany ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Bone Scintigraphy ◽  
Fdg Pet ◽  
Conventional Radiography ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Three Phase ◽  
Hip Replacements

scholarly journals Cytokine Profile in Patients with Aseptic Loosening of Total Hip Replacements and Its Relation to Metal Release and Metal Allergy

2019 ◽  
Vol 8 (8) ◽  
pp. 1259 ◽  
Author(s):  
Rune J. Christiansen ◽  
Henrik J. Münch ◽  
Charlotte M. Bonefeld ◽  
Jacob P. Thyssen ◽  
Jens J. Sloth ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Patch Testing ◽  
Immunological Response ◽  
Metal Release ◽  
Metal Allergy ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Tnf Α ◽  
Hip Replacements ◽  
Ifn Γ

Metal release from total hip replacements (THRs) is associated with aseptic loosening (AL). It has been proposed that the underlying immunological response is caused by a delayed type IV hypersensitivity-like reaction to metals, i.e., metal allergy. The purpose of this study was to investigate the immunological response in patients with AL in relation to metal release and the prevalence of metal allergy. THR patients undergoing revision surgery due to AL or mechanical implant failures were included in the study along with a control group consisting of primary THR patients. Comprehensive cytokine analyses were performed on serum and periimplant tissue samples along with metal analysis using inductive coupled plasma mass spectrometry (ICP-MS). Patient patch testing was done with a series of metals related to orthopedic implant. A distinct cytokine profile was found in the periimplant tissue of patients with AL. Significantly increased levels of the proinflammatory cytokines IL-1β, IL-2, IL-8, IFN-γ and TNF-α, but also the anti-inflammatory IL-10 were detected. A general increase of metal concentrations in the periimplant tissue was observed in both revision groups, while Cr was significantly increased in patient serum with AL. No difference in the prevalence of metal sensitivity was established by patch testing. Increased levels of IL-1β, IL-8, and TNF-α point to an innate immune response. However, the presence of IL-2 and IFN-γ indicates additional involvement of T cell-mediated response in patients with AL, although this could not be detected by patch testing.

Middle Term Results of Native Implant «ESI» Use in Primary Total Hip Ar­throplasty

2004 ◽  
Vol 11 (3) ◽  
pp. 44
Author(s):  
S. V Kagramanov ◽  
V. I Nuzhdin
Keyword(s):  
Aseptic Loosening ◽  
Chromium Alloy ◽  
Cobalt Chromium ◽  
Cementless Fixation ◽  
Middle Term ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Cobalt Chromium Alloy

Middle term results of 886 primary total hip replacements using «ESI» implants (cementless fixation of components) have been analyzed. In 22 cases (2.48%) revision was required. When implants with «Chyrulen»-like high molecular polyethylene leaner and cobalt-chromium alloy head were used (718 operations) early aseptic loosening (excluding early dislocation, trauma­tic instability, etc.) developed in 1.11% of cases. Total number of unsatisfactory results did not exceed 5%. The causes for revision interventions have been considered in details.

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