scholarly journals Systematic Screening of Adverse Reactions to Metal Debris after Recap-M2A-Magnum Metal-on-Metal Total Hip Arthroplasty

2017 ◽  
Vol 106 (4) ◽  
pp. 342-349 ◽  
Author(s):  
H. Mäntymäki ◽  
M. Junnila ◽  
P. Lankinen ◽  
M. Seppänen ◽  
T. Vahlberg ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Large Diameter ◽  
Metal Debris ◽  
Revision Operation ◽  
Systematic Screening ◽  
Total Hip ◽  
Metal On Metal ◽  
Oxford Hip Score

Background and Aims: An adverse reaction to metal debris is a known complication after large diameter head metal-on-metal total hip arthroplasty. However, the failure rate varies depending on the implant design. Therefore, we investigated the prevalence of adverse reaction to metal debris, as well as the symptoms and risk factors after undergoing a ReCap-M2a-Magnum large diameter head metal-on-metal total hip arthroplasty. Materials and Methods: Between 2005 and 2012, 1188 patients (1329 hips) underwent ReCap-M2a-Magnum total hip arthroplasty at our institution. Systematic screening for adverse reaction to metal debris was arranged using the Oxford Hip Score questionnaire, hip and pelvic radiographs, and assessments of the serum chromium and cobalt ion levels. Clinical evaluation and magnetic resonance imaging were performed for the symptomatic patients, as well as those with either chromium or cobalt ion levels ⩾5 µg/L. The prevalence of adverse reaction to metal debris after ReCap-M2a-Magnum total hip arthroplasty was assessed, and the risk factors for adverse reaction to metal debris were evaluated using logistic regression. The mean follow-up time was 5.2 (0.003–9.1) years. This study was an extension of a previous study conducted at our institution with 80 patients. Results: In total, 33 patients (33 hips, 2.5% of all hips) required a revision operation due to adverse reaction to metal debris. Moreover, 157 hips exhibited definitive adverse reaction to metal debris, but a revision operation was not performed (157 of 1329 hips, 11.8% of all hips). Overall, 190 out of 1329 (14.3%) hips had definitive adverse reaction to metal debris. Pain, subluxation sensation, clicking, swelling, a small head size, and a fair/poor Oxford Hip Score were associated with definitive adverse reaction to metal debris. Conclusion: We found a high prevalence of adverse reaction to metal debris in the ReCap-M2a-Magnum total hip arthroplasty patients in this study; however, most of the patients did not require revision operations.

scholarly journals Adverse reaction to metal debris after ReCap-M2A-Magnum large-diameter-head metal-on-metal total hip arthroplasty

2013 ◽  
Vol 84 (6) ◽  
pp. 549-554 ◽  
Author(s):  
Jari Mokka ◽  
Mika Junnila ◽  
Matti Seppänen ◽  
Petri Virolainen ◽  
Tuukka Pölönen ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Large Diameter ◽  
Metal Debris ◽  
Total Hip ◽  
Metal On Metal

Adverse reaction to metal debris after small-head diameter metal-on-metal total hip arthroplasty: an increasing concern

2018 ◽  
Vol 28 (2_suppl) ◽  
pp. 35-42 ◽  
Author(s):  
Fabio D’Angelo ◽  
Davide Tanas ◽  
Enrico Gallazzi ◽  
Luigi Zagra
Keyword(s):  
Adverse Reaction ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Diagnostic Tools ◽  
Metal Debris ◽  
Large Variability ◽  
Head Diameter ◽  
Total Hip ◽  
Metal On Metal ◽  
Small Head

Introduction: Failures due to adverse reaction to metal debris (ARMD) have become an area of common focus among surgeons performing hip replacements. Several authors have reported data on the prevalence of these masses, in both symptomatic and asymptomatic patients after either large-diameter head metal-on-metal (MoM) total hip arthroplasty (THA) or hip resurfacing arthroplasty, with a large variability of rate. To our knowledge, few data are reported on the association of this lesion with the use of small-head diameter MoM. Methods: 15 hips that were revised for ARMD in small-head MoM THA were included in this study. We focused our attention on the difficulties of diagnosis and treatment and also on the histologic aspects of the harvested pathologic tissue. Results: The histological examination of our cases showed a presence of lymphocytic infiltrate suggesting a delayed hypersensitivity reaction to the metal of type IV (ALVAL), but different from each other in term of the prevalence of the cellular component. Osteolysis and severe soft tissue damage were also observed. Revision resulted in remission of the lesion and successful implant. Conclusions: Our observation suggests that the evidence of ARMD should be considered even in case of small-head MoM arthroplasty and therefore these patients should be followed scrupulously with 2nd level diagnostic tools such as magnetic resonance imaging with metal artifact reduction sequence (MARS-MRI) and metal ion levels at least once. Further investigations are necessary to establish the real prevalence of this phenomenon in the whole population of small-head MoM THAs.

scholarly journals Small-head metal on metal total hip arthroplasty is associated with a high rate of complication and reoperation at mid-term follow-up

2021 ◽  
Vol 9 ◽  
pp. 205031212110147
Author(s):  
Nobuhiko Sumiyoshi ◽  
Kazuhiro Oinuma ◽  
Yoko Miura
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Adverse Reactions ◽  
Small Diameter ◽  
High Rate ◽  
Metal Debris ◽  
Total Hip ◽  
Metal On Metal ◽  
Small Head

Background: Adverse reactions to metal debris are significant complications after metal-on-metal total hip arthroplasty. Recently, late appearances of adverse reactions to metal debris and subsequent need for reoperations have been reported with small-diameter head metal-on-metal devices. We retrospectively investigated mid-term clinical outcomes of small-head metal-on-metal total hip arthroplasty. Methods: We reviewed 159 hips in 139 patients who had a small-head metal-on-metal total hip arthroplasty (M2a Taper; Biomet, Warsaw, IN) with a minimum 5-year follow-up and documented postoperative complications. Results: Focal osteolysis in either the femur or acetabulum was observed in 12 hips (7.5%, 44 months after surgery on average), with pseudotumor observed in 8 hips (5%, 120 months after surgery on average). Four hips (2.5%) had dislocations (84 months after surgery on average) and six hips (3.8%, 122 months after surgery on average) underwent reoperation. Conclusion: Small-head metal-on-metal total hip arthroplasty is associated with a high degree of complications at mid-term follow-up period. Considering this, we discourage the use of metal-on-metal total hip arthroplasty regardless of head size.

Total Hip Arthroplasty with a Large-Diameter Metal-on-Metal Cup (Durom) and a Standard Stem: Short-Term Results

2012 ◽  
pp. 91-97
Author(s):  
Panayiotis Christofilopoulos ◽  
Anne Lübbeke ◽  
Charles Berton ◽  
Alexandre Lädermann ◽  
Martin Berli ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Large Diameter ◽  
Short Term ◽  
Total Hip ◽  
Metal On Metal

scholarly journals A Misdiagnosed Complication of a Metal-on-Metal Total Hip Arthroplasty

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Az-Eddine Djebara ◽  
Cédric Joseph ◽  
Florence Rousseau ◽  
Benoit Brunschweiler ◽  
Patrice Mertl
Keyword(s):  
Total Hip Arthroplasty ◽  
Yersinia Enterocolitica ◽  
Hip Arthroplasty ◽  
Large Diameter ◽  
Specific Treatment ◽  
Surrounding Tissue ◽  
Human Pathogens ◽  
Total Hip ◽  
First Case ◽  
Metal On Metal

Introduction. The enterobacterial genus Yersinia includes a number of human pathogens. Large-diameter, metal-on-metal prostheses are no longer used because of their high failure rate. Here, we describe the first case of Yersinia enterocolitica infection of a metal-on-metal total hip arthroplasty. Clinical Examination. A metal-on-metal prosthesis failed ten years after implantation. After surgical revision, bacteriological testing revealed the presence of a pathogenic strain of Yersinia enterocolitica. Combination antibiotic therapy resulted in a favorable clinical outcome. Discussion. Three cases of hip arthroplasty infected with Yersinia enterocolitica have been described in the literature. The present case is the first infection of a metal-on-metal total hip arthroplasty. We suggest that the risk of infection is increased by the release of metal wear particles and their influence on the surrounding tissue. Conclusion. When a large-diameter, metal-on-metal total hip arthroplasty fails, the known complications associated with this type of prosthesis should not deter the physician from screening for an infectious process that requires specific treatment.

scholarly journals Surgical Approach May Influence Survival of Large-Diameter Head Metal-on-Metal Total Hip Arthroplasty: A 6- to 10-Year Follow-Up Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Chih-Chien Hu ◽  
Tsan-Wen Huang ◽  
Shih-Jie Lin ◽  
Po-Chun Lin ◽  
Feng-Chih Kuo ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Adverse Events ◽  
Hip Arthroplasty ◽  
Surgical Approach ◽  
Large Diameter ◽  
Harris Hip Score ◽  
Total Hip ◽  
Metal On Metal ◽  
Tissue Reactions

Large-diameter head (LDH) metal-on-metal (MoM) total hip arthroplasty (THA) has lost popularity because of metal allergy or ALTRs (adverse local tissue reactions) in the past decade. Whether the surgical approach may influence the survival of LDH-MoM-THA has not been reported. From 2006 to 2009, we performed 96 LDH-MoM-THAs on 80 patients using an in situ head-neck assembly technique through a modified Watson-Jones approach. With a mean follow-up of 8.4 years (range, 6.3–10.1 years), the implant survival rate was 100%. All patients were satisfied with the results and the Harris Hip Score improved from 52 points to 98 points. No ALTRs were found, but 17.7% of the 96 hips (17 adverse events) experienced adverse events related to the cup, including 5 cases of outlier cup malposition, 11 cases of inadequate cup seating, and 1 acetabular fracture. The tissue tension that was improved by a muscle-sparing approach might lessen the chance of microseparation or edge-loading that is taken as the major risk for early implant failure. Further investigation of whether these LDH-MoM-THAs would fail or not would require a longer follow-up or even retrieval analysis in the future.

Taper Failure After Large-Diameter Metal-on-Metal Total Hip Arthroplasty

Orthopedics ◽  
2016 ◽  
Vol 39 (5) ◽  
pp. e984-e987 ◽  
Author(s):  
Zachary H. Goldstein ◽  
Kenneth Estrera ◽  
Brett R. Levine
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Large Diameter ◽  
Total Hip ◽  
Metal On Metal

Early Failure of Metal-on-Metal Large-Diameter Head Total Hip Arthroplasty Revised with a Dual-Mobility Bearing

2013 ◽  
Vol 3 (3) ◽  
pp. e95 ◽  
Author(s):  
Charles Riviere ◽  
Martin Lavigne ◽  
Ahmed Alghamdi ◽  
Pascal-André Vendittoli
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Large Diameter ◽  
Early Failure ◽  
Dual Mobility ◽  
Total Hip ◽  
Metal On Metal
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