scholarly journals Bearing exchange in the management of pseudotumours

2013 ◽  
Vol 95 (4) ◽  
pp. 266-270 ◽  
Author(s):  
MA Kemp ◽  
A Mitra ◽  
T Mendes da Costa ◽  
RF Spencer
Keyword(s):  
Soft Tissue ◽  
Hip Resurfacing ◽  
Tissue Reaction ◽  
Wear Rates ◽  
Metal On Metal ◽  
Metal Wear ◽  
Soft Tissue Reactions ◽  
Tissue Reactions ◽  
Considerable Discussion ◽  
Ceramic On Ceramic

Introduction Soft tissue reactions following metal-on-metal (MoM) arthroplasty of the hip have been under considerable discussion. These reactions are seen following both hip resurfacing and MoM total hip arthroplasty (THA). The phenomenon may arise owing to shedding of metal particles in high wear states, hypersensitivity with normal metal wear rates or a combination of the two. Methods Three patients were identified who had developed a soft tissue reaction (pseudotumour) following MoM hip resurfacing procedures. The prostheses were revised to ceramic-on-ceramic (CoC) THA with only minimal debridement of the pseudotumour. Pre and postoperative magnetic resonance imaging was performed to assess the size of the lesions. Results Progressive and satisfactory resolution of the associated pseudotumours was identified following revision of the prostheses to CoC THA. Conclusions In the early stages of pseudotumour formation following MoM hip resurfacing, this potentially devastating condition can be managed adequately with revision to a CoC bearing THA with minimal soft tissue excision.

scholarly journals Aseptic Ligatures Induce Marginal Peri-Implant Bone Loss—An 8-Week Trial in Rabbits

2019 ◽  
Vol 8 (8) ◽  
pp. 1248 ◽  
Author(s):  
David Reinedahl ◽  
Silvia Galli ◽  
Tomas Albrektsson ◽  
Pentti Tengvall ◽  
Carina B. Johansson ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Bone Resorption ◽  
Close Contact ◽  
Contact Point ◽  
Healing Time ◽  
Tissue Reaction ◽  
Clinical Value ◽  
Bone Contact ◽  
Soft Tissue Reactions ◽  
Tissue Reactions

The clinical value of ligature-induced experimental peri-implantitis studies has been questioned due to the artificial nature of the model. Despite repeated claims that ligatures of silk, cotton and other materials may not induce bone resorption by themselves; a recent review showed that the tissue reaction toward them has not been investigated. Hence, the current study aimed to explore the hard and soft tissue reactions toward commonly used ligature materials. A total of 60 dental implants were inserted into the femur (n = 20) and tibia (n = 40) of 10 rabbits. The femoral implants were ligated with sterile 3-0 braided silk in one leg and sterile cotton retraction chord in the other leg. The tibial implants were ligated with silk or left as non-ligated controls. All wounds were closed in layers. After a healing time of 8 weeks, femoral (silk versus cotton) and proximal tibial (silk versus non-ligated control) implants were investigated histologically. Distal tibial (silk versus non-ligated control) implants were investigated with real time polymerase chain reaction (qPCR). The distance from the implant-top to first bone contact point was longer for silk ligated implants compared to non-ligated controls (p = 0.007), but did not vary between cotton and silk. The ligatures triggered an immunological reaction with cell infiltrates in close contact with the ligature materials, adjacent soft tissue encapsulation and bone resorption. qPCR further demonstrated an upregulated immune response toward the silk ligatures compared to non-ligated controls. Silk and cotton ligatures provoke foreign body reactions of soft tissue encapsulation type and bone resorption around implants in the absence of plaque.

scholarly journals Clinical Results and Serum Metal Ion Concentrations following Ceramic-on-Metal Total Hip Arthroplasty at a Mean Follow-Up of 60 Months

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
W. Maurer-Ertl ◽  
D. Pranckh-Matzke ◽  
J. Friesenbichler ◽  
G. Bratschitsch ◽  
L. A. Holzer ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Metal Ion ◽  
Ion Concentrations ◽  
Current Series ◽  
Metal On Metal ◽  
Soft Tissue Reactions ◽  
Tissue Reactions

Background. Increased metal ion levels following total hip arthroplasty (THA) with metal-on-metal bearings are a highly debated topic. Local soft tissue reactions with chronic pain and systemic side effects such as neuropathy are described. The aim of the current study was to determine the serum metal ion concentrations of Cobalt (Co) and Chrome (Cr) after THA with a ceramic-on-metal (CoM) bearing. Patients and Methods. Between 2008 and 2010, 20 patients underwent THA using a CoM bearing. Clinical function was evaluated by standardized scores systems (Harris Hip Score and WOMAC Score) and radiological examination included X-rays. Patient’s blood samples were obtained for metal ion analysis and correlation analysis was done between these results and implant position. Results. Overall, 13 patients with 14 CoM devices were available for the current series. The mean age at time of surgery was 61 years (range, 41 to 85). The postoperative follow-up ranged from 49 to 68 months (mean, 58). Metal ion determination showed mean concentrations of 3,1 µg/L (range, 0,3–15,2 µg/L) for Co and 1,6 µg/L (range, 0,1–5,5 µg/L) for Cr, respectively. A correlation between cup anteversion and Co and Cr concentrations was shown. Conclusion. The current series showed increments for Co and Cr following CoM THA. However, these levels are lower compared to metal ion concentrations in patients with metal-on-metal bearings and the international accepted threshold for revision of MoM devices. We recommend routine follow-up including at least one obligatory evaluation of serum metal ion concentrations and an MRI once to exclude local soft tissue reactions.

Midterm outcomes of total hip arthroplasty with a modular Birmingham head

2019 ◽  
pp. 112070001987738 ◽  
Author(s):  
Duncan W Cushnie ◽  
Brent A Lanting ◽  
Richard McCalden ◽  
Douglas DR Naudie ◽  
James L Howard
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Tissue Reaction ◽  
Harris Hip Score ◽  
Total Hip ◽  
Tissue Reactions ◽  
Clinical Records

Introduction: Birmingham Hip Resurfacing (BHR) implants may be combined with a conventional femoral stem to create a modular metal-on-metal total hip arthroplasty (BHR MoM THA). There is little outcome data regarding this construct. This study examines midterm outcomes of BHR MoM THA compared to oxidised zirconium total hip arthroplasty (THA). Methods: A retrospective institutional review identified all patients receiving BHR MoM THA between April 2005 and February 2011 and a matched control cohort of zirconium THA patients. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), and SF-12 Health status scores were obtained. Revisions and complications were collected from clinical records. Radiographs were assessed for evidence of component malposition, loosening, osteolysis, or heterotopic ossification. Results: 63 modular BHR MoM THA were identified in 61 patients (36 with BHR cups, 27 with R3 cups) and 63 zirconium THA in 58 matched controls. Mean follow-up was 58 months. 14 BHR MoM THA hips (22.2%) were revised (4 infections, 1 dislocation, 9 soft tissue reactions) compared to 3 (4.8%) zirconium THA (all infections). At latest follow-up, 18.4% of surviving BHR MoM THA hips were painful compared to 0.5% of zirconium THA controls ( p < 0.001). WOMAC, HHS, and SF-12 did not differ significantly between surviving members of the 2 groups. Discussion: BHR MoM THA demonstrated a high revision rate, largely for adverse local soft tissue reaction and pain. Among those not revised, many reported some residual pain despite similar quality of life measures to those who received zirconium THA.

Alternative Bearing Couples in Total Hip Replacements: Solutions for Young Patients

2003 ◽  
Vol 13 (2_suppl) ◽  
pp. 31-35 ◽  
Author(s):  
J. Fisher ◽  
E. Ingham ◽  
M.H. Stone
Keyword(s):  
Polyethylene Wear ◽  
Young Patients ◽  
Volumetric Wear ◽  
Wear Rates ◽  
Total Hip Replacements ◽  
Metal On Metal ◽  
Hip Replacements ◽  
Gamma Irradiated ◽  
Ceramic On Ceramic

There is now considerable clinical concern about the effect of polyethylene wear debris induced osteolysis in long term failure of hip replacements. This paper compares the wear of stabilised and crosslinked polyethylene to alternative hard on hard bearings. The volumetric wear rates of stabilised and moderately crosslinked polyethylene 50 to 35 mm3/million cycles were less than previously reported for historical gamma irradiated in air polyethylene, but still of a level that in the long term could cause osteolysis. The moderately crosslinked polyethylene produced less wear than non-crosslinked polyethylene, but particles were smaller and more reactive resulting in little change in the osteolytic potential. Alumina ceramic on ceramic produced substantially less wear and osteolytic potential. Metal on metal also produced less wear than polyethylene but the particles adversely influence cell viability.

A Retrospective Cohort Study on the Influence of Comorbidity on Soft Tissue Reactions, Revision Surgery, and Implant Loss in Bone-anchored Hearing Implants

2015 ◽  
Vol 36 (5) ◽  
pp. 812-818 ◽  
Author(s):  
Christine A. den Besten ◽  
Rik C. Nelissen ◽  
Petronella G. M. Peer ◽  
Hubert T. Faber ◽  
Catherina A. J. Dun ◽  
...  
Keyword(s):  
Cohort Study ◽  
Soft Tissue ◽  
Revision Surgery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Soft Tissue Reactions ◽  
Tissue Reactions

Soft tissue reactions evoked by implanted gallium phosphide

Biomaterials ◽  
2008 ◽  
Vol 29 (35) ◽  
pp. 4598-4604 ◽  
Author(s):  
Cecilia E. Linsmeier ◽  
Lars Wallman ◽  
Linda Faxius ◽  
Jens Schouenborg ◽  
Lars M. Bjursten ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Gallium Phosphide ◽  
Soft Tissue Reactions ◽  
Tissue Reactions
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