scholarly journals Association between metal hypersensitivity and implant failure in patients who underwent titanium cranioplasty

2019 ◽  
Vol 131 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Yirui Sun ◽  
Yue Hu ◽  
Qiang Yuan ◽  
Jian Yu ◽  
Xing Wu ◽  
...  
Keyword(s):  
Titanium Implant ◽  
Implant Failure ◽  
Titanium Plate ◽  
Metal Hypersensitivity ◽  
Implant Exposure ◽  
Major Complications ◽  
Alternative Materials ◽  
Titanium Cranioplasty ◽  
Craniofacial Defects

OBJECTIVEDigitally designed titanium plates are commonly used for the reconstruction of craniofacial defects, although implant exposure (referred to as failure) is one of the major complications. Metal hypersensitivities have been suggested as possible causes of implant failure of orthopedic, intravascular, gynecological, and dental devices, yet there has been no consensus on the requirement for allergy screening before cranioplasty.METHODSIn this study, the authors prospectively investigated the prevalence of metal hypersensitivity in patients for whom cranioplasty is planned and assess its relationship with titanium implant failure (exposure).RESULTSBased on records from 207 included patients, 39.61% of patients showed hypersensitivity to at least one kind of metal. Approximately one-quarter (25.12%) of patients had multiple metal allergies. Co, Cd, and Zn were the 3 most frequently identified metal hypersensitivities. No allergy to titanium was detected in this study. The overall incidence of cranioplasty implant failure was 5.31% (11 of 207). Patients showing hypersensitivities to more than 3 kinds of metal had higher risks of titanium plate exposure.CONCLUSIONSBased on their findings, the authors suggest that routine allergy screening be performed before titanium plate cranioplasty. For patients with hypersensitivities to more than 3 metals, alternative materials, such as polyetheretherketone, should be considered for cranioplasty.

scholarly journals Titanium Implant Failure After Chest Wall Osteosynthesis

2015 ◽  
Vol 99 (6) ◽  
pp. 1945-1952 ◽  
Author(s):  
Jean-Philippe Berthet ◽  
Abel Gomez Caro ◽  
Laurence Solovei ◽  
Matthieu Gilbert ◽  
Sébastien Bommart ◽  
...  
Keyword(s):  
Chest Wall ◽  
Titanium Implant ◽  
Implant Failure

Frontozygomatic Titanium Cranioplasty in Frontosphenotemporal (“Pterional”) Craniotomy

2008 ◽  
Vol 62 (suppl_1) ◽  
pp. ONS262-ONS265 ◽  
Author(s):  
Shaan M. Raza ◽  
Quoc-Anh Thai ◽  
Gustavo Pradilla ◽  
Rafael J. Tamargo
Keyword(s):  
Vascular Malformations ◽  
Titanium Plate ◽  
Temporalis Muscle ◽  
Pterional Craniotomy ◽  
Orbital Pain ◽  
Definitive Solution ◽  
Cosmetic Outcomes ◽  
Common Problems ◽  
Titanium Cranioplasty

Abstract Objective: One of the most common problems after frontosphenotemporal, or pterional, craniotomy is the marked depression of the frontozygomatic fossa caused by atrophy of the temporalis muscle. Although temporalis muscle reconstruction techniques have been proposed to prevent this problem, a definitive solution has not been achieved. We report the results of a titanium cranioplasty technique in a prospective series of patients who underwent frontosphenotemporal craniotomy. Methods: Between April 2002 and June 2006, 209 consecutive patients underwent a frontosphenotemporal craniotomy for aneurysms, vascular malformations, or tumors. At the time of surgery, the patients underwent a frontozygomatic fossa cranioplasty with a titanium plate, to which the temporalis muscle was attached. In this series, 194 patients had documented follow-up periods averaging 9.5 months (range, 1 mo–4 yr; median, 7.5 mo), and the cosmetic results of the cranioplasty have been assessed. Results: The cosmetic outcomes have been outstanding in all patients treated to date. Two patients had the cranioplasty removed due to either orbital pain or local infection secondary to sepsis. Conclusion: The frontozygomatic cranioplasty during frontosphenotemporal craniotomy prevents the characteristic depression at the frontozygomatic fossa and accomplishes an outstanding cosmetic result.

Cranioplasty With Custom-Made Titanium Plates—14 Years Experience

Neurosurgery ◽  
2012 ◽  
Vol 72 (2) ◽  
pp. 248-256 ◽  
Author(s):  
Anthony Wiggins ◽  
Richard Austerberry ◽  
David Morrison ◽  
Kwok M. Ho ◽  
Stephen Honeybul
Keyword(s):  
Hospital Stay ◽  
Skull Fracture ◽  
Length Of Hospital Stay ◽  
Major Complication ◽  
Bone Flap ◽  
Infection Prophylaxis ◽  
Titanium Plate ◽  
Increased Risk ◽  
Custom Made ◽  
Titanium Cranioplasty

Abstract BACKGROUND: There is no consensus on which material is best suited for repair of cranial defects. OBJECTIVE: To investigate the outcomes following custom-made titanium cranioplasty. METHODS: The medical records for all patients who had titanium cranioplasty at 2 major neurosurgical centers in Western Australia were retrieved and analyzed for this retrospective cohort study. RESULTS: Altogether, 127 custom-made titanium cranioplasties on 113 patients were included. Two patients had 3 titanium cranioplasties and 10 patients had 2. Infected bone flap (n = 61, 54%), either from previous craniotomy or autologous cranioplasty, and contaminated bone flap (n = 16, 14%) from the initial injury were the main reasons for requiring titanium cranioplasty. Complications attributed to titanium cranioplasty were common (n = 33, 29%), with infection being the most frequent complication (n = 18 patients, 16%). Complications were, on average, associated with an extra 7 days of hospital stay (interquartile range 2–17). The use of titanium as the material for the initial cranioplasty (P = .58), the presence of skull fracture(s) (P > .99) or scalp laceration(s) (P = .32) at the original surgery, and proven local infection before titanium cranioplasty (P = .78) were not significantly associated with an increased risk of infection. Infection was significantly more common after titanium cranioplasty for large defects (hemicraniectomy [39%] and bifrontal craniectomy [28%]) than after cranioplasty for small defects (P = .04). CONCLUSION: Complications after using titanium plate for primary or secondary cranioplasty were common (29%) and associated with an increased length of hospital stay. Infection was a major complication (16%), and this suggested that more vigorous perioperative infection prophylaxis is needed for titanium plate cranioplasty.

scholarly journals In-vivo Investigations of Hydroxyapatite/Co-polymeric Composites Coated Titanium Plate for Bone Regeneration

2021 ◽  
Vol 8 ◽  
Author(s):  
Weilong Diwu ◽  
Xin Dong ◽  
Omaima Nasif ◽  
Sulaiman Ali Alharbi ◽  
Jian Zhao ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Chemical Nature ◽  
Bone Cells ◽  
Titanium Implant ◽  
Titanium Plate ◽  
Uv Visible ◽  
Xrd Techniques ◽  
Porous Morphology

A perfect mimic of human bone is very difficult. Still, the latest advancement in biomaterials makes it possible to design composite materials with morphologies merely the same as that of bone tissues. In the present work is the fabrication of selenium substituted Hydroxyapatite (HAP-Se) covered by lactic acid (LA)—Polyethylene glycol (PEG)—Aspartic acid (AS) composite with the loading of vincristine sulfate (VCR) drug (HAP-Se/LA-PEG-AS/VCR) for twin purposes of bone regenerations. The HAP-Se/LA-PEG-AS/VCR composite coated on titanium implant through electrophoretic deposition (EPD). The prepared composite characterized using FTIR, XRD techniques to rely on the composites' chemical nature and crystalline status. The morphology of the composite and the titanium plate with the composite coating was investigated by utilizing SEM, TEM instrument techniques, and it reveals the composite has porous morphology. The drug (VCR) load in HAP-Se/LA-PEG-AS and releasing nature were investigated through UV-Visible spectroscopy at the wavelength of 295 nm. In vitro study of SBF treatment shows excellent biocompatibility to form the HAP crystals. The viability against MG63 and toxicity against Saos- 2 cells have expressed the more exceptional biocompatibility in bone cells and toxicity with the cancer cells of prepared composites. The in-vivo study emphasizes prepared biomaterial suitable for implantation and helps accelerate bone regeneration on osteoporosis and osteosarcoma affected hard tissue.

scholarly journals A simple way to manage a chronic ulcer at the cranioplasty titanium implant exposure site by dermal autograft and platelet-rich plasma

2020 ◽  
Vol 1 (1) ◽  
pp. e0002
Author(s):  
I-Lung Lee ◽  
Yun-Nan Lin ◽  
Shu-Hung Huang ◽  
Chia-Li Chung ◽  
Chieh-Han Chuang ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Titanium Implant ◽  
Chronic Ulcer ◽  
Implant Exposure ◽  
Exposure Site

2408How can we improve the success of cardiac resynchronization therapy implantation?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Nunes Ferreira ◽  
P Antonio Silverio ◽  
J R Agostinho ◽  
I Aguiar-Ricardo ◽  
J Rigueira ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Standard Technique ◽  
Surgical Revision ◽  
Implant Failure ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Major Complications ◽  
Implantation Techniques ◽  
Procedure Duration ◽  
Technique Failure

Abstract Introduction The left ventricular (LV) lead implantation in cardiac resynchronization therapy (CRT) is one of the most important and complex steps, leading to implantation failure in 10–15% of cases. New LV lead implantation techniques are needed to allow better resynchronization and decrease mortality and hospitalizations. Objectives To evaluate the efficacy and safety of the snare technique in the LV lead implantation in cases of standard technique failure. Methods Prospective, single-center study of patients undergoing CRT implantation since 2015. Demographic, clinical, and CRT implantation techniques were evaluated, taking into account the vessel with the best resynchronization capacity. The snare technique, through the active traction of the lead to the target vessel, was used in cases of standard technique failure. Time to surgical revision and mortality were evaluated by the Cox regression and Kaplan-Meier methods. Major complications, defined as reasons for prolonged hospitalization or potentially fatal, were evaluated. Results 486 CRTs were implanted since 2015 (73.9% males, 73 years (IQR 66–79), median follow-up of 487 days (IQR 175–749), 91% for heart failure, dilated cardiomyopathy in 55.4%. In 17.3% of these patients (n=84), LV lead was implanted through the snare technique, 94% of the cases in a lateral vein, 100% efficacy in the positioning in the intended vessel. Comparing the snare technique with the standard technique, patients implanted with snare presented a lower all-cause surgical revision (HR 0.31, 95% CI 0.094–0.98, p=0.035), with a number needed to treat of 25 patients to prevent one surgical revision, and a lower revision rate due to LV lead implant failure/dislodgement (Log Rank 5.1, p=0.024). There were no surgical revisions for LV lead repositioning in patients undergoing the snare technique. The rate of major complications (4.8% vs 3.0%, p=0.41), 30-day mortality (3.5% vs 1.8%, p=0.28) and all-cause mortality (13.1% vs 13.9%, p=0.47) were similar to the standard procedure. Major complications in both groups were pericardial effusion and contrast nephropathy. The snare technique presented a longer procedure duration (104 vs 78 min, p<0.01) and fluoroscopy time (26.6 vs 15.5 min, p<0.01). Over time, there was a learning curve with reduction in procedure duration and fluoroscopy time. Conclusion The snare technique allows LV lead implantation in the vein with the best resynchronization characteristics, increasing the success rate in the implantation of CRT. It also reduced all-cause surgical revisions and surgical revisions due to LV lead implant failure/dislodgement, with a favourable safety profile similar to the standard technique.

scholarly journals Deformation of a Titanium Calvarial Implant following Trauma: A Case Report

2016 ◽  
Vol 9 (2) ◽  
pp. 158-161 ◽  
Author(s):  
Valerie R. De Water ◽  
Ellianne J. dos Santos Rubio ◽  
Joost W. Schouten ◽  
Maarten J. Koudstaal
Keyword(s):  
Mechanical Properties ◽  
Traffic Accident ◽  
Brain Parenchyma ◽  
Alloplastic Material ◽  
Titanium Plate ◽  
Cranial Defect ◽  
Calvarial Defects ◽  
One Year ◽  
Titanium Cranioplasty ◽  
The Brain

Alloplastic material is widely used for the reconstruction of calvarial defects. The objective of this article is to describe the effect of mechanical impact on a titanium calvarial implant and to discuss mechanical properties of alternative implant materials. The patient is a 19-year-old man who was involved in a traffic accident and underwent decompressive craniectomy for an extensive subdural hematoma. Reimplantation of the skull flap was complicated by infection and the flap had to be removed. The remaining cranial defect was closed with a titanium plate. The recovery was without complications. One year later, the patient was hit on the titanium plate, during a soccer match, by the elbow of a fellow player. The implant deflected inward, leaving a visible indentation of the cranial vault. Fortunately, there were no significant neurological symptoms and radiography did not show any signs of damage or pressure on the brain parenchyma. The patient had no aesthetic complaints regarding the shape. Thus, there was no indication to remove the plate. This case illustrates the limits of the protection offered by titanium cranioplasty.

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