scholarly journals Surface Characterization of Retrieved Metal-on-Metal Total Hip Implants from Patients with Adverse Reaction to Metal Debris

Materials ◽  
2014 ◽  
Vol 7 (3) ◽  
pp. 1866-1879 ◽  
Author(s):  
Maria Burbano ◽  
Robert Russell ◽  
Michael Huo ◽  
Robert Welch ◽  
Diana Roy ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Surface Characterization ◽  
Hip Implants ◽  
Metal Debris ◽  
Total Hip ◽  
Metal On Metal

scholarly journals Does modularity of metal-on-metal hip implants increase cobalt: chromium ratio?

2019 ◽  
pp. 112070001987363
Author(s):  
Kevin C Ilo ◽  
Karim Aboelmagd ◽  
Harry S Hothi ◽  
Asaad Asaad ◽  
John A Skinner ◽  
...  
Keyword(s):  
Metal Ion ◽  
Hip Implants ◽  
Cobalt Chromium ◽  
Metal Debris ◽  
Material Loss ◽  
Total Hip ◽  
Modular Stem ◽  
Metal On Metal ◽  
Hip Replacements ◽  
Hip Arthroplasties

Background: Blood metal ion levels are used in the surveillance of metal-on-metal (MoM) hip implants. Modular implants contain an extra source of metal debris that may affect the ratio of metal ions in the blood. Methods: This was a retrospective study of 503 patients with hip replacements made by a single manufacturer (Smith & Nephew, Warwick, UK) with the same bearing surface. There were 54 total hip arthroplasties, 35 Birmingham Mid-Head Resections and 414 hip resurfacings. Whole blood metal ion levels and their ratios were analysed to investigate the effect of a modular junction. Results: The cobalt:chromium ratios were greater in the total hip arthroplasty group (mean 2.3:1) when compared to the resurfacings group (mean 1.3:1, p = <0.05) and Birmingham Mid-Head Resection group (mean 1.1:1, p = 0.11). Conclusions: This study demonstrated a trend for a higher cobalt:chromium ratio in patients with MoM total hip replacement that may be due to metal debris from the modular stem-head junction. Further work is required to correlate clinical data with retrieval analysis to confirm the effect of taper material loss on the cobalt:chromium ratio.

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 Surface characterization of metal-on-metal hip implants tested in a hip simulator

Wear ◽  
1999 ◽  
Vol 225-229 ◽  
pp. 708-715 ◽  
Author(s):  
A Wang ◽  
S Yue ◽  
J.D Bobyn ◽  
F.W Chan ◽  
J.B Medley
Keyword(s):  
Surface Characterization ◽  
Hip Implants ◽  
Hip Simulator ◽  
Metal On Metal

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.

scholarly journals Blood Metal Ion Thresholds to Identify Patients with Metal-on-Metal Hip Implants at Risk of Adverse Reactions to Metal Debris

2017 ◽  
Vol 99A (18) ◽  
pp. 1532-1539 ◽  
Author(s):  
Gulraj S. Matharu ◽  
Fiona Berryman ◽  
Andrew Judge ◽  
Aleksi Reito ◽  
Jamie McConnell ◽  
...  
Keyword(s):  
At Risk ◽  
Metal Ion ◽  
Adverse Reactions ◽  
Hip Implants ◽  
Metal Debris ◽  
Metal On Metal
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