scholarly journals Evaluation of Aerosol Electrospray Analysis of Metal-on-Metal Wear Particles from Simulated Total Joint Replacement

Sensors ◽  
2019 ◽  
Vol 19 (17) ◽  
pp. 3751 ◽  
Author(s):  
Gobert von Skrbensky ◽  
Karoline Mühlbacher ◽  
Emir Benca ◽  
Alexander Kolb ◽  
Reinhard Windhager ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Wear Debris ◽  
Total Joint Replacement ◽  
Wear Particles ◽  
Particle Detection ◽  
Metal Debris ◽  
Artificial Joints ◽  
Hip Simulator ◽  
Metal On Metal ◽  
Metal Wear

Wear is a common cause for aseptic loosening in artificial joints. The purpose of this study was to develop an automated diagnostical method for identification of the number and size distribution of wear debris. For this purpose, metal debris samples were extracted from a hip simulator and then analyzed by the electrospray method combined with a differential mobility analyzer, allowing particle detection ranging from several nanometers up to 1 µm. Wear particles were identified with a characteristic peak at 15 nm. The electrospray setup was successfully used and validated for the first time to characterize wear debris from simulated total joint replacement. The advantages of this diagnostic method are its time- and financial efficiency and its suitability for testing of different materials.

scholarly journals Pseudotumor in Metal-on-metal Total Hip Arthroplasty: An Unusual Complication

2018 ◽  
Vol 52 (1) ◽  
pp. 26-30
Author(s):  
Jagandeep S Virk ◽  
Sudhir K Garg ◽  
Purnima Aggarwal ◽  
Reetu Kundu ◽  
Robin Bohat
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Wear Debris ◽  
Ultrahigh Molecular Weight Polyethylene ◽  
Unusual Complication ◽  
Metal Debris ◽  
Total Hip ◽  
Metal On Metal ◽  
Metal Wear ◽  
New Type

ABSTRACT Second-generation metal-on-metal (MoM) total hip arthroplasty (THA) was introduced to overcome the complications associated with the wear debris from ultrahigh molecular weight polyethylene (UHMWPE). However, a new type of complication began appearing, described as aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL). Patients with ALVAL complain of pain and, in some cases, extensive swelling around the hip joint known as “pseudotumors.” The cause is unknown and probably multifactorial. This may be an adverse reaction to an excess of particulate metal wear debris or a hypersensitivity reaction to a normal amount of metal debris. Surgical findings are typical and symptoms tend to resolve reliably following conversion to an alternative bearing surface. We report one such case of a 55-year-old male, who underwent a revision of bearing surfaces because of ALVAL and pseudotumor formation following an MoM THA at our institute. How to cite this article Virk JS, Garg SK, Aggarwal P, Kundu R, Bohat R. Pseudotumor in Metal-on-metal Total Hip Arthroplasty: An Unusual Complication. J Postgrad Med Edu Res 2018;52(1):26-30.

Patients with metal-on-metal articulation in trapeziometacarpal total joint arthroplasty may have elevated serum chrome and cobalt

2013 ◽  
Vol 38 (8) ◽  
pp. 860-865 ◽  
Author(s):  
T. B. Hansen ◽  
L. Dremstrup ◽  
M. Stilling
Keyword(s):  
Joint Replacement ◽  
Clinical Effect ◽  
Normal Values ◽  
Total Joint Replacement ◽  
Elevated Serum ◽  
Joint Arthroplasty ◽  
Dash Score ◽  
Metal Debris ◽  
Metal On Metal ◽  
The Mean

Serum chrome and cobalt was measured in 50 patients with trapeziometacarpal total joint replacement with metal-on-metal articulation and compared with serum chrome and cobalt values in 23 patients with trapeziometacarpal total joint replacement with metal-on-polyethylene articulation. In 10 of 50 (20%) patients with metal-on-metal articulation, slightly elevated serum chrome or cobalt values were found compared with only one in 23 (4%) patients with metal-on-polyethylene articulation. All metal values were lower than accepted ‘normal values’ for metal-on-metal hip arthroplasty and so considered not to be a general health risk. However, the mean disabilities of the arm, shoulder and hand (DASH) score was 24 in patients with elevated serum chrome or cobalt compared with 10 in patients with normal metal values ( p < 0.05) suggesting a local clinical effect of the elevated serum chrome or cobalt values. We recommend that patients with trapeziometacarpal total joint replacement with metal-on-metal articulation are followed with DASH score and radiological examination every 3–5 years and serum chrome and cobalt should be analysed in symptomatic cases to learn more about possible local complications leading to, or arising from, metal debris.

scholarly journals Chromium and cobalt intoxication mimicking mitochondriopathy

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Tim W. Rattay ◽  
Torsten Kluba ◽  
Ludger Schöls
Keyword(s):  
Diabetes Mellitus ◽  
Weight Loss ◽  
Mitochondrial Dna ◽  
Wear Debris ◽  
Hip Prosthesis ◽  
Mitochondrial Cytopathy ◽  
Whole Exome ◽  
Metal On Metal ◽  
Metal Wear ◽  
History Of

AbstractA 53-year old male with a history of progressive visual impairment, hearing loss, peripheral neuropathy, poorly controlled diabetes mellitus, cardiomyopathy, and weight loss was referred to the rare disease center due to the suspicion of mitochondrial cytopathy. In line with mitochondrial dysfunction, lactate in CSF was increased. Genetic testing by whole-exome sequencing and mitochondrial DNA did not reveal a likely cause. The case remained unsolved until he developed pain in his right hip, where he had received total hip arthroplasty 12 years earlier. An orthopedic evaluation revealed substantial shrinkage of the head of the hip prosthesis. Due to metal-on-metal wear, debris chromium and cobalt levels in serum were massively increased and significantly improved with multisystemic impairment after exchanging the defective implant.

Simple isolation method for the bulk isolation of wear particles from metal on metal bearing surfaces generated in a hip simulator test

2012 ◽  
Vol 23 (4) ◽  
pp. 891-901 ◽  
Author(s):  
Fang Lu ◽  
Matt Royle ◽  
Ferdinand V. Lali ◽  
Alister J. Hart ◽  
Simon Collins ◽  
...  
Keyword(s):  
Wear Particles ◽  
Isolation Method ◽  
Hip Simulator ◽  
Metal On Metal ◽  
Simulator Test

Biological reaction to debris in relation to joint prostheses

1997 ◽  
Vol 211 (2) ◽  
pp. 187-197 ◽  
Author(s):  
P A Revell ◽  
N AL-Saffar ◽  
A Kobayashi
Keyword(s):  
Bone Resorption ◽  
Bone Loss ◽  
Inflammatory Response ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Wear Particles ◽  
Cellular Reaction ◽  
Biological Reaction ◽  
Joint Prostheses

Bone loss induced by the inflammatory response to wear particles is a major cause of long-term failure of total joint replacement. This review describes the cellular reaction occurring in response to these particles and what is currently known about the inflammatory mechanisms contributing to bone resorption.

Can cobalt levels estimate in-vivo wear of metal-on-metal bearings used in hip arthroplasty?

2007 ◽  
Vol 221 (8) ◽  
pp. 929-942 ◽  
Author(s):  
M Khan ◽  
J H Kuiper ◽  
J B Richardson
Keyword(s):  
Clinical Studies ◽  
Wear Debris ◽  
Metal Ion ◽  
Large Diameter ◽  
Small Diameter ◽  
Wear Rates ◽  
Hip Simulator ◽  
Metal On Metal ◽  
Metal Levels

High levels of cobalt and chromium ions are detected in the blood and urine of patients with metal-on-metal (MoM) hip replacement. These elements are released as a result of wear at the bearing surfaces. Wear rates depend on a multitude of factors, which include the bearing geometry, carbon content, manufacturing processes, lubrication, speed and direction of sliding of the surfaces, pattern of loading, and orientation of the components. In-vivo wear of MoM bearings cannot be reliably measured on X-rays because no distinction can be made between the bearing surfaces. Hip simulator studies have shown that wear rates are higher during the initial bedding-in phase and subsequently drop to very low levels. Accordingly, metal ion levels would be expected to decrease with the use of the bearing, measured as implantation time following surgery. However, several clinical studies have found that metal ion levels either gradually rise or fluctuate instead of decreasing to lower levels. Moreover, hip simulator studies predict that large-diameter bearings have lower wear rates than small-diameter bearings. In clinical studies, however, metal levels in patients with large-diameter bearings are unexpectedly higher than those in patients with small-diameter bearings. As a consequence, high cobalt ion levels in patients do not necessarily imply that their MoM bearings produce much wear debris at the time that their levels were measured; it may simply be due to accumulation of wear debris from the preceding time. Exercise-related cobalt rise may overcome this limitation and give a better assessment of the current wear status of a MoM bearing surface than a measure of cobalt levels only.

0939 Wear properties evaluation of metal-on-metal artificial joints using hip simulator.

2010 ◽  
Vol 2009.22 (0) ◽  
pp. 351
Author(s):  
Tosiaki Kaneeda ◽  
Masato Tamiya ◽  
Hiroshi Matsuura ◽  
Hisashi Matsushita ◽  
Hiroaki Kuno ◽  
...  
Keyword(s):  
Wear Properties ◽  
Artificial Joints ◽  
Hip Simulator ◽  
Metal On Metal

In vitro analysis of the wear, wear debris and biological activity of surface-engineered coatings for use in metal-on-metal total hip replacements

2003 ◽  
Vol 217 (3) ◽  
pp. 155-163 ◽  
Author(s):  
S Williams ◽  
J L Tipper ◽  
E Ingham ◽  
M H Stone ◽  
J Fisher
Keyword(s):  
Biological Activity ◽  
Wear Debris ◽  
Cytotoxic Effect ◽  
Wear Particles ◽  
Total Hip ◽  
Geometry Model ◽  
Total Hip Replacements ◽  
Metal On Metal ◽  
Metal Ion Release ◽  
Hip Replacements

Extremely low wear rates have been reported for metal-on-metal total hip replacements, but concerns remain about the effects of metal ion release, dissolution rates and toxicity. Surface-engineered coatings have the potential to improve wear resistance and reduce the biological activity of the wear debris produced. The aim of this study was to examine the wear and wear debris generation from surface-engineered coatings: titanium nitride (TiN), chromium nitride (CrN) and chromium carbon nitride (CrCN) applied to a cobalt-chrome alloy (CoCr) substrate. The coatings were articulated against themselves in a simple geometry model. The wear particles generated were characterized and the cytotoxic effect on U937 macrophages and L929 fibroblasts assessed. The CrN and CrCN coatings showed a decrease in wear compared to the CoCr bearings and produced small (less than 40 nm in length) wear particles. The wear particles released from the surface engineered bearings also showed a decreased cytotoxic effect on cells compared to the CoCr alloy debris. The reduced wear volumes coupled with the reduced cytotoxicity per unit volume of wear indicate the potential for the clinical application of this technology.

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