Diagnosis and Detection of Subtle Aseptic Loosening in Total Hip Arthroplasty

Anil, Utkarsh; Singh, Vivek; Schwarzkopf, Ran

doi:10.1016/j.arth.2022.02.060

Cited by 25 publications

(21 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although in previous studies osseointegration of the stem was evaluated solely by the use of imaging techniques [ 2 , 34 ], we strongly advocate for intraoperative testing. We must bear in mind that, unfortunately, there is no standardized imaging protocol for definitely diagnosing femoral stem loosening [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Partial Two-Stage Exchange for Infected Total Hip Arthroplasty: A Treatment to Take into Account

Moreno-Romero

Ordas-Bayon

Gomez-Rice

et al. 2023

JPM

View full text Add to dashboard Cite

Introduction: Two-stage revision is the gold standard for chronic periprosthetic joint infection (PJI). The removal of well-fixed implants, especially the femoral component, can be extremely difficult and additional osteotomies may be needed, which is time-consuming and results in bone stock loss. When the femoral stem is osseointegrated, there is no clear indication for the use of partial two-stage revision. The primary objective was to assess infection eradication after surgery. Methods: Retrospective study of specific case series. A total of eight patients with a chronic uncemented PJI, in the setting of complex revision surgeries, were treated with partial two-stage revision, which included selective retention of the well-fixed femoral component and complete acetabular removal. Stem retention was carried out regardless of the bacteria or associated comorbidities. Results: All patients were re-revision cases with at least two previous surgeries (range, 2–4). Complex revisions were performed in five cases (non-articulated spacer) and simple revisions in three cases (articulated spacer). The minimum follow-up time was 24 months (range, 24–132 months). The infection eradication rate at final follow-up was 100%. Conclusion: Partial two-stage reconstruction is a promising technique for the treatment of chronic PJI in patients with a well-fixed stem and complex re-revision acetabular procedures. Further prospective studies and prolonged follow-ups are required to confirm our results.

show abstract

Section: Discussionmentioning

confidence: 99%

Partial Two-Stage Exchange for Infected Total Hip Arthroplasty: A Treatment to Take into Account

Moreno-Romero

Ordas-Bayon

Gomez-Rice

et al. 2023

JPM

View full text Add to dashboard Cite

show abstract

“…Aseptic loosening of the primary THA was known for major causes of revision especially in young male with high activity level and early osteoarthritis in cemented or uncemented prosthesis [20] , [21] . It could happens by three combination of mechanism, unqualified initial fixation, mechanical loss of fixation during time or biological fixation loss due to osteolysis around implant that induced by particulate with a simple three diagnostic component, accurate history and clinical examination including laboratory investigation and imaging [4] . However, this should be prevented by combining good osseointegration for uncemented prosthesis, excellent physical characteristic of the implant, great implant choosing for every patient bone characteristic, and the patient conditions and compliance needs to be optimize [22] .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, many studies said the use of high placement of acetabular component was known as an option technique in patient with several condition undergoing hip arthroplasty [2] , [3] . However, the large amount of primary THA directly proportional to elevating of revision total hip arthroplasty (rTHA) demand with nearly 100.000 procedure estimated in 2030 [4] . In 2015 until 2018, Australian orthopedic centre analysed that 2–3 % of the total 120.000 patient with primary THA will undergo the revision of THA with the most frequent causes is periprosthetic fracture and loosening [5] .…”

Section: Introductionmentioning

confidence: 99%

Morselized bone autograft for high placement of acetabular component closure with hip arthroplasty revision after 3-years screws and cup loosening: A case report

Bari

Chilmi

Arianto

et al. 2022

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

“…( 16 ) described a phenomenon of extensive bone resorption leading to loosening without infection in four patients after receiving hip arthroplasty surgery, and this is the first detailed description of AL ( 16 ). In definition, AL can be generally described as a failure of the fixation of one or more prosthetic components without any infection ( 17 ). It may probably originate from inadequate initial fixation, mechanical loss of fixation over time, or biological loss of fixation, all of which are the leading causes of particles-induced osteolysis around the prosthesis ( 4 , 17 ).…”

Section: Overview Of Aseptic Looseningmentioning

confidence: 99%

“…In definition, AL can be generally described as a failure of the fixation of one or more prosthetic components without any infection ( 17 ). It may probably originate from inadequate initial fixation, mechanical loss of fixation over time, or biological loss of fixation, all of which are the leading causes of particles-induced osteolysis around the prosthesis ( 4 , 17 ). Joint pain is the typical symptom of patients with AL, which always become worse when the affected joint carries out physical activity or bears weight.…”

Section: Overview Of Aseptic Looseningmentioning

confidence: 99%

Macrophages in aseptic loosening: Characteristics, functions, and mechanisms

et al. 2023

View full text Add to dashboard Cite

Aseptic loosening (AL) is the most common complication of total joint arthroplasty (TJA). Both local inflammatory response and subsequent osteolysis around the prosthesis are the fundamental causes of disease pathology. As the earliest change of cell behavior, polarizations of macrophages play an essential role in the pathogenesis of AL, including regulating inflammatory responses and related pathological bone remodeling. The direction of macrophage polarization is closely dependent on the microenvironment of the periprosthetic tissue. When the classically activated macrophages (M1) are characterized by the augmented ability to produce proinflammatory cytokines, the primary functions of alternatively activated macrophages (M2) are related to inflammatory relief and tissue repair. Yet, both M1 macrophages and M2 macrophages are involved in the occurrence and development of AL, and a comprehensive understanding of polarized behaviors and inducing factors would help in identifying specific therapies. In recent years, studies have witnessed novel discoveries regarding the role of macrophages in AL pathology, the shifts between polarized phenotype during disease progression, as well as local mediators and signaling pathways responsible for regulations in macrophages and subsequent osteoclasts (OCs). In this review, we summarize recent progress on macrophage polarization and related mechanisms during the development of AL and discuss new findings and concepts in the context of existing work.

show abstract

Diagnosis and Detection of Subtle Aseptic Loosening in Total Hip Arthroplasty

Cited by 25 publications

References 54 publications

Partial Two-Stage Exchange for Infected Total Hip Arthroplasty: A Treatment to Take into Account

Partial Two-Stage Exchange for Infected Total Hip Arthroplasty: A Treatment to Take into Account

Morselized bone autograft for high placement of acetabular component closure with hip arthroplasty revision after 3-years screws and cup loosening: A case report

Macrophages in aseptic loosening: Characteristics, functions, and mechanisms

Contact Info

Product

Resources

About