How to Proceed with Asymptomatic Modular Dual Taper Hip Stems in the Case of Acetabular Revision

Grupp, Thomas M.; Baxmann, M.; Jansson, Volkmar; Heller, Karl-Dieter; Morlock, Michael M.; Knaebel, Hanns-Peter

doi:10.3390/ma13051098

Cited by 6 publications

(11 citation statements)

References 94 publications

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“…5b). After removal and replacement, the body's buildup of metal ions and particles will drop gradually; however, patients may develop hypersensitivity to a low level of metals [6,12].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to the result of a large head on total hip arthroplasty (THA), MoM hip resurfacing with a smaller femoral head size has increased risk of mechanical deterioration and edge loading with high release of metal particles. Mobile-bearing knees has also been associated with an increased rate of metallosis due to increased release of smaller particles and granular debris compared to fixed bearing knees [6,19].…”

Section: Implant Articulation Designmentioning

confidence: 99%

“…A suboptimal cup inclination angle greater than 50-55°a lso contributes to metallosis [6]. In hip replacement surgeries, a low femoral offset and an acetabular angle greater than 45°c an enhance wear particle formation from the acetabular [12].…”

Section: Surgical Procedural Mistakes and Errorsmentioning

confidence: 99%

“…The most commonly used materials for joint replacement devices include polymers, ceramic composites, and metals [4]. Among these metals are stainless steel (iron-based alloy), cobalt alloys, chromium alloys, nickel, titanium-based alloys (Ti-6Al-4V), molybdenum, and tungsten [5,6]. The usage of a particular material, metal or alloy, depends on the application.…”

Section: Introductionmentioning

confidence: 99%

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The Mechanism of Metallosis After Total Hip Arthroplasty

Ude

Esdaille

Ogueri

et al. 2021

Regen. Eng. Transl. Med.

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Metallosis is defined as the accumulation and deposition of metallic particles secondary to abnormal wear from prosthetic implants that may be visualized as abnormal macroscopic staining of periprosthetic soft tissues. This phenomenon occurs secondary to the release of metal ions and particles from metal-on-metal hip implants in patients with end-stage osteoarthritis. Ions and particles shed from implants can lead to local inflammation of surrounding tissue and less commonly, very rare systemic manifestations may occur in various organ systems. With the incidence of total hip arthroplasty increasing as well as rates of revisions due to prosthesis failure from previous metal-on-metal implants, metallosis has become an important area of research. Bodily fluids are electrochemically active and react with biomedical implants. Particles, especially cobalt and chromium, are released from implants as they abrade against one another into the surrounding tissues. The body’s normal defense mechanism becomes activated, which can elicit a cascade of events, leading to inflammation of the immediate surrounding tissues and eventually implant failure. In this review, various mechanisms of metallosis are explored. Focus was placed on the atomic and molecular makeup of medical implants, the component/surgical associated factors, cellular responses, wear, tribocorrosion, joint loading, and fluid pressure associated with implantation. Current treatment guidelines for failed implants include revision surgery. An alternative treatment could be chelation therapy, which may drive future studies. Lay Summary Arthroplasty is an invasive procedure which disrupts surrounding joint tissues, and can greatly perturb the joint’s immune homeostasis. In some instances, this may pose a difficult challenge to implant integration. Particles released from implants into the surrounding joint tissues activate the body’s defense mechanism, eliciting a cascade of events, which leads to biotribocorrosion and electrochemical attacks on the implant. This process may lead to the release of even more particles. Besides, implant makeup and designs, frictions between bearing surfaces, corrosion of non-moving parts with modular junctions, surgical mistakes, patient factor, comorbidities, and loosened components can alter the expected function of implants. High accumulations of these ions and particulates result in metallosis, with accompanying adverse complications. Current recommended treatment for failed prosthesis is revision surgeries. However, chelation therapy as a prophylactic intervention may be useful in future efforts but more investigation is required.

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“…5b). After removal and replacement, the body's buildup of metal ions and particles will drop gradually; however, patients may develop hypersensitivity to a low level of metals [6,12].…”

Section: Discussionmentioning

confidence: 99%

Section: Implant Articulation Designmentioning

confidence: 99%

Section: Surgical Procedural Mistakes and Errorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Mechanism of Metallosis After Total Hip Arthroplasty

Ude

Esdaille

Ogueri

et al. 2021

Regen. Eng. Transl. Med.

View full text Add to dashboard Cite

show abstract

“…The main aspects that are addressed in this Special Issue are related to new materials, the design and manufacturing considerations of implants [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ], implant wear and its potential clinical consequences [ 11 , 12 , 13 , 14 , 15 , 16 ], implant fixation [ 17 , 18 , 19 ], infection-related material aspects [ 20 , 21 ] and taper-related research topics [ 22 , 23 , 24 ].…”

mentioning

confidence: 99%