Metallosis following full thickness wear in total hip arthroplasty

Birkett, Nicholas; El-Daly, Ibraheim; Ibraheim, Hajir; Mbubaegbu, Chima

doi:10.1093/jscr/rjv122

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…8 Metallosis can be supposed preoperatively with radiographic signs such as the "cloud sign," "bubble sign," and the "metal-line signs". 3,4 Additionally, bubbly appearing radio densities representing metal deposition outlining the synovium are known as the "bubble" sign. 4,8 The "cloud" sign is the most commonly cited radiographic indication of possible metallosis and is interpreted as amorphous, fluffy densities in periprosthetic soft tissues, most commonly found posterior to the hip implant.…”

Section: Discussionmentioning

confidence: 99%

“…2 Metallosis is used to label infiltration metallic wear debris secondary to metal-on-metal wear into the bone, synovium, and periprosthetic soft tissues. 3 Debris due to a chronic inflammatory response leading to joint instability, swelling, pain and may cause osteolysis, implant loosening, and eventually implant. 4,5 The rare incidence of metallosis usually causes diagnosis challenges, especially after a long time procedure.…”

Section: Introductionsmentioning

confidence: 99%

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Excellent Result of Revision Total Hip Replacement with Unexpected Metallosis

farhadi¹,

Hernugrahanto²,

Sedar

et al. 2021

Hip Knee J.

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Background: Metallosis is a syndrome of metal-induced synovitis with infiltration and accumulation of metallic debris into the periprosthetic structures, including soft and bony tissues. The debris causes a chronic inflammatory reaction due to joint instability, pain, osteolysis, implant loosening, or implant failure. The absence of a specific sign or symptom that indicates metallosis causes difficulty to diagnose.Presentation of Case: A 35-year-old female, history of primary left total hip replacement since seven years ago after avascular necrosis of the femoral head, presented with an eight-month history of left hip pain and limited range of motion. Radiograph results showed that there is no evidence of periprosthetic fracture or infection. The patient underwent a left revision total hip replacement, which revealed extensive necrotic black metal debris throughout the joint space.Discussion: Effective treatment requires a revision of total hip replacement to remove metal debris, bone graft area osteolysis, and to address the mechanical failure. The greatest possible of metallic debris during debridement is vital to avoid further osteolysis and prevent more extensive damage. Excellent clinical result was evaluated by Harris’s hip score in 18 months postoperatively.Conclusion: This case is a rare example of chronic metallosis presenting seven years following total hip replacement. Revision total hip replacement is the consensus management choice to avoid further destruction of the bone and joint capsule that can occur with metal-induced inflammation. Keywords:

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Section: Discussionmentioning

confidence: 99%

Section: Introductionsmentioning

confidence: 99%

Excellent Result of Revision Total Hip Replacement with Unexpected Metallosis

farhadi¹,

Hernugrahanto²,

Sedar

et al. 2021

Hip Knee J.

View full text Add to dashboard Cite

show abstract

“…However, when implanted in the human body, metal on metal implants failed as they release metal ions and wear debris due to the long-term contact with the corrosive physiological solution. Further, the released metal ions cause an allergic reaction called metal hypersensitivity or metallosis , and are also associated with the formation of pseudotumors. − In contrast to the metal on metal implants, ceramics were found to exhibit low wear rate; nevertheless, the sudden fracture, squeaking noise, and the high cost of ceramics implants also have raised concerns about their usage. , …”

Section: Introductionmentioning

confidence: 99%

Enhanced Tribocorrosion Resistance of Hard Ceramic Coated Ti-6Al-4V Alloy for Hip Implant Application: In-Vitro Simulation Study

Cheng

Gopal

McNallan

et al. 2019

ACS Biomater. Sci. Eng.

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Developing coatings for various applications is an area of research of uttermost importance, to protect surfaces from severe damage by improving the wear and corrosion resistance of the materials. Recently, there has been increasing interest in ceramic coatings for biomedical applications, as the surface may become more inert in nature for the biological reactions and potentially increase the lifespan of the implants and minimize the side effects on the patients. Hence this study is focused on the tribocorrosion behavior of the ceramic coatings for the hip implant application on commonly used implant titanium alloy. The three types of the ceramic coatings are conventional monolithic micron alumina (IDA), micron alumina−40 wt % yttria-stabilized zirconia (YSZ) composite coating (IDAZ), and by-layer nanostructured alumina−13 wt % titania/YSZ (IDZAT) on Ti-6Al-4V alloy. A series of tests, under free potential and potentiostatic mode, were conducted using a hip simulator tribocorrosion setup under simulated joint fluid (bovine calf serum with protein concentration 30g/L). The tribological conditions are pin-on-ball contact with a load of 16N (approximately contact pressure of 50 MPa), the frequency of 1 Hz (walking frequency), and with an amplitude of 30°. The tribocorrosion studies clearly revealed that the coatings have better wear and corrosion resistance and the predominant damage mechanism was mechanical wear rather than corrosion. Among the coatings, the IDZAT shows enhanced tribocorrosion performance by exhibiting more positive OCP, no induced current, and a lower coefficient of friction.

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Metallosis in shoulder arthroplasty: an integrative review of literature

et al. 2016

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Shoulder arthroplasty has gained popularity as an efficient means of achieving pain relief and improved function in a variety of complex shoulder disorders. Despite promising reports, given the increasing number of shoulder arthroplasty procedures, various causes that may contribute to failure of a well-functioning arthroplasty are being increasingly recognized. One such disastrous condition is metallosis, a subject which has not been much talked off with reference to shoulder arthroplasty. This article besides reviewing the existing literature intends to discuss the possible causes that contribute to metallosis and devise a protocol for its timely diagnosis and management.

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Metallosis following full thickness wear in total hip arthroplasty

Cited by 5 publications

References 8 publications

Excellent Result of Revision Total Hip Replacement with Unexpected Metallosis

Excellent Result of Revision Total Hip Replacement with Unexpected Metallosis

Enhanced Tribocorrosion Resistance of Hard Ceramic Coated Ti-6Al-4V Alloy for Hip Implant Application: In-Vitro Simulation Study

Metallosis in shoulder arthroplasty: an integrative review of literature

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