No association between pseudotumors, high serum metal-ion levels and metal hypersensitivity in large-head metal-on-metal total hip arthroplasty at 5–7-year follow-up

Hjorth, Mette Holm; Stilling, Maiken; Søballé, Kjeld; Bolvig, Lars; Thyssen, Jacob P.; Mechlenburg, Inger; Jakobsen, Stig Storgaard

doi:10.1007/s00256-015-2264-8

Cited by 28 publications

(29 citation statements)

References 50 publications

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“…The results showed that when tissues of patients with suspected high wear were compared with those of patients with suspected metal sensitivity, the former had a lower ALVAL score and fewer lymphocytes but more macrophages and metal particles. Athanasou [78] postulated that while an increase in wear increases the frequency of ALVAL and pseudotumours in periprosthetic tissues, some reactions can be associated with low wear, likely owing to variability in the adaptive immune responses, and cited studies supporting this conclusion [181,182].…”

Section: Pathophysiology Of Metal Hypersensitivity Reactionsmentioning

confidence: 72%

Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

2016

J Investig Allergol Clin Immunol

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The use of metals in the medical field has become increasingly prevalent over the past few decades. Patients find themselves being exposed to metals in a variety of ways, ranging from external exposure to instruments such as the stainless steel in surgical blades to internal exposure via medical devices being implanted in their bodies. There has been growing interest in the possibility of developing hypersensitivity reactions to constituent metals in medical implant devices, both in cutaneous and systemic forms. Hypersensitivity reactions to metals are uncommon, but they are reported and require appropriate evaluation and management, particularly if they are symptomatic. In view of the lack of consensus in the field on the appropriate steps to evaluate and manage patients with suspected metal hypersensitivity reactions, this review aims to analyze current evidence on hypersensitivity reactions to metallic implants in orthopedic surgery, endovascular surgery, obstetrics and gynecology, and dental surgery. Key words: Metal hypersensitivity. Metallic implants. ResumenEl empleo de metales dentro de la medicina ha ido aumentando de forma progresiva en las últimas décadas. Los pacientes se exponen a metales de diferentes formas desde fuentes externas, como instrumental quirúrgico como el presente en las hojas de acero de los bisturíes, hasta implantes metálicos. Como consecuencia de ello se está produciendo un interés creciente por la posibilidad de desarrollar reacciones de hipersensibilidad a metales presentes en los materiales y objetos implantados, tanto en forma de reacciones cutáneas como sistémicas. Las reacciones de hipersensibilidad a metales no son frecuentes, pero pueden desarrollarse, y por ello, requieren de un diagnóstico y tratamiento adecuado, especialmente en aquellos pacientes que desarrollen síntomas. No existe un consenso en el proceso diagnóstico ni en el tratamiento de estas reacciones en los pacientes con sospecha de alergia a metales. Esta revisión tiene por objeto actualizar la evidencia existente sobre las reacciones de hipersensibilidad a implantes metálicos en cirugía ortopédica, cirugía endovascular, cirugía obstétrica y ginecológica (OB-GYN) así como la dental. Palabras clave: Hipersensibilidad a metales. Implantes metálicos.

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Section: Pathophysiology Of Metal Hypersensitivity Reactionsmentioning

confidence: 72%

Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

2016

J Investig Allergol Clin Immunol

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“…There is no significant association of metal allergy to pseudotumors, but the result of that study was based on a small group of cases 20 . Patients age seems to be another factor.…”

Section: Risk Factorsmentioning

confidence: 91%

Clinical consequences of pseudotumors in hip arthroplasty

Karagiannis¹

2018

JRPMS

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The occurrence of pseudotumors currently constitutes an important topic of interest among orthopaedic surgeons who prefer metal on metal arthroplasty and especially hip resurfacing arthroplasty. Adverse reactions to metal ions are associated with the formation of such lesions and the orientation of implants has also been implicated in their pathogenesis. The diagnosis of pseudotumors is as difficult as complex. There is a variety of symptoms and patients with mild or tolerable pain may not seek medical attention. Revision surgeries may be the only solution in some cases. The goal of this article is to review the clinical presentation, prognosis of pseudotumors and associated complications, based on evidence published in the literature.

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“…Так, M.H. Hjorth et al отмечают развитие осложнений в 19,5% случаев [8], тогда как S. Konan et al регистрируют 32% осложнений [9]. Локальные осложнения пары трения металл-металл проявляются в виде грануляционных разрастаний в ответ на металлические частицы [10][11][12].…”

Section: локальные осложненияunclassified

“…Эти частицы (прежде всего, кобальта и хрома) образуются в результате износа пары трения, а также микроподвижности между головкой и конусом бедренного компонента эндопротеза. Эти частицы оказывают токсическое воздействие на мягкие ткани в области эндопротеза, вызывая атрофию мышц, а также развитие асептического некроза всех тканей (в том числе и костной) в области эндопротеза, с образованием полостей большого диаметра либо плотных масс [8].…”

Section: локальные осложненияunclassified

Metal-on Metal Hip Arthroplasty. Local and Systemic Complications, Indications for Revision Surgery

Lyubchak¹,

Shubnyakov²,

Sivkov³

et al. 2017

СПНО (MPSE)

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По данным международных регистров, в мире установлено большое количество эндопротезов тазобедренного сустава с парой трения металл-металл. При наблюдении в динамике у пациентов часто возникают локальные и системные осложнения, приводящие к ревизии. К специфическим локальным осложнениям относят псевдоопухоли, механизмы образования которых до настоящего времени не определены. Системные осложнения многие авторы связывают с токсическим действием ионов металлов, прежде всего кобальта и хрома. На данный момент нет единого алгоритма ведения пациентов, у которых установлены эндопротезы с парой трения металл-металл, а также четко не установлены показания к ревизии. В публикации представлены данные литературы, в том числе зарубежной и регистров эндопротезирования, на основе которых авторы провели анализ существующих специфичных локальных и системных осложнений, показания к ревизии. Ключевые слова: эндопротезирование тазобедренного сустава, металл-металл, псевдоопухоли, ионы металлов, ведение пациентов. METAL-ON METAL HIP ARTHROPLASTY. LOCAL AND SYSTEMIC COMPLICATIONS, INDICATIONS FOR REVISION

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No association between pseudotumors, high serum metal-ion levels and metal hypersensitivity in large-head metal-on-metal total hip arthroplasty at 5–7-year follow-up

Cited by 28 publications

References 50 publications

Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

Clinical consequences of pseudotumors in hip arthroplasty

Metal-on Metal Hip Arthroplasty. Local and Systemic Complications, Indications for Revision Surgery

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