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OSTEOLYSIS IN PATIENTS WITH A METAL‐ON‐METAL HIP ARTHROPLASTY
Author(s) -
Carr Ashley M.,
DeSteiger Richard
Publication year - 2008
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04390.x
Subject(s) - medicine , osteolysis , periprosthetic , surgery , implant , arthroplasty , total hip arthroplasty , hip arthroplasty , radiography , radiology
Background: Despite design and manufacturing improvements in contemporary metal‐on‐metal hip replacements, the problem of wear particles persists. The local and systemic biological consequences of this ionic debris have been the subject of much investigation and it has become clear that cell‐mediated delayed‐type hypersensitivity reactions are a discrete mode of osteolysis in susceptible patients. Methods: We have carried out a consecutive series of 125 primary hip replacements using the Metasul (Zimmer, Warsaw, IN, USA) bearing couple. The radiographs, periprosthetic tissue and retrieved implants of patients undergoing revision for osteolysis were analysed. Results: Three patients underwent revision procedures during a follow‐up period of 3–9 years. Histological analysis showed a perivascular lymphocytic infiltrate of the pseudocapsule. Infection was excluded in each patient, there was no implant loosening and no evidence of impingement between trunion and acetabular component. Conclusion: We report a prevalence of 2.6% of patients displaying femoral osteolysis associated with characteristic clinical and histological findings.