ABSTRACT
BACKGROUND: Wear cannot be completely prevented after total hip arthroplasty. If severe polyethylene (PE) liner wear develops, the so-called catastrophic failure occurs and metallosis develops. We postulated that longevity of the new implant may be affected after revision surgery for metallosis following a catastrophic failure of a PE liner due to the substantial amount of PE wear particles and infiltration of the metal particles in this catastrophic condition. METHODS: Twenty-three hips of 23 patients were identified because they showed metallosis during revision total hip arthroplasties performed in Seoul National University Hospital between January 1996 and August 2004. They were followed for at least 6.5 years after the index revision total hip arthroplasty. The clinical and radiological results of revision total hip arthroplasties in these patients were evaluated. RESULTS: The median Harris hip score increased from 60 points before revision total hip arthroplasties to 90 points at the final follow-up. Osteolysis was detected at an average of 9.3 years after revision total hip arthroplasties in 13 hips and acetabular cup loosening at average 9.8 years after revision total hip arthroplasties in 9 hips. With radiographic evidence of osteolysis and loosening as the end points, the 15-year survival rates were 28.2% and 56.0%, respectively. CONCLUSIONS: The survival rate of revision total hip arthroplasty in patients with metallosis following a catastrophic failure of a PE liner was low.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Arthroplasty, Replacement, Hip , Biocompatible Materials , Hip Joint/diagnostic imaging , Hip Prosthesis/adverse effects , Joint Diseases/diagnostic imaging , Metals/adverse effects , Metals, Heavy/poisoning , Osteolysis/etiology , Poisoning/etiology , Polyethylene/adverse effects , Prosthesis Design , Prosthesis Failure/etiology , ReoperationABSTRACT
We report a case of 69-year-old female patient who presented with a dislocated insert causing tibial component failure and catastrophic metallosis after 4 years of prosthesis implantation. In case of a trauma history, surgeons must suspect friction noise and motion loss as clinical symptoms indicating dislocation of the insert at the initial postoperative period. Timely diagnosis can prevent catastrophic consequences.
ABSTRACT
Metallosis has been reported in the setting of weight-bearing joint arthroplasties, like the hip and knee joints. However, the prevalence of metallosis in non-articular portions is very uncommon. We report a rare case of a patient who had metallosis secondary by fibular nonunion after fixation with plate and screw. In addition, we discuss the clinical and the operative findings, as well as the outcome of this uncommon complication.
Subject(s)
Humans , Arthroplasty , Hip , Joints , Knee Joint , Prevalence , Weight-BearingABSTRACT
Popularity of ceramic materials has increased among joint reconstruction surgeons for treatment of young patients who wish to maintain their active lifestyle. However, ceramic fracture is one of the most serious complications, and there are many concerns regarding the acceleration of third body wear and refracture of ceramic articulation after revision total hip arthroplasty for a ceramic fracture. To date, a few authors have reported on complications due to residual ceramic particles after revision surgery. We report on a case of metallosis due to metal head wear caused by residue of fractured ceramic particles lodged in the polyethylene liner after revision total hip arthroplasty for a ceramic liner fracture.
Subject(s)
Humans , Acceleration , Arthroplasty, Replacement, Hip , Ceramics , Head , Joints , Life Style , PolyethyleneABSTRACT
A ceramic articulation thought to be superior to metal-on-polyethylene due to its extremely low coefficient of friction and its potential for resistance to wear. But ceramic is brittle, which makes it theoretically susceptible to fracture. Although many authors have reported that metal-on-polyethylene articular pairing had good results after a ceramic head fracture, there have been few reports about complication due to the remaining ceramic particles after revision surgery. We report here on a case of severe metallosis that was thought to be due to third body wear by the remaining fractured ceramic particles after revision total hip arthroplasty.
Subject(s)
Ceramics , Friction , Head , HipABSTRACT
The titanium miniplate osteosynthesis system has been used for fixation of bone fragments in the maxillofacial areas due to easy manipulation and even has been proposed for unnecessity of miniplate removal because of the biocompatibility and the corrosion resistance. But recently, there have been some suggestions for its removal, on the basis of findings that there have been pigmentations around the adjacent tissues during miniplate removal procedure and they are the depositions of metal particles. Purposes of this study are to ascertain the presence and nature of pigmentation observed within tissues adjacent to titanium miniplate, and to suggest possible causes of it. We could observe the black pigmentation during miniplate removal procedure for recent about 1.5 year. Pigmented tissues were stained with hematoxylin-eosin(H-E) for light microscophic(LM) examination to investigate the black pigmentations and the histomorphology around them. The scanning electron microscopy(SEM) with energy dispersive X-ray(EDX) analysis was used to examine the ultrastructural nature of pigmentations. Many metal particles with variable sizes and shapes were seen in the connective tissue by SEM and were identified as titanium by EDX.