Analysis of retrieved alumina ceramic components from Mittelmeier total hip prostheses

Nevelos, Jim; Ingham, Eileen; Doyle, Christina; Fisher, John; Nevelos, AB

doi:10.1016/s0142-9612(99)00081-2

Cited by 140 publications

(137 citation statements)

References 8 publications

Supporting

Mentioning

125

Contrasting

Order By: Relevance

“…There were also frequent reports of ''stripe'' wear across heads and around cup rims [15,54,62,71,77]. Our MoM retrieval studies noted similar stripe damage in retrieved MoM [6,9,10], although other groups disavowed their existence [34].…”

Section: Introductionsupporting

confidence: 58%

See 1 more Smart Citation

Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

Clarke

Lazennec

Savisaar

et al. 2013

Clin Orthop Relat Res

View full text Add to dashboard Cite

Background Concerns have been raised about the sequelae of metal-on-metal (MoM) bearings in total hip arthroplasty (THA). However, retrieval studies, which offer the best insight into the clinically relevant mechanisms of MoM wear, have followed predictable trends to date such as indicting cobalt-chromium (CoCr) metallurgy, cup design, high conformity between the head and cup, ''steep cups,'' ''microseparation,'' and ''edge wear.'' Questions/purposes We wished to evaluate a set of retrieved 28-mm MoM THA for signs of (1) cup-to-stem impingement; (2) normal wear pattern and concomitant stripe damage on femoral heads that would signify adverse wear mechanics; and (3) well-defined evidence of thirdbody scratches on bearings that would indicate large abrasive particles had circulated the joint space. Methods Ten 28-mm MOM retrievals were selected on the basis that femoral stems were included. Revision surgeries at 3 to 8 years were for pain, osteolysis, and cup loosening. CoCr stems and the MoM bearings were produced by one vendor and Ti6Al4V stems by a second vendor. All but two cases had been fixed with bone cement. We looked for patterns of normal wear and impingement signs on femoral necks and cup rims. We looked for adverse wear defined as stripe damage that was visually apparent on each bearing. Wear patterns were examined microscopically to determine the nature of abrasions and signs of metal transfer. Graphical models recreated femoral neck and cup designs to precisely correlate impingement sites on femoral necks to cup positions and head stripe patterns.

show abstract

Section: Introductionsupporting

confidence: 58%

“…Stripe wear on femoral heads has been a common finding in CoC retrievals [16,20,54,62,70,75,76] but rarely mentioned in the MoM literature. It is possible that bearing damage could have been produced either by THA dislocation or alternatively by instruments used at revision surgery [8,30,60].…”

Section: Discussionmentioning

confidence: 99%

Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

Clarke

Lazennec

Savisaar

et al. 2013

Clin Orthop Relat Res

View full text Add to dashboard Cite

show abstract

“…Several reports [1,26,28] describe how wear rates for ceramic-on-ceramic bearings are affected by cup inclination angles. In vitro retrieval studies have suggested these bearings exhibit extremely low wear rates, ranging from 0.025 to 0.05 lm per year [12,31].…”

Section: Introductionmentioning

confidence: 99%

“…In vitro retrieval studies have suggested these bearings exhibit extremely low wear rates, ranging from 0.025 to 0.05 lm per year [12,31]. In vitro experimental studies such as those describe by Nevelos et al [28] are conducted under ideal conditions; ideal positioning and continuous joint lubrication may create more conservative testing parameters than may be experienced in vivo [28]. Several reports debate whether ceramic-on-ceramic bearings exhibit increased [28] or equal [29] wear at increased acetabular inclination angles.…”

Section: Introductionmentioning

confidence: 99%

“…In vitro experimental studies such as those describe by Nevelos et al [28] are conducted under ideal conditions; ideal positioning and continuous joint lubrication may create more conservative testing parameters than may be experienced in vivo [28]. Several reports debate whether ceramic-on-ceramic bearings exhibit increased [28] or equal [29] wear at increased acetabular inclination angles. Therefore, it is unclear whether inclination angles affect the durability of ceramicon-ceramic implants.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does Acetabular Inclination Angle Affect Survivorship of Alumina-ceramic Articulations?

Johansson

Johnson

Zywiel

et al. 2011

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Reports in the literature have linked high acetabular inclination angles to increased wear of ceramicon-ceramic bearings. However, many of these studies were only conducted in vitro and did not address the clinical relevance of such findings. Questions/purposes We therefore determined: (1) whether the cup inclination angle influences survival or function in patients with ceramic-on-ceramic implants; (2) the incidence of radiolucencies, osteolysis, and subsidence of ceramic-on-ceramic implants; and (3) whether the survival rate higher for ceramic-on-ceramic THAs than for conventional metal-on-polyethylene THAs.Methods We retrospectively reviewed 537 THAs performed in 512 prospectively followed patients having THA between October 1996 and October 2000. Eleven patients (12 hips) were lost to followup before 2 years, leaving 501 patients (525 THAs); of these, 421 were alumina ceramic-on-ceramic articulations and 104 cobaltchromium-on-polyethylene. The mean age was 54 years. We determined acetabular cup inclination angles, Harris hip scores, Health-Status-Questionnaire-12 scores, and presence and location of any radiolucencies, osteolysis, or radiographic subsidence. We compared survival using the Kaplan-Meier method. The minimum followup was 24 months (mean, 59 months; range, 24-120 months). Results Twenty-two of the 424 THAs (4.2%) were revised. We observed no difference in clinical or radiographic outcomes with respect to cup inclination angles. Radiographically, two loose acetabular components and two femoral components had subsided. The 5-year survival rate was slightly higher for ceramic-on-ceramic bearings (98%) than for metal-on-polyethylene (92%).

show abstract

Role of interleukin‐6 in a patient with tumor necrosis factor receptor–associated periodic syndrome: Assessment of outcomes following treatment with the anti–interleukin‐6 receptor monoclonal antibody tocilizumab

Vaitla¹,

Radford²,

Tighe³

et al. 2011

Arthritis & Rheumatism

View full text Add to dashboard Cite

In this report, we describe treatment outcomes in the first case of a patient with tumor necrosis factor receptor-associated periodic syndrome (TRAPS) treated with the anti-interleukin-6 (anti-IL-6) receptor monoclonal antibody tocilizumab. Since IL-6 levels are elevated in TRAPS, we hypothesized that tocilizumab might be effective. The patient, a 52-year-old man with lifelong TRAPS in whom treatment with etanercept and anakinra had failed, was administered tocilizumab for 6 months, and the therapeutic response was assessed by measurement of monocyte CD16 expression and cytokine levels. Following treatment, the evolving acute attack was aborted and further attacks of TRAPS were prevented. The patient did not require corticosteroids and showed significant clinical improvement in scores for pain, stiffness, and well-being. Moreover, the acutephase response diminished significantly with treatment. Monocyte CD16 expression was reduced and the numbers of circulating CD14؉CD16؉ and CD14؉؉CD16؊ monocytes were transiently decreased. However, cytokine levels were not reduced. This case supports the notion of a prominent role for IL-6 in mediating the inflammatory attacks in TRAPS, but blockade of IL-6 did not affect the underlying pathogenesis. These preliminary findings require confirmation.

show abstract

Analysis of retrieved alumina ceramic components from Mittelmeier total hip prostheses

Cited by 140 publications

References 8 publications

Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

Does Acetabular Inclination Angle Affect Survivorship of Alumina-ceramic Articulations?

Role of interleukin‐6 in a patient with tumor necrosis factor receptor–associated periodic syndrome: Assessment of outcomes following treatment with the anti–interleukin‐6 receptor monoclonal antibody tocilizumab

Contact Info

Product

Resources

About