Bearing exchange in the management of pseudotumours

Kemp, MA; Mitra, Amit; Costa, Thomas Mendes Da; Spencer, RF

doi:10.1308/003588413x13511609958497

Cited by 6 publications

(7 citation statements)

References 15 publications

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“…Twelve articles remained after 198 articles were screened [4,11,12,18,24,28,30,34,38,43,44,48] (Fig. 3).…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…The most frequently reported methods for treating a failed stemmed MoM THA were acetabular revision for modular and nonmodular acetabular components, liner insert exchange for modular acetabular components, and full revision of the femoral and acetabular components (Table 3) [4,24,28,30,34,48]. The mean followup for these articles ranged from 3 to 33 months.…”

Section: Mom Wear In Tha/hrmentioning

confidence: 99%

“…In addition, there have been reported cases of patients presenting with systemic symptoms that have been ultimately attributable to the MoM bearing and marked elevation of metal levels [41]. In many cases, cross-sectional imaging depicts destruction of the soft tissue envelope around the joint and, in some cases, periprosthetic bone loss [24]. While corrosion of modular junctions is not a new finding, its contribution to failed arthroplasties seems to be on the rise.…”

Section: Introductionmentioning

confidence: 99%

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The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

Engh

Padgett

2014

Clin Orthop Relat Res

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Background Wear and corrosion occurring in patients with hip and knee arthroplasty are common causes of failure leading to revision surgery. A variety of surgical approaches to these problems have been described, with varying efficacy. Polyethylene wear, metal-on-metal (MoM) hip bearing wear, and problems associated with modular taper corrosion are the areas of greatest clinical impact; results of revisions for these problems are likely to dictate a large portion of revision resources for the foreseeable future, and so they call for specific study. Questions/purposes We identified the most frequently reported procedures to treat hip polyethylene wear, knee polyethylene wear, MoM wear after THA, and modular taper corrosion and determined the timing and reasons these failed. Methods We performed systematic reviews of the published literature on the four topics using MEDLINE 1 and Embase in October 2013; searches were supplemented by hand searches of bibliographies. Prespecified criteria resulted in the identification of 38 relevant articles, of which 33 were either case reports or Level IV evidence. Followup was generally at short term and ranged from 0.2 to 8 years. Results The most frequently reported procedures for treating clinically important wear were a partial or complete revision. When treating polyethylene wear, the more frequently reported reasons for hip and knee rerevisions were loosening, continued wear, and instability. Soft tissue reactions were more common and occasionally extensive in patients with MoM or modular taper corrosion. Patients with soft tissue reactions had more complications and higher rerevision rates. Conclusions Studies with longer followup and higher levels of evidence are needed to direct the treatment of wear and corrosion. When soft tissue damage secondary to MoM wear or taper corrosion is present, the results of treatment can be poor. There is an urgent need to better understand these two mechanisms of failure.

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“…Twelve articles remained after 198 articles were screened [4,11,12,18,24,28,30,34,38,43,44,48] (Fig. 3).…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

Section: Mom Wear In Tha/hrmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

Engh

Padgett

2014

Clin Orthop Relat Res

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“…A pathogenic reaction to ceramic particles is unlikely. In case reports, where there are adverse reactions to metal components of hip implants, a significant improvement in the symptoms and falling metal ion levels following revisions using metal-free materials (ceramics, highly cross-linked polyethylene, polyethylene) are described in the area of bearing couples [1,12,13,14,18,21,25,26,27,37,39,45,46,47,57,58].…”

Section: Ceramic: Microparticles and Macroparticlesmentioning

confidence: 99%

“…nitrides, oxynitrides) [51], as they offer outstanding biological conditions. In the case of adverse reactions to components of metal implants, an improvement in the symptoms and falling metal ion concentrations in the blood following revision surgery using metal-free materials (ceramics, highly cross-linked polyethylene, polyethylene) in hip endoprosthetics [1,12,13,14,18,21,25,26,27,37,39,45,46,47,57,58], and non-sensitive metallic materials (surface-treated implants) and ceramics in knee endoprosthetics [3,5,6,17,44,49,51,53,55], have been described.…”

Section: Slim-reaction Patterns In Dysfunctional Metal-on-metal Bearimentioning

confidence: 99%

Implant-Associated Pathology: An Algorithm for Identifying Particles in Histopathologic Synovialis/Slim Diagnostics

Krenn¹,

Thomas

Thomsen

et al. 2014

Traumatology and Orthopedics of Russia

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Update on endoprosthesis pathology: Particle algorithm for particle identification in the SLIM

Krenn

Kretzer

Thomas

et al. 2013

Seminars in Arthroplasty

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Bearing exchange in the management of pseudotumours

Abstract: In the early stages of pseudotumour formation following MoM hip resurfacing, this potentially devastating condition can be managed adequately with revision to a CoC bearing THA with minimal soft tissue excision.

Cited by 6 publications

References 15 publications

The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

Implant-Associated Pathology: An Algorithm for Identifying Particles in Histopathologic Synovialis/Slim Diagnostics

Update on endoprosthesis pathology: Particle algorithm for particle identification in the SLIM

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