Supramacroparticulate PE in 6 different joint endoprostheses localisations: An indicator for PE damage?

Krenn, Simon; Thomsen, M.; Usbeck, Sylvia; Scheuber, L.; Boettner, Friedrich; Krukemeyer, Manfred Georg; Huber, Monika; Kretzer, Jan Philippe; Gehrke, Thorsten; Krenn, Veit

doi:10.1016/j.prp.2017.03.014

Cited by 7 publications

(8 citation statements)

References 28 publications

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“…We believe that the large number and size of polyethylene particles is related to the formation of pseudotumors. Furthermore, the cup anteversion in both cases was smaller than the safe zones suggested by Murphy et al (31 ± 8 ) [12] and Danoff et al (17 ± 4 ) [13], potentially leading to the generation of large wear particles due to anterior edge loading or rim impingement of the polyethylene liner [9,21].…”

Section: Discussionmentioning

confidence: 60%

“…[ 9 ] who observed a previously unreported and unusual-sized particle in their series of 13 cases that showed loosening of the implants. The survival rate of the prostheses with polyethylene supra-macroparticles was lower than expected [ 21 ]. The polyethylene supra-macroparticles could be a consequence of excessive mechanical loading such as dislocation, subluxation, and impingement [ 9 , 21 ].…”

Section: Discussionmentioning

confidence: 97%

“…The survival rate of the prostheses with polyethylene supra-macroparticles was lower than expected [ 21 ]. The polyethylene supra-macroparticles could be a consequence of excessive mechanical loading such as dislocation, subluxation, and impingement [ 9 , 21 ]. In our cases, a conventional polyethylene liner, ArCom®, was used; however, the amount of polyethylene wear was significant (0.14-0.30 mm/year; Table 1 ).…”

Section: Discussionmentioning

confidence: 97%

“…(31° ± 8°) [ 12 ] and Danoff et al. (17° ± 4°) [ 13 ], potentially leading to the generation of large wear particles due to anterior edge loading or rim impingement of the polyethylene liner [ 9 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Do Polyethylene Supra-Macroparticles Lead to Pseudotumor Formation in Metal-on-Polyethylene Total Hip Arthroplasty?

et al. 2020

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We describe 2 cases of pseudotumors induced by an unusual size of polyethylene wear particle after metal-on-polyethylene total hip arthroplasty (MoP THA). The supra-macroparticles of size >100 μm originated from a polyethylene liner with relatively small cup anteversion, potentially leading to excessive loading and increased wear of the anterior edge of the polyethylene liner. Histopathology showed a foreign-body reaction to the polyethylene particles without an adverse reaction to metal debris and with no severe signs of corrosion at the head-neck junction, which have been noted in past reports of pseudotumors in MoP THA. It has been suggested that the large polyethylene wear particles might be the cause of pseudotumor formation in MoP THA.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Do Polyethylene Supra-Macroparticles Lead to Pseudotumor Formation in Metal-on-Polyethylene Total Hip Arthroplasty?

et al. 2020

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“…Large polyethylene particles are generated commonly because of abnormal wear attributed to excessive mechanical loading such as dislocation, subluxation, impingement, and edge loading [ 8 , 36 ]. The significant change in acetabular cup orientation can become a risk factor for such abnormal wear modes.…”

Section: Discussionmentioning

confidence: 99%

Do polyethylene wear particles affect the development of pseudotumor in total hip arthroplasty? A minimum 15-year follow-up

et al. 2023

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Background Adverse local tissue reactions have been problematic as an implant-related complication in total hip arthroplasty (THA). Despite the absence of significant metal wear and corrosion, granulomatous pseudotumor has been reported to be caused by polyethylene wear. We performed a long-term follow-up study investigating the relationship between polyethylene wear and pseudotumor formation in THA. Methods This study included 57 patients (64 hips) that underwent primary THA with metal-on-polyethylene or ceramic-on-polyethylene bearing over a minimum follow-up of 15 years. They were stratified into pseudotumor and non-pseudotumor groups and their linear wear rates of polyethylene liner and serum cobalt (Co) and chromium (Cr) ion levels were compared. Pseudotumor was diagnosed on metal artifact reduction sequence-MRI according to its composition and wall thickness using the Hauptfleisch classification. Results The incidence of pseudotumor was 34% (22/64 hips) at the mean follow-up of 16.9 years. Metal ion levels did not differ between the pseudotumor and non-pseudotumor groups, and none of the patients exceeded the Co/Cr ratio of 2.0 μg/L. Moreover, the wear rate in the pseudotumor group was 1.8 times greater than in the non-pseudotumor group (0.14 vs. 0.08 mm/year, P < 0.001). According to an analysis of the receiver operating characteristic curves, the cutoff level of the wear rate to discriminate between pseudotumor and non-pseudotumor patients at 15 years was 0.11 mm/year (area under the curve = 91%; sensitivity = 95%; specificity = 78%; accuracy = 87%). Conclusions Our results might provide new insights into excessive polyethylene wear potentially leading to the future development of both pseudotumor and osteolysis. Further studies are needed to clarify the direct relationship between polyethylene wear and pseudotumor and the mutual effects of osteolysis and pseudotumor in particle reactions.

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Histopathologische Klassifikationsprinzipien rheumatischer Gelenkerkrankungen

et al. 2018

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Supramacroparticulate PE in 6 different joint endoprostheses localisations: An indicator for PE damage?

Cited by 7 publications

References 28 publications

Do Polyethylene Supra-Macroparticles Lead to Pseudotumor Formation in Metal-on-Polyethylene Total Hip Arthroplasty?

Do Polyethylene Supra-Macroparticles Lead to Pseudotumor Formation in Metal-on-Polyethylene Total Hip Arthroplasty?

Do polyethylene wear particles affect the development of pseudotumor in total hip arthroplasty? A minimum 15-year follow-up

Histopathologische Klassifikationsprinzipien rheumatischer Gelenkerkrankungen

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