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Metal-on-Metal Hip Arthroplasty - Europe PMC

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Last Updated: 09 May 2022

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Clinical outcomes, metal ion levels, lymphocyte profiles, and implant survival following five different bearings of total hip arthroplasty: A mean 10-year follow-up study.

At a long-term follow-up of more than ten years, the purpose of this research was to see if there are differences between THAs and five other bearings. The Harris hip score, Western Ontario and McMaster Universities Osteoarthritis Index scores, a range of motion, blood cell count, and liver-kidney function were measured. Blood lymphocyte and serum metal ion levels were determined by flow cytometry, and serum and urine metal ion levels were determined by flow cytometry. In metal-containing bearings, the ion concentrations were significantly elevated. The implant survival rate for the MoM and CoC groups was 96. 7% and 93. 3%, which was significantly lower than that of other groups. Conclusions Metal ion levels were elevated in metal-containing bearings, especially in MoM THA patients. Implant survival rates in CoC and MoM THAs were considerably lower, owing to pseudotumor formation, mainly due to pseudotumor formation.

Source link: https://europepmc.org/article/MED/35490981


Median 10-year whole blood metal ion levels and clinical outcome of ReCap-M2a-Magnum metal-on-metal total hip arthroplasty.

After ReCap-M2a-Magnum's large-diameter head metal-on-metal total hip arthroplasty, we have previously stated that the whole blood chromium and cobalt ion levels fell in the short term. This report examines long-term metal ion levels and clinical effects after ReCap-Magnum THA's ReCap-Magnum THA. Patients and methods ReCap-M2a-Magnum THA was used in 1,450 patients in our hospital district from 2005 to 2012. 2 or more metal ion tests were obtained among 991 patients, with 2 or more metal ions measured. In a random coefficient scheme, individual metal ion change was determined using logarithmic metal ion values. Results Geometric mean of Cr decreased from 1. 8 ppb to 1. 0 ppb, according to the results. At 14 years old, the hip-specific survival was 85% for revision due to any reason at 14 years, and the hip-specific survival for any metal-related adverse event was 69% at 14 years. In the long-term follow-up to ReCap-M2a-Magnum THA patients, WB Cr and Co levels continued to decline.

Source link: https://europepmc.org/article/MED/35438184


Biomechanical effect of metal augment and bone graft on cup stability for acetabular reconstruction of total hip arthroplasty in hip dysplasia: a finite element analysis.

Typical treatment options for adult developmental dysplasia of the hip acetabular bone defect in Crowe II and III have been used scientifically. Nevertheless, the biomechanical effects of different augmented materials for THA's shell repair on shell stability have never been discussed. Methods In the present study, autologous bone graft and metal augment were simulated with several acetabular bone defect models of THA. In the Massachusetts case, the peak contact stress between shell and host bone was greater. For BG models, the high local contact strains were present at the junction of bone graft and host bone, respectively, although for MA models, the concentrated contact stresses were at the surface of MA. In the Massachusetts case, the peak relative micromotion between shell and host bone was higher.

Source link: https://europepmc.org/article/MED/35321681


Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) After Total Hip Arthroplasty (THA). A Non-Invasive Approach for Preoperative Differentiation Between Periprosthetic Joint Infection (PJI) and Aseptic Complications?

Magnetic resonance imaging has become a popular diagnostic tool for the evaluation of hip arthroplasty implants since metal artefact reduction sequences are now available. The purpose of the current study was to determine the effectiveness of MARS MRI in comparison to standard diagnostic techniques to distinguish between aseptic failure and PJI. Methods: : MARS-MRI was conducted in a coronal and axial STIR from July 2018 to September 2019, a non-fat-saturated T2 in coronal view and a non-fat-saturated T1 in transverse view in 45 patients with painful hip pain following THA, which was a painful hip fracture in patients with painful hip pain after THA. Conclusion: MARS-MRI is as effective as standard diagnostic techniques to distinguish between aseptic failure and PJI in patients with total hip arthroplasty. MARS-MRI may be a vital component of PJI diagnostics, and further studies with larger patient populations will determine whether MARS-MRI could be a significant part of PJI diagnostics.

Source link: https://europepmc.org/article/PPR/PPR468600


Hip Arthroplasty With the Use of a Reconstruction Cage and Porous Metal Augment to Treat Massive Acetabular Bone Loss: A Midterm Follow-Up.

Background The acetabular bone restitution of a large acetabular bone fracture is difficult. The Kaplan-Meier survivors study for cage failure that required revision surgery was performed. Binomial regression analysis was used to determine the association of aseptic cage failure with baseline results. The comparisons were compared between pre-intervention and post-intervention ambulatory aid needs. Four aseptic cage revisions had been identified. At ten years, Aseptic KM survival statistics, which estimated 87. 4% at ten years, stood at 87. 4%. At 9 years for patients with vs. c vs. 92. 8%, with aseptic KM survival at 56% versus 92. 8% at 9 years. Binomial testing showed no correlation between cage failure and baseline results, but not showing a correlation between cage failure and baseline characteristics. After surgery, the Wilcoxon signed-rank test showed a significant decrease in ambulatory aide demand after surgery. Conclusion In the case of significant acetabular bone loss in which a cup-cage is not a viable option, good survivorship of an aseptic cage failure can be expected at a mid-term follow-up that uses an antiprotrusio cage instead of porous metal augments.

Source link: https://europepmc.org/article/MED/35271981


Poor Patient Follow-up After Metal-on-Metal Total Hip Arthroplasty.

However, although patients are warned of the importance of a follow-up, our mean follow-up rate for patients after average non-metal-on-metal THA is just 19%. Multiple reports have been released by the U. S. Food and Drug Administration on the benefits of a follow-up every two years after MOM THA's THA. Between 2002 and 2010, two separate centers administered 570 MOM THA services. Only 61% did their first examination of ion levels, and only 30% of patients had a second set of ion measurements. Despite widespread dissemination of reports regarding MOM THA's potential risks and concerted efforts to alert patients for a follow-up, we have been able to achieve a follow-up rate of only 26%. In our cases, this rate is only marginally higher than the mean follow-up to non-MOM THA.

Source link: https://europepmc.org/article/MED/35245138


New-Generation Low-Field Magnetic Resonance Imaging of Hip Arthroplasty Implants Using Slice Encoding for Metal Artifact Correction: First In Vitro Experience at 0.55 T and Comparison With 1.5 T.

Slice encoding for metal artifact correction is now available in low-end field magnetic resonance imaging systems, which may result in smaller metallic artifacts and improved image quality than standard-of-care 1. 5 T MRI. When considering measured spatial resolution, signal-to-noise ratios, and acquisition times, 3 expert readers' findings revealed how to refine an MRI protocol at 0. 55 T, the type of metal artifact reduction methods, and the effect of various pulse sequence parameters on metal artifacts were determined by qualitative analysis of the images by three independent readers. Conclusions Overall, the VAT + SEMAC sequence, which contained at least six SEMAC encoding steps for Ti and 9 for cobalt-chromium implants, was ranked higher than other sequences for metal reduction. Minimum residual artifacts and low magnetic susceptibility are among Ti constructs that can be properly portrayed with optimized turbo spin echo sequences, eliminating the need for SEMAC. In cross-platform comparisons, 0. 55 T acquisitions using the enhanced protocols are correlated with 45% to 64% smaller artifacts than 1. 5 T VAT+ SEMAC and VAT + compressed-sensing/SEMAC protocols, resulting in a 17% to 28 percent decrease in signal-to-noise ratio effectiveness, resulting in a 57% to 48 percent decrease in noise reduction. Invariably lower at 0. 55 T than 1. 5 T, but B1-related artifacts are invariably smaller at 0. 55 T than 1. 5 T; however, signal pileups at 0. 55 T are typical; however, conclusions should be influenced by B1 debility, although not always smaller.

Source link: https://europepmc.org/article/MED/35239614


Reliability of slice-encoding for metal artefact correction (SEMAC) MRI to identify prosthesis loosening in patients with painful total hip arthroplasty - a single centre, prospective, surgical validation study.

To determine an alternative explanation for hip pains, it is imperative to investigate periprosthetic anatomical structures in symptomatic patients in order to find an alternative cause of hip pains. The eleven patients needed revision surgery, all from group P. None from group A required revision surgery. In 21 hips, eight hips had trochanteric bursitis, eight hips had extraarticular origins, eight hips had extraarticular pain, eight hips had extraarticular bursitis, eight hips had extraarticular cause, and the remaining five hips had spontaneous pain relief. We found moderate-to-weak correlations between SEMAC-MRI findings for prosthesis loosening and revision surgery results. In Group P, T1W-SEMAC, specificity, PPV, and NPV were in T1W-SEMAC, as in STIR-SEMAC and PDW-SEMAC. Conclusion Negative SEMAC-MRI findings can effectively exclude prosthesis loosening after revision surgery, and SEMAC-MRI can identify alternative causes of hip pain more precisely. Advances in knowledge Negative SEMAC-MRI in painful THA patients can safely exclude prosthesis loosening as a cause.

Source link: https://europepmc.org/article/MED/35148205

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions