How to Manage Metallosis: A Retrospective Cohort Analysis after Revision Hip Surgery.

MARS-MRI chromium cobalt corrosion metal-on-metal metallosis periprosthetic joint infection pseudotumor total hip arthroplasty tribology

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
21 Jul 2023
Historique:
received: 20 03 2023
revised: 13 07 2023
accepted: 17 07 2023
medline: 29 7 2023
pubmed: 29 7 2023
entrez: 29 7 2023
Statut: epublish

Résumé

Adverse local tissue reactions to metal debris are due to a metal-on-metal bearing complication caused by micromotions at modular interfaces that induce corrosion of the protective oxide layer. This process could lead to wear, fretting, and abrasion with the release of metal ions locally and systemically, which may cause adverse local reactions in nearby tissues. The aim of this study is to describe a series of patients with painful local adverse tissue reactions secondary to corrosion at the modular neck-body interface, to document the clinical presentation, diagnostic workup, and surgical findings of our research, and to search for a possible correlation between metallosis and infection. A retrospective study of patients with adverse local tissue reactions due to metal surface corrosion was performed. Blood samples were collected to identify erythrocyte sedimentation rate, C reactive protein, and procalcitonin, and a magnetic resonance imaging protocol was performed. Serum cobalt and chromium levels of the 43 patients tested were significantly higher on average. However, both erythrocyte sedimentation rate and C-reactive protein were significantly elevated. Magnetic resonance imaging showed adverse reactions to metal debris with large soft tissue masses and surrounding tissue damage. Corrosion in hip prosthesis can lead to the release of metal ions and debris locally and systemically, resulting in local soft tissue changes. A "tumor-like" debridement can reduce this complication.

Sections du résumé

BACKGROUND BACKGROUND
Adverse local tissue reactions to metal debris are due to a metal-on-metal bearing complication caused by micromotions at modular interfaces that induce corrosion of the protective oxide layer. This process could lead to wear, fretting, and abrasion with the release of metal ions locally and systemically, which may cause adverse local reactions in nearby tissues. The aim of this study is to describe a series of patients with painful local adverse tissue reactions secondary to corrosion at the modular neck-body interface, to document the clinical presentation, diagnostic workup, and surgical findings of our research, and to search for a possible correlation between metallosis and infection.
METHODS METHODS
A retrospective study of patients with adverse local tissue reactions due to metal surface corrosion was performed. Blood samples were collected to identify erythrocyte sedimentation rate, C reactive protein, and procalcitonin, and a magnetic resonance imaging protocol was performed.
RESULTS RESULTS
Serum cobalt and chromium levels of the 43 patients tested were significantly higher on average. However, both erythrocyte sedimentation rate and C-reactive protein were significantly elevated. Magnetic resonance imaging showed adverse reactions to metal debris with large soft tissue masses and surrounding tissue damage.
CONCLUSIONS CONCLUSIONS
Corrosion in hip prosthesis can lead to the release of metal ions and debris locally and systemically, resulting in local soft tissue changes. A "tumor-like" debridement can reduce this complication.

Identifiants

pubmed: 37510924
pii: jcm12144809
doi: 10.3390/jcm12144809
pmc: PMC10381485
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Antongiulio Bruschetta (A)

Orthopaedic Institute of Southern Italy "Franco Scalabrino", 98165 Messina, Italy.

Michelangelo Palco (M)

Department of Orthopaedic and Traumatology, Casa di Cura Caminiti, 89018 Villa San Giovanni, Italy.

Domenico Fenga (D)

Section of Orthopaedics and Traumatology, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, 98122 Messina, Italy.

Gabriele Giuca (G)

Section of Orthopaedics and Traumatology, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, 98122 Messina, Italy.

Lukas A Holzer (LA)

Perth Orthopaedic and Sports Medicine Centre, Perth, WA 6005, Australia.

Angelo Alito (A)

Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98122 Messina, Italy.

Giorgio Cacciola (G)

Orthopaedic Institute of Southern Italy "Franco Scalabrino", 98165 Messina, Italy.

Federico De Meo (F)

Orthopaedic Institute of Southern Italy "Franco Scalabrino", 98165 Messina, Italy.

Pietro Cavaliere (P)

Orthopaedic Institute of Southern Italy "Franco Scalabrino", 98165 Messina, Italy.

Classifications MeSH