Infection or metal hypersensitivity? The diagnostic challenge of failure in metal-on-metal bearings.

Hdl Handle:
http://hdl.handle.net/10147/135679
Title:
Infection or metal hypersensitivity? The diagnostic challenge of failure in metal-on-metal bearings.
Authors:
Galbraith, John G; Butler, Joseph S; Browne, Tara-Jane; Mulcahy, David; Harty, James A
Affiliation:
Department of Trauma & Orthopaedic Surgery, Cork University Hospital & St Mary's Orthopaedic Hospital, Cork, Ireland. johng442@hotmail.com
Citation:
Infection or metal hypersensitivity? The diagnostic challenge of failure in metal-on-metal bearings. 2011, 77 (2):145-51 Acta Orthop Belg
Journal:
Acta orthopaedica Belgica
Issue Date:
Apr-2011
URI:
http://hdl.handle.net/10147/135679
PubMed ID:
21667724
Abstract:
The use of second generation metal-on-metal hip articulations has gained favour in the past few years. A hypersensitivity reaction to the metal-on-metal bearing, although rare, is a reported complication and is a novel mode of failure of these implants. Differentiating failure secondary to infection from failure secondary to metal hypersensitivity represents a significant diagnostic challenge. A retrospective review of all cases of hip arthroplasty using metal-on-metal bearings over a 5-year period at a tertiary referral centre identified 3 cases of failure secondary to metal hypersensitivity. Clinical presentation, serological markers, radiological imaging and histological analysis of all cases identified were evaluated. Histological analysis of periprosthetic tissue in all 3 cases identified characteristic features such as perivascular lymphocytic aggregates and chronic inflammation consistent with aseptic lymphocytic vasculitis-associated lesions (ALVAL). This study highlights that failure secondary to metal hypersensitivity must be considered in patients presenting with the reappearance of persistent pain, marked joint effusion, and the development of early osteolysis in the absence of infection.
Item Type:
Article
Language:
en
MeSH:
Adult; Aged; Female; Hip Prosthesis; Humans; Hypersensitivity; Male; Metals; Middle Aged; Osteolysis; Prosthesis Design; Prosthesis Failure; Prosthesis-Related Infections; Retrospective Studies
ISSN:
0001-6462

Full metadata record

DC FieldValue Language
dc.contributor.authorGalbraith, John Gen
dc.contributor.authorButler, Joseph Sen
dc.contributor.authorBrowne, Tara-Janeen
dc.contributor.authorMulcahy, Daviden
dc.contributor.authorHarty, James Aen
dc.date.accessioned2011-07-08T14:49:48Z-
dc.date.available2011-07-08T14:49:48Z-
dc.date.issued2011-04-
dc.identifier.citationInfection or metal hypersensitivity? The diagnostic challenge of failure in metal-on-metal bearings. 2011, 77 (2):145-51 Acta Orthop Belgen
dc.identifier.issn0001-6462-
dc.identifier.pmid21667724-
dc.identifier.urihttp://hdl.handle.net/10147/135679-
dc.description.abstractThe use of second generation metal-on-metal hip articulations has gained favour in the past few years. A hypersensitivity reaction to the metal-on-metal bearing, although rare, is a reported complication and is a novel mode of failure of these implants. Differentiating failure secondary to infection from failure secondary to metal hypersensitivity represents a significant diagnostic challenge. A retrospective review of all cases of hip arthroplasty using metal-on-metal bearings over a 5-year period at a tertiary referral centre identified 3 cases of failure secondary to metal hypersensitivity. Clinical presentation, serological markers, radiological imaging and histological analysis of all cases identified were evaluated. Histological analysis of periprosthetic tissue in all 3 cases identified characteristic features such as perivascular lymphocytic aggregates and chronic inflammation consistent with aseptic lymphocytic vasculitis-associated lesions (ALVAL). This study highlights that failure secondary to metal hypersensitivity must be considered in patients presenting with the reappearance of persistent pain, marked joint effusion, and the development of early osteolysis in the absence of infection.-
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshFemale-
dc.subject.meshHip Prosthesis-
dc.subject.meshHumans-
dc.subject.meshHypersensitivity-
dc.subject.meshMale-
dc.subject.meshMetals-
dc.subject.meshMiddle Aged-
dc.subject.meshOsteolysis-
dc.subject.meshProsthesis Design-
dc.subject.meshProsthesis Failure-
dc.subject.meshProsthesis-Related Infections-
dc.subject.meshRetrospective Studies-
dc.titleInfection or metal hypersensitivity? The diagnostic challenge of failure in metal-on-metal bearings.en
dc.typeArticleen
dc.contributor.departmentDepartment of Trauma & Orthopaedic Surgery, Cork University Hospital & St Mary's Orthopaedic Hospital, Cork, Ireland. johng442@hotmail.comen
dc.identifier.journalActa orthopaedica Belgicaen
dc.description.provinceMunster-

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