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dc.contributor.authorGalbraith, John G
dc.contributor.authorButler, Joseph S
dc.contributor.authorBrowne, Tara-Jane
dc.contributor.authorMulcahy, David
dc.contributor.authorHarty, James A
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
html.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.


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