Browse
Submit Data
Databases
API
Help

Dataset Information

52 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Neurologic Dysfunction Associated With Mechanically Assisted Crevice Corrosion and Elevated Cobalt Ion Levels After Total Hip Arthroplasty.

ABSTRACT: Adverse local tissue reactions secondary to mechanically assisted crevice corrosion (MACC) at the trunnion is a complication of total hip arthroplasty known to cause local soft-tissue damage. However, what is not as well appreciated is that MACC in metal-on-polyethylene (MOP) articulations can lead to cobalt ion serum elevations with associated neurological dysfunction just as in metal-on-metal articulations. We report a compelling case for the association of neurologic dysfunction tied to metal ion elevations secondary to MACC at two distinct MOP tapers in a 58-year-old intensive care unit nurse with two hips implanted 3 years apart. This report further raises awareness about the potential of MACC-generated elevated ion levels to produce neurological symptoms that might otherwise be overlooked in patients with MOP articulations.

SUBMITTER: Yan BW

PROVIDER: S-EPMC8501461 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Neurologic Dysfunction Associated With Mechanically Assisted Crevice Corrosion and Elevated Cobalt Ion Levels After Total Hip Arthroplasty.

Yan Brandon W BW Bini Stefano A SA

Arthroplasty today 20211007

Adverse local tissue reactions secondary to mechanically assisted crevice corrosion (MACC) at the trunnion is a complication of total hip arthroplasty known to cause local soft-tissue damage. However, what is not as well appreciated is that MACC in metal-on-polyethylene (MOP) articulations can lead to cobalt ion serum elevations with associated neurological dysfunction just as in metal-on-metal articulations. We report a compelling case for the association of neurologic dysfunction tied to metal ...[more]

PMID: 34646925

Similar Datasets

A case of bilateral hip mechanically assisted crevice corrosion after staged total hip arthroplasty.

Project description:Mechanically assisted crevice corrosion (MACC), also known as trunnionosis, and adverse local tissue reaction (ALTR) are entities that can lead to pain and necessitate revision in total hip arthroplasty (THA). We present a case of a 75-year-old female who received a bilateral staged primary THA with metal on cross-linked polyethylene implants and had subsequent bilateral revisions for MACC and ALTR. In both instances, she presented with anterior thigh pain, weakness, and difficulty ambulating, and she was revised to ceramic on cross-linked polyethylene implants. This case may suggest a biologic predisposition or systemic immunogenic reaction to metal debris in some patients with ALTR or represent an implant-specific complication. To our knowledge, this is the first case reported of a patient having bilateral MACC from staged THA performed by 2 different surgeons using the same brand implant.

| S-EPMC6123318 | biostudies-literature

Bilateral Mechanically-Assisted Crevice Corrosion Resulting in Femoral Stem-Head Dissociation in Metal-on-Polyethylene Total Hip Arthroplasty.

Project description:There are emerging reports of complications related to corrosion in modular femoral components. We report a unique case describing an 83-year-old man with bilateral mechanically-assisted crevice corrosion in hip replacements performed 10 years previously, by the same surgeon using the same size 3 Accolade TMZF stem and same 44-mm CoCr LFIT V40 head (Stryker Orthopedics, Mahwah NJ). Our patient presented with complete femoral stem-head complex dissociation of his right hip and elevated serum cobalt and chromium levels. He subsequently underwent right hip revision arthroplasty while his contralateral hip is monitored closely as an outpatient. This case helps to define the poorly understood mechanisms and component design factors implicated in this emerging issue. We also hope to provoke discussions about guidelines for monitoring and revising failing metal-on-polyethylene arthroplasty systems.

| S-EPMC7921711 | biostudies-literature

Mechanically assisted crevice corrosion of the head-neck taper in a large head metal-on-metal total hip arthroplasty.

Project description:Taper corrosion of the head-neck junction is a potentially significant and devastating problem facing orthopedic surgeons. We present a case of a 53 year old male who presented for routine follow up for a left, large head, metal on metal total hip arthroplasty five years out. The patient was asymptomatic at the visit. X-rays at the time demonstrated a large amount of medial calcar osteolysis. Serum ion levels revealed a mildly increased cobalt and normal chromium level and hip aspiration revealed brownish fluid. At the time of revision surgery, corrosion of the head-neck taper was found with a normal appearing bearing surface leading to the diagnosis of mechanically assisted crevice corrosion of the head-neck taper with medial calcar osteolysis.

| S-EPMC4958113 | biostudies-literature

Custom titanium sleeve for surgical treatment of mechanically assisted crevice corrosion in the well-fixed, noncontemporary stem in total hip arthroplasty.

Project description:Adverse local tissue reaction associated with total hip replacement may occur when mechanically assisted crevice corrosion occurs at metal-metal modular junctions in which at least one of the components is fabricated from cobalt-chromium alloy. Complete removal of components may be associated with significant morbidity; when components are well fixed and in acceptable position, it may be appropriate to consider modular rather than complete revision. We have diagnosed mechanically assisted crevice corrosion in total hip arthroplasty patients with noncontemporary but well-fixed femoral components and found that modular conversion to a ceramic femoral head to remove a source of CoCr corrosion and fretting products was only possible by having a custom titanium sleeve manufactured. Surgical implantation with a revision style Biolox ceramic head (CeramTec, Plochingen, Germany) was then achieved.

| S-EPMC4958117 | biostudies-literature

Mechanically Assisted Crevice Corrosion in a Metal-on-Polyethylene Total Hip Presenting With Lower Extremity Vascular Compromise.

Project description:Mechanically assisted crevice corrosion in modular total hip replacements may lead to an adverse local tissue reaction (ALTR) with a variety of sequelae. Although an ALTR is most commonly recognized with metal-on-metal modular hip constructs, tribocorrosion at the head-neck junction of metal-on-polyethylene (MoP) total hip arthroplasties may also lead to an ALTR. We present a case of a 79-year-old woman with a history of MoP total hip arthroplasty who presented with unilateral leg swelling, joint pain, and stiffness and subsequently underwent revision for an ALTR secondary to mechanically assisted crevice corrosion. This unique case of lower extremity vascular compromise resulting from an ALTR is important because clinicians should consider corrosion-related ALTRs when treating patients with an MoP hip prosthesis presenting with new-onset lower extremity swelling.

| S-EPMC7327377 | biostudies-literature

Late Hematogenous Total Hip Infection After Revision for Mechanically Assisted Crevice Corrosion With Adverse Local Tissue Reaction.

Project description:Mechanically assisted crevice corrosion (MACC) at the trunnion-bore junction of a total hip arthroplasty may cause adverse local tissue reaction (ALTR) with inflammatory reaction and tissue necrosis. Complications, including acute infection, continued pain, and instability, are therefore common after a revision surgery for MACC. We now present 2 cases of late hematogenous bacterial infection years after revision for MACC and ALTR, a previously unreported outcome in this population. We hypothesize that MACC-induced tissue necrosis does not heal over time, and some patients with metal-on-polyethylene total hip arthroplasty treated for ALTR are at long-term risk of hematogenous bacterial infection.

| S-EPMC9647085 | biostudies-literature

"Off-label" Usage of an Oxidized Zirconium Femoral Head in Revision of a Total Hip Arthroplasty with Mechanically Assisted Crevice Corrosion and a Legacy Taper.

Project description:We present a case of a 72-year-old male with a history of a late 1980s metal-on-polyethylene total hip arthroplasty who presented with unilateral leg vascular compromise, joint pain, and stiffness and subsequently underwent revision for adverse local tissue reaction secondary to mechanically assisted crevice corrosion. His stable and extensively porous coated femoral implant had a legacy taper with no currently manufactured option for a non-Co-alloy femoral head. After shared decision-making with the patient, we opted to use an oxidized zirconium femoral head from another manufacturer with a similar taper during his revision surgery and documented that his vascular compromise resolved and his serum Co was undetectable 3 years after the revision.

| S-EPMC7930501 | biostudies-literature

Impingement Resulting in Femoral Notching and Elevated Metal-Ion Levels After Dual-Mobility Total Hip Arthroplasty.

Project description:A 60-year-old woman underwent revision total hip arthroplasty with a modular dual-mobility articulation for recurrent dislocation. At 1-year follow-up, the patient reported no dislocations but had occasional clicking and discomfort with extreme motion. A Dunn radiograph identified notching of the femoral stem, attributed to impingement. Metal ions were elevated without adverse local-tissue reaction. After 4.5 years of observation, the notch size remained stable. She denied pain. Neither stem fracture nor prosthetic dislocation occurred. Impingement against cobalt-chromium acetabular bearing surfaces can result in notching of titanium femoral components after total hip arthroplasty. Increased anteversion intended to protect against posterior dislocation may be a risk factor. Posterior notching is best visualized on Dunn views, so incidence may be underestimated. No associated femoral implant fractures were identified on literature review.

| S-EPMC7772443 | biostudies-literature

Severe Corrosion of Modular Dual Mobility Acetabular Components Identified During Revision Total Hip Arthroplasty.

Project description:There has been a significant increase in the use of modular dual mobility (MDM) acetabular cups for primary and revision total hip arthroplasty (THA) secondary to decreased dislocation rate and increased impingement-free range of motion. Mating of dissimilar metals in THA can result in mechanically assisted crevice corrosion, with increased serum metal ion levels and potentially adverse local tissue reaction that can lead to revision surgery. In this case report, we present a patient who had THA using MDM components, and his follow-up laboratory testing showed asymptomatic elevated serum cobalt level. The patient subsequently developed an intraprosthetic dislocation that required revision surgery. At the time of revision, significant corrosion was noted on the backside of the modular acetabular liner and the inner surface of the titanium shell. Serum cobalt levels returned to normal after revision surgery. This case suggests that mechanically assisted crevice corrosion at the modular surface of MDM components does occur. In addition, we believe surgeons should judiciously use MDM technology only for patients at significantly increased risk of dislocation after THA.

| S-EPMC8167322 | biostudies-literature

Cobalt cardiomyopathy in hip arthroplasty.

Project description:BackgroundCobalt toxicity-related cardiomyopathy in hip arthroplasty has recently been reported in the literature. The purpose of this review is to identify and assess available published evidence of cardiomyopathy in hip arthroplasty patients and to derive recommendations for management.MethodsWe evaluated 23 cases reported until October 2018 and stratified them into 3 categories, based upon pre-existing risk factors for cardiomyopathy, histological confirmation, and evidence of systemic signs of cobalt toxicity.ResultsCobalt toxicity was considered to be the definite cause of cardiomyopathy in 8 cases, and probably contributory in 13 cases. Two cases were considered to have developed cardiomyopathy secondary to pre-existing risk factors. Majority of the patients had a good recovery of cardiac function after hip revision and cardiac management, but 5 cases deteriorated and died.ConclusionsAlthough cobalt-related cardiomyopathy has been reported in a small number of cases of hip arthroplasty, a delay or missed diagnosis may lead to significant morbidity and mortality. Timely diagnosis, removal of causative implant, and avoidance of metal articulations in revision for fractured ceramic implants may help in an effective management.

| S-EPMC6728440 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data