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The pathology of failed McKee-Farrar implants: correlation with modern metal-on-metal-implant failure
ABSTRACT: The McKee-Farrar (MF) prosthesis was the first widely used total hip replacement (THR) to employ a metal-on-metal (MoM) articulation. These implants had a high rate of early aseptic loosening but a number achieved good long-term implant survival, stimulating the reintroduction of second an...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5362663/ https://www.ncbi.nlm.nih.gov/pubmed/28332156 http://dx.doi.org/10.1007/s10856-017-5882-y |
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author | Munemoto, Mitsuru Grammatopoulos, George Tanaka, Yasuhito Gibbons, Max Athanasou, Nicholas A. |
author_facet | Munemoto, Mitsuru Grammatopoulos, George Tanaka, Yasuhito Gibbons, Max Athanasou, Nicholas A. |
author_sort | Munemoto, Mitsuru |
collection | PubMed |
description | ABSTRACT: The McKee-Farrar (MF) prosthesis was the first widely used total hip replacement (THR) to employ a metal-on-metal (MoM) articulation. These implants had a high rate of early aseptic loosening but a number achieved good long-term implant survival, stimulating the reintroduction of second and third generation implants of this type. In this study we analysed archival histopathology of periprosthetic tissues in twenty cases of MF aseptic implant failure to determine if there was evidence of an innate and adaptive immune response similar to that seen in modern MoM implants. The presence of macrophages, the extent of necrosis and the ALVAL response were graded semi-quantitatively. Variable but in most cases extensive tissue necrosis was associated with a heavy macrophage response to Cobalt-Chrome (Co-Cr) wear particles in periprosthetic tissues; most cases also contained evidence of a predominantly lymphocyte response which in eight cases was moderate or heavy (Oxford Grade 2/3). Our findings show that inflammatory and necrotic changes to deposition of Co-Cr wear particles are found in periprosthetic tissues of failed MF implants, indicating that there is an innate and adaptive response similar to that noted in second/third generation MoM implants; they also suggest that the pathobiological response to metal wear particles is likely to have contributed to MF implant failure in these cases. GRAPHICAL ABSTRACT: [Image: see text] |
format | Online Article Text |
id | pubmed-5362663 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-53626632017-04-04 The pathology of failed McKee-Farrar implants: correlation with modern metal-on-metal-implant failure Munemoto, Mitsuru Grammatopoulos, George Tanaka, Yasuhito Gibbons, Max Athanasou, Nicholas A. J Mater Sci Mater Med Biomaterial-Tissue Interaction in Humans ABSTRACT: The McKee-Farrar (MF) prosthesis was the first widely used total hip replacement (THR) to employ a metal-on-metal (MoM) articulation. These implants had a high rate of early aseptic loosening but a number achieved good long-term implant survival, stimulating the reintroduction of second and third generation implants of this type. In this study we analysed archival histopathology of periprosthetic tissues in twenty cases of MF aseptic implant failure to determine if there was evidence of an innate and adaptive immune response similar to that seen in modern MoM implants. The presence of macrophages, the extent of necrosis and the ALVAL response were graded semi-quantitatively. Variable but in most cases extensive tissue necrosis was associated with a heavy macrophage response to Cobalt-Chrome (Co-Cr) wear particles in periprosthetic tissues; most cases also contained evidence of a predominantly lymphocyte response which in eight cases was moderate or heavy (Oxford Grade 2/3). Our findings show that inflammatory and necrotic changes to deposition of Co-Cr wear particles are found in periprosthetic tissues of failed MF implants, indicating that there is an innate and adaptive response similar to that noted in second/third generation MoM implants; they also suggest that the pathobiological response to metal wear particles is likely to have contributed to MF implant failure in these cases. GRAPHICAL ABSTRACT: [Image: see text] Springer US 2017-03-22 2017 /pmc/articles/PMC5362663/ /pubmed/28332156 http://dx.doi.org/10.1007/s10856-017-5882-y Text en © The Author(s) 2017 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Biomaterial-Tissue Interaction in Humans Munemoto, Mitsuru Grammatopoulos, George Tanaka, Yasuhito Gibbons, Max Athanasou, Nicholas A. The pathology of failed McKee-Farrar implants: correlation with modern metal-on-metal-implant failure |
title | The pathology of failed McKee-Farrar implants: correlation with modern metal-on-metal-implant failure |
title_full | The pathology of failed McKee-Farrar implants: correlation with modern metal-on-metal-implant failure |
title_fullStr | The pathology of failed McKee-Farrar implants: correlation with modern metal-on-metal-implant failure |
title_full_unstemmed | The pathology of failed McKee-Farrar implants: correlation with modern metal-on-metal-implant failure |
title_short | The pathology of failed McKee-Farrar implants: correlation with modern metal-on-metal-implant failure |
title_sort | pathology of failed mckee-farrar implants: correlation with modern metal-on-metal-implant failure |
topic | Biomaterial-Tissue Interaction in Humans |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5362663/ https://www.ncbi.nlm.nih.gov/pubmed/28332156 http://dx.doi.org/10.1007/s10856-017-5882-y |
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