Cargando…

A Rare Case of Adverse Reaction to Metal Debris in a Ceramic-on-Ceramic Total Hip Replacement

Adverse Reaction to Metal Debris (ARMD) is one of the most frequent complications after Total Hip Replacement (THR) and often a cause of surgical revision. This is true especially for implants with Metal-on-Metal (MoM) and Large Diameter Heads (LDHs), which are frequently used to improve stability a...

Descripción completa

Detalles Bibliográficos
Autores principales: Cannella, Adriano, Greco, Tommaso, Polichetti, Chiara, De Martino, Ivan, Mascio, Antonio, Maccauro, Giulio, Perisano, Carlo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9501357/
https://www.ncbi.nlm.nih.gov/pubmed/36135580
http://dx.doi.org/10.3390/jfb13030145
_version_ 1784795454630789120
author Cannella, Adriano
Greco, Tommaso
Polichetti, Chiara
De Martino, Ivan
Mascio, Antonio
Maccauro, Giulio
Perisano, Carlo
author_facet Cannella, Adriano
Greco, Tommaso
Polichetti, Chiara
De Martino, Ivan
Mascio, Antonio
Maccauro, Giulio
Perisano, Carlo
author_sort Cannella, Adriano
collection PubMed
description Adverse Reaction to Metal Debris (ARMD) is one of the most frequent complications after Total Hip Replacement (THR) and often a cause of surgical revision. This is true especially for implants with Metal-on-Metal (MoM) and Large Diameter Heads (LDHs), which are frequently used to improve stability and reduce the risk of dislocation. However, ARMD is not exclusive to MoM replacement, as it can also occur in other implants such Ceramic-on-Ceramic (CoC), Metal-on-Polyethylene (MoP), and Ceramic-on-Polyethylene (CoP). In these non-MoM implants, ARMD is not caused by the tribo-corrosion between bearing surfaces but, rather, by the fretting at the interface between neck and stem of dissimilar metals. A case of a severe ARMD that happened to a 73-year-old female patient with CoC bearing THR at the right hip is presented in this case report. In this case, the ARMD was misdiagnosed for over a year, resulting in the development of a massive pseudotumor. The treatment of choice was a two-stage revision with the implant of a hip megaprosthesis. After more than 2 years of follow-up, complete recovery of hip Range of Motion (ROM) and normalization of chromium and cobalt levels in blood and urine were achieved. Despite the relatively short follow-up period, this can be considered a successful treatment of a major and misdiagnosed ARMD in a non-MoM hip replacement.
format Online
Article
Text
id pubmed-9501357
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-95013572022-09-24 A Rare Case of Adverse Reaction to Metal Debris in a Ceramic-on-Ceramic Total Hip Replacement Cannella, Adriano Greco, Tommaso Polichetti, Chiara De Martino, Ivan Mascio, Antonio Maccauro, Giulio Perisano, Carlo J Funct Biomater Case Report Adverse Reaction to Metal Debris (ARMD) is one of the most frequent complications after Total Hip Replacement (THR) and often a cause of surgical revision. This is true especially for implants with Metal-on-Metal (MoM) and Large Diameter Heads (LDHs), which are frequently used to improve stability and reduce the risk of dislocation. However, ARMD is not exclusive to MoM replacement, as it can also occur in other implants such Ceramic-on-Ceramic (CoC), Metal-on-Polyethylene (MoP), and Ceramic-on-Polyethylene (CoP). In these non-MoM implants, ARMD is not caused by the tribo-corrosion between bearing surfaces but, rather, by the fretting at the interface between neck and stem of dissimilar metals. A case of a severe ARMD that happened to a 73-year-old female patient with CoC bearing THR at the right hip is presented in this case report. In this case, the ARMD was misdiagnosed for over a year, resulting in the development of a massive pseudotumor. The treatment of choice was a two-stage revision with the implant of a hip megaprosthesis. After more than 2 years of follow-up, complete recovery of hip Range of Motion (ROM) and normalization of chromium and cobalt levels in blood and urine were achieved. Despite the relatively short follow-up period, this can be considered a successful treatment of a major and misdiagnosed ARMD in a non-MoM hip replacement. MDPI 2022-09-08 /pmc/articles/PMC9501357/ /pubmed/36135580 http://dx.doi.org/10.3390/jfb13030145 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Cannella, Adriano
Greco, Tommaso
Polichetti, Chiara
De Martino, Ivan
Mascio, Antonio
Maccauro, Giulio
Perisano, Carlo
A Rare Case of Adverse Reaction to Metal Debris in a Ceramic-on-Ceramic Total Hip Replacement
title A Rare Case of Adverse Reaction to Metal Debris in a Ceramic-on-Ceramic Total Hip Replacement
title_full A Rare Case of Adverse Reaction to Metal Debris in a Ceramic-on-Ceramic Total Hip Replacement
title_fullStr A Rare Case of Adverse Reaction to Metal Debris in a Ceramic-on-Ceramic Total Hip Replacement
title_full_unstemmed A Rare Case of Adverse Reaction to Metal Debris in a Ceramic-on-Ceramic Total Hip Replacement
title_short A Rare Case of Adverse Reaction to Metal Debris in a Ceramic-on-Ceramic Total Hip Replacement
title_sort rare case of adverse reaction to metal debris in a ceramic-on-ceramic total hip replacement
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9501357/
https://www.ncbi.nlm.nih.gov/pubmed/36135580
http://dx.doi.org/10.3390/jfb13030145
work_keys_str_mv AT cannellaadriano ararecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT grecotommaso ararecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT polichettichiara ararecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT demartinoivan ararecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT mascioantonio ararecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT maccaurogiulio ararecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT perisanocarlo ararecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT cannellaadriano rarecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT grecotommaso rarecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT polichettichiara rarecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT demartinoivan rarecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT mascioantonio rarecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT maccaurogiulio rarecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement
AT perisanocarlo rarecaseofadversereactiontometaldebrisinaceramiconceramictotalhipreplacement