Acute delayed infection: increased risk in failed metal on metal total hip arthroplasty.

Abstract

Adverse local tissue reactions occurring in metal-on-metal total hip arthroplasty (MoM THA) could potentially lead to secondary failure modes such as dislocation or infection. The authors report a series of 124 patients treated with MoM hip arthroplasty between 2006 and 2010 with a minimum follow-up of 3 years. Eight hips presented with acute delayed or late periprosthetic joint infection (PJI) (defined as an infection occurring after 3 months in an otherwise well functioning implant). The rate of infection observed was higher than expected, almost 4 times higher (5.6%) compared to previous historical cohorts from our institution (1.3%). This high risk of infection in patients with DePuy ASR implants requires further study but we theorize that the increased prevalence of infection could be due to a combination of particulate debris, molecular (rather than particulate) effects of Co and Cr ions on soft tissues, and/or products of corrosion that may change the local environment predisposing to infection.

• Authors: Hernan A Prieto, Elie F Berbari, Rafael J Sierra
• Journal: The Journal of arthroplasty (J Arthroplasty) Vol. 29 Issue 9 Pg. 1808-12 (Sep 2014) ISSN: 1532-8406 [Electronic] United States
• PMID: 24851788 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Chromium
• Cobalt

Topics

• Acute Disease
• Adult
• Aged
• Arthroplasty, Replacement, Hip (adverse effects)
• Chromium (blood)
• Cobalt (blood)
• Corrosion
• Female
• Follow-Up Studies
• Hip Joint (diagnostic imaging, surgery)
• Hip Prosthesis (adverse effects)
• Humans
• Male
• Metal-on-Metal Joint Prostheses (adverse effects)
• Middle Aged
• Prosthesis Failure (etiology)
• Prosthesis-Related Infections (etiology, prevention & control)
• Radiography
• Reoperation
• Retrospective Studies
• Risk Assessment
• Young Adult