Adverse Local Tissue Reaction Associated With a Modular Hip Hemiarthroplasty
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Clinical Orthopaedics and Related Research® A Publication of The Association of Bone and Joint Surgeons®
CASE REPORT
Adverse Local Tissue Reaction Associated With a Modular Hip Hemiarthroplasty Michael R. Whitehouse PhD, MSc, FRCS (Tr & Orth), Makoto Endo MD, PhD, Bassam A. Masri MD, FRCS(C)
Received: 25 February 2013 / Accepted: 19 June 2013 Ó The Association of Bone and Joint Surgeons1 2013
Abstract Background The local and systemic effects of wear debris and corrosion products remain a concern in arthroplasty and reaction to corrosion or wear products from modular junctions has been reported in primary and revision total joint arthroplasties. These effects have not been reported previously for unipolar hemiarthroplasties where there is no prosthetic bearing surface to contribute to the phenomenon. This may have implications for clinical surveillance and implant design. Case Description We report the case of a 72-year-old man who had symptomatic pseudotumor formation, confirmed by pathologic examination of the excised pseudotumor, with a
large-head modular hip hemiarthroplasty. Metallosis and corrosion of the modular head/neck taper junction were noted at the time of revision surgery. Literature Review To our knowledge, this is the first report of pseudotumor formation where the corrosion or wear products arose from the modular junction of the implant with no bearing couple present to contribute wear debris that may influence the formation of the pseudotumor. Purposes and Clinical Relevance Adverse tissue reactions to wear debris generated at prosthetic articulating surfaces and corrosion and wear products from nonarticulating prosthetic junctions have been reported. The problem has been reported to be higher in metal-on-metal bearing
One of the authors certifies that he (MRW), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount of less than USD 10,000 from the British Orthopaedic Association funded by a commercial entity (Zimmer Inc, Warsaw, IN, USA; traveling fellowship). One of the authors certifies that he (BAM), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount of USD 10,000–USD 100,000 from a commercial entity, Zimmer Inc. The institution of the authors (BAM, MRW) has received funding from Zimmer Inc, DePuy Synthes Canada Ltd, Johnson & Johnson (Canada) Inc (Markham, Ontario, Canada), Stryker Canada (Hamilton, Ontario, Canada), and Bayer Inc (Toronto, Ontario, Canada). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use. Each author certifies that his or her institution approved or waiv
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