Early failure of a Birmingham resurfacing hip replacement with lymphoreticular spread of metal debris:pre-operative diagnosis with MR

Toms, A P, Nolan, J, Barker, T, Darrah, C and Malcolm, P (2009) Early failure of a Birmingham resurfacing hip replacement with lymphoreticular spread of metal debris:pre-operative diagnosis with MR. British Journal of Radiology, 82 (977). e87-91. ISSN 0007-1285

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Abstract

Metal-on-metal hip replacements are the subject of much current debate. There is some evidence that there may be a hypersensitivity reaction, specific to metal-on-metal total hip replacements (THRs), which is associated with early failure of these prostheses. It has to date only been described in total replacements and not in metal-on-metal hip resurfacing. We present the case of a 68-year-old man who underwent bilateral metal-on-metal hip resurfacing for osteoarthrosis. The patient presented 6 months after surgery with pain and lateral thigh swelling. Pre-operative ultrasound and MRI demonstrated findings similar to those described in early failing metal-on-metal THRs, as well as evidence of lymphoreticular spread of metal debris. The operative findings included extensive aseptic soft-tissue necrosis. Histology revealed necrosis and a dense perivascular lymphocytic infiltrate along with metal debris within sinus histiocytes. The surgical, radiological and histological findings are similar to soft-tissue reactions described in metal-on-metal THRs.

Item Type: Article
Uncontrolled Keywords: aged,arthroplasty, replacement, hip,foreign-body migration,hip prosthesis,humans,magnetic resonance imaging,male,metals,osteoarthritis, hip,prosthesis design,prosthesis failure
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 15 Sep 2014 13:40
Last Modified: 21 Apr 2020 23:25
URI: https://ueaeprints.uea.ac.uk/id/eprint/50135
DOI: 10.1259/bjr/32928628

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