Sunday, May 29, 2011

Surprising statement from older (2004) Journal Article

I was reading some journal articles from 2004 and found something suprising.  There are risks to replacement surgery but had not heard this risk highlighted in the abstract below:
 
While all components can be associated with the distant spread of particles and metal ions, it is the environment of revision arthroplasty that provides the greatest potential for the generation and systemic dissemination of wear debris.
 
 
J Arthroplasty. 2004 Dec;19(8 Suppl 3):94-101.

Accumulation in liver and spleen of metal particles generated at nonbearing surfaces in hip arthroplasty.

Source

Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois 60612, USA.

Abstract

Systemic migration of metal particles generated at nonbearing surfaces rather than the intended primary bearing was studied in postmortem specimens from 30 patients with total hip arthroplasty. Using light and electron microscopy with x-ray microanalysis, submicrometer metal particles were identified within macrophages in the liver and/or the spleen in 11 of 15 patients with a revised arthroplasty and in 2 of 15 patients with primary hip arthroplasty. The macrophages formed focal aggregates in the organs without apparent toxicity. Fretting at ancillary fixation devices, loose components, and modular connections can generate a substantial volume of debris. These particles are in addition to those generated at the bearing surfaces, further increasing both the local and systemic particulate burdens. While all components can be associated with the distant spread of particles and metal ions, it is the environment of revision arthroplasty that provides the greatest potential for the generation and systemic dissemination of wear debris. The long-term effects of accumulated wear particles in the liver and spleen are unknown.

No comments:

Post a Comment