Monday, November 28, 2011

Preliminary observations on possible premalignant changes in bone marrow adjacent to worn total hip arthroplasty implants

I must have missed this journal article in my past research. Thought it was worth publishing. 
Clin Orthop Relat Res. 1996 Aug;(329 Suppl):S269-79.

Case CP, Langkamer VG, Howell RT, Webb J, Standen G, Palmer M, Kemp A, Learmonth ID.


Department of Histopathology, University of Bristol, United Kingdom.


Previous epidemiologic studies have suggested that there may be a risk of malignancy, especially lymphoma and leukemia, after joint replacement, but the followup has been relatively short. This is a preliminary study to see if there is any biologic basis for such a risk. Blood and bone marrow samples from 71 patients at revision arthroplasty of a loose or worn prosthesis and 30 control patients at primary arthroplasty were analyzed with cytogenetic techniques and molecular biology. There was a higher chromosomal aberration rate in cells adjacent to the prosthesis at revision surgery compared with iliac crest marrow from the same patients or with femoral bone marrow at primary arthroplasty. Clonal expansion of lymphocytes without a serum paraprotein was seen in 2 of 21 patients at revision arthroplasty performed more than 10 years after primary arthroplasty. The results of this preliminary study suggest that future epidemiologic studies should concentrate on patients with longer postoperative intervals to see if there is any risk that would be pertinent to a young patient at primary arthroplasty.

[note that they are using cytogenic techniques here...likely the FISH techniques I spoke about in the FISH series.   see this post series of 6 articles. this is the first in the series but you can just follow them through:  My investigation will be complete by mid December on these tests, where to get them and what the benefits and downsides are of the tests.

The other thing that is important in this article is note that  it was written in 1996.  Can you guess how much work has been done on investigating the long term systemic effects of these chemicals on our body?  Guess? 

Do you See how important funding  studies are in any legal settlement?  While money might be important for some, a couple of hundred thousand dollars isn't  gonna do any good if you have some long term systemic disease like cancer to deal with.  Funding these studies is very important.  It is critical that they get funded now.]

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