Sunday, December 4, 2011

New Study published on the Corail Pinnalce-First study to report wear rates of these hips post explant

This is an important paper especially for the pinnacle patients.  It is the first study to report ware rates of the Pinnacles ex vivo (after explant.)  It is also one of the first studies to report on Taper ware being a critical factor contributing  to the developments of adverse reactions following the MoM Total hip  replacement.  "TAPER DAMAGE SHOULD BE CONSIDERED AS ANOTHER POTENTIAL SOURCE OF METALLIC DEBRIS ALONGSIDE THAT WHICH MAY ORIGINATE FROM  THE ARTICULATING SURFACES." 

http://research.ncl.ac.uk/metalhip/resources/Analysis%20of%20failed%20ex%20vivo%2036mm%20metal%20on%20metal%20pinnacle%20hips.pdf

I should mention that this was a poster presentation by the bioengineering group at NewCastle University in England.  One of the primary researchers was David Langton who is a PhD canditate in Bio medical engineering and is studying soley the Depuy ASRs as I understand it. 

The implication of this presentation.  Many believe the major and only issue involved with the cause of the MoM wear debris (flaking metals into the blood stream) is the grinding of the head against the cup.  This study is saying something totally different.  This is saying that another cause may be the taper  (stem connected to the ball) is yet another cause of the metal flaking.

Now this is all interesting because right before my surgery, I brought this topic up with my surgeon.   I specifically asked him about my MRI as it showed  there was "minimal femoral osteolysis in the posterior margin of the gruen zone 1." (top outer portion of the femur.)  This is exactly what this study is suggesting.  I recall showing him the study which was published in 2011 "Influence of material coupling and assembly condition on the magnitude of Micromotion at the stem-neck interface of a modular hip endoprosthesis."

While it didn't occur to me at the time,  the last line of the abstract noted: "titanium neck adapters with titanium stems should generally be used with caution."  My surgery used a titanium cup.  I have no clue whther the titanium cup is an issue.

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