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Histologic, Serologic, and Tribologic Findings in Failed Metal-on-Metal Total Hip Arthroplasty by Christopher E. Pelt, Jill Erickson, Ian Clarke, Thomas.

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Presentation on theme: "Histologic, Serologic, and Tribologic Findings in Failed Metal-on-Metal Total Hip Arthroplasty by Christopher E. Pelt, Jill Erickson, Ian Clarke, Thomas."— Presentation transcript:

1 Histologic, Serologic, and Tribologic Findings in Failed Metal-on-Metal Total Hip Arthroplasty by Christopher E. Pelt, Jill Erickson, Ian Clarke, Thomas Donaldson, Lester Layfield, and Christopher L. Peters J Bone Joint Surg Am Volume 95(21):e163 November 6, 2013 ©2013 by The Journal of Bone and Joint Surgery, Inc.

2 Intraoperative photograph showing metallosis. Christopher E. Pelt et al. J Bone Joint Surg Am 2013;95:e163 ©2013 by The Journal of Bone and Joint Surgery, Inc.

3 An example of wear mapping performed at DARF, showing the anterior (Fig. 2-A), medial (Fig. 2- B), posterior (Fig. 2-C), superior (Fig. 2-D), and semi-polar (Fig. 2-E) hemispheres. Christopher E. Pelt et al. J Bone Joint Surg Am 2013;95:e163 ©2013 by The Journal of Bone and Joint Surgery, Inc.

4 An example of a ball that was revised after multiple dislocations. Christopher E. Pelt et al. J Bone Joint Surg Am 2013;95:e163 ©2013 by The Journal of Bone and Joint Surgery, Inc.

5 The main wear zone (MWZ) in a 46-mm metal-on-metal (MOM) design differs from that in a 38- mm MOM design in terms of location and size, with stripe wear in the 38-mm design. Christopher E. Pelt et al. J Bone Joint Surg Am 2013;95:e163 ©2013 by The Journal of Bone and Joint Surgery, Inc.

6 Typical views of a ball with evidence of crossing polar stripes. Christopher E. Pelt et al. J Bone Joint Surg Am 2013;95:e163 ©2013 by The Journal of Bone and Joint Surgery, Inc.

7 An example of a cup aligned with polar stripe #2 in Figure 5; that stripe is therefore not seen in this image. Christopher E. Pelt et al. J Bone Joint Surg Am 2013;95:e163 ©2013 by The Journal of Bone and Joint Surgery, Inc.

8 Serum metal ion levels in the two groups defined on the basis of the intraoperative finding of the presence or absence of metallosis. Christopher E. Pelt et al. J Bone Joint Surg Am 2013;95:e163 ©2013 by The Journal of Bone and Joint Surgery, Inc.

9 Serum metal ion levels in the two groups defined on the basis of a high (2 to 3+) or low (0 to 1+) metal load score. Christopher E. Pelt et al. J Bone Joint Surg Am 2013;95:e163 ©2013 by The Journal of Bone and Joint Surgery, Inc.

10 Figs. 9-A, 9-B, and 9-C Representative photographs of the various histologic presentations (hematoxylin and eosin; ×125, ×40, and ×125, respectively). Christopher E. Pelt et al. J Bone Joint Surg Am 2013;95:e163 ©2013 by The Journal of Bone and Joint Surgery, Inc.

11 A treatment algorithm that can be a starting point for the diagnostic workup and treatment of a patient with a problematic metal-on-metal arthroplasty. Christopher E. Pelt et al. J Bone Joint Surg Am 2013;95:e163 ©2013 by The Journal of Bone and Joint Surgery, Inc.


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