ArticleBMC clinical pathology2016
Histopathological characterization of corrosion product associated adverse local tissue reaction in hip implants: a study of 285 cases.
Article in BMC clinical pathology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 72 citations in OpenAlex.
- Kinetics and Fluid-Specific Behavior of Metal Ions After Hip Replacement.Bioengineering (Basel, Switzerland) · 2025Article
- Research progress on nanotoxicity and detoxification of cobalt in metal-based implants.Annals of medicine · 2025Review
- Long-term survival, radiological, and histomorphological evaluation of hip resurfacing arthroplasty (HemiCAP) in the treatment of femoral head osteonecrosis: An 11-year follow-up case report.International journal of surgery case reports · 2025Article
- [Pathologies of joint endoprostheses : Histopathological diagnostics for endoprosthetic centers].Pathologie (Heidelberg, Germany) · 2025Article
- Adverse local tissue reactions in arthroplasty: opportunities and challenges for a common terminology across scientific, clinical and regulatory fields.EFORT open reviews · 2025Article
- Imaging and speciation of intracellular metallic implant debris using synchrotron-based X-ray fluorescence micro-spectroscopy: a study of two cases.Scientific reports · 2025Article
- Under-reporting by surgical pathologists in tissue removed during revision surgery for metal-on-metal arthroplasties.Annals of medicine and surgery (2012) · 2024Article
- Long-term survivorship of an exchangeable-neck hip prosthesis with a Ti-alloy/Ti-alloy neck-stem junction.Archives of orthopaedic and trauma surgery · 2023Article
- Femoral Nerve Compression due to Adverse Local Tissue Reaction After Ceramic-on-ceramic Total Hip Arthroplasty.Arthroplasty today · 2023Article
- The Progress in Tribocorrosion Research (2010-21): Focused on the Orthopedics and Dental Implants.Journal of bio- and tribo-corrosion · 2023Article
- Combination of cobalt, chromium and titanium nanoparticles increases cytotoxicityJournal of orthopaedic translation · 2023Article
- Roles of inflammatory cell infiltrate in periprosthetic osteolysis.Frontiers in immunology · 2023Review
- Periarticular metal hypersensitivity complications of hip bearings containing cobalt-chromium.EFORT open reviews · 2022Article
- Hip implant modular junction: The role of CoCrMo alloy microstructure on fretting-corrosion.Journal of the mechanical behavior of biomedical materials · 2022Article
- A Rare Case of Adverse Reaction to Metal Debris in a Ceramic-on-Ceramic Total Hip Replacement.Journal of functional biomaterials · 2022Article
- Inflammatory tissue reactions around aseptically loose cemented hip prostheses: A retrieval study of the Spectron EF stem with Reflection All-Poly acetabular cup.Journal of biomedical materials research. Part B, Applied biomaterials · 2022Article
- An Atypical Adverse Local Tissue Reaction After Ceramic-on-Ceramic Primary Total Hip Arthroplasty.Arthroplasty today · 2022Article
- Semi-quantitative histology confirms that the macrophage is the predominant cell type in metal-on-metal hip tissues.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2022Article
- The role of Vitamin E in hip implant-related corrosion and toxicity: Initial outcome.Journal of the mechanical behavior of biomedical materials · 2021Article
- Metal allergy in primary and revision total knee arthroplasty : a scoping review and evidence-based practical approach.Bone & joint open · 2021Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdverse local tissue reaction (ALTR), characterized by a heterogeneous cellular inflammatory infiltrate and the presence of corrosion products in the periprosthetic soft tissues, has been recognized as a mechanism of failure in total hip replacement (THA). Different histological subtypes may have unique needs for longitudinal clinical follow-up and complication rates after revision arthroplasty. The purpose of this study was to describe the histological patterns observed in the periprosthetic tissue of failed THA in three different implant classes due to ALTR and their association with clinical features of implant failure.
methodsConsecutive patients presenting with ALTR from three major hip implant classes (N = 285 cases) were identified from our prospective Osteolysis Tissue Database and Repository. Clinical characteristics including age, sex, BMI, length of implantation, and serum metal ion levels were recorded. Retrieved synovial tissue morphology was graded using light microscopy. Clinical characteristics and features of synovial tissue analysis were compared between the three implant classes. Histological patterns of ALTR identified from our observations and the literature were used to classify each case. The association between implant class and histological patterns was compared.
resultsOur histological analysis demonstrates that ALTR encompasses three main histological patterns: 1) macrophage predominant, 2) mixed lymphocytic and macrophagic with or without features of associated with hypersensitivity/allergy or response to particle toxicity (eosinophils/mast cells and/or lymphocytic germinal centers), and 3) predominant sarcoid-like granulomas. Implant classification was associated with histological pattern of failure, and the macrophagic predominant pattern was more common in implants with metal-on-metal bearing surfaces (MoM HRA and MoM LHTHA groups). Duration of implantation and composition of periprosthetic cellular infiltrates was significantly different amongst the three implant types examined suggesting that histopathological features of ALTR may explain the variability of clinical implant performance in these cases.
conclusionsALTR encompasses a diverse range of histological patterns, which are reflective of both the implant configuration independent of manufacturer and clinical features such as duration of implantation. The macrophagic predominant pattern and its mechanism of implant failure represent an important subgroup of ALTR which could become more prominent with increased length of implantation.
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