Pseudotumors associated with total hip arthroplasty have been associated with metal-on-metal and metal-on-polyethylene total hip arthroplasties due to a granulomatous foreign-body reaction to methyl methacrylate, polyethylene, or metal ion release, but they have not been related to prosthetic joint infections. In this paper, we report an unusual case of Candida albicans total hip arthroplasty i...

This case illustrates the potential for systemic cobalt toxicity in non-metal-on-metal bearings and its potentially devastating consequences. We present a 71-year-old male with grinding sensations in his right hip following ceramic-on-ceramic total hip arthroplasty (THA). After diagnosing a fractured ceramic liner, the hip prosthesis was revised into a metal-on-polyethylene bearing. At one year...

Outcomes of total knee arthroplasties performed with modern all-polyethylene tibial components have been found to be comparable with or better than those of arthroplasties done with metal-backed modular components in numerous mid-to-long-term follow-up studies, radiostereometric analyses, and the few prospective randomized trials available. Advantages of an all-polyethylene tibial component ove...

BACKGROUND Currently, the use of metal-backed tibial components is more common than the use of all-polyethylene components in total knee arthroplasty. However, the available literature indicates that all-polyethylene tibial components are not inferior to the metal-backed design. We hypothesized that there would be no difference in the ten-year survival rate between all-polyethylene and metal-ba...

Metal transfer to femoral heads may result from impingement against the metallic acetabular shell following subluxation/dislocation, or when metallic debris enters the articulation zone. Such transfers roughen the head surface, increasing polyethylene wear in total hip replacements. Presently, we examined the surface roughness of retrieved femoral heads with metallic transfer. Profilometry reve...

Previous research has shown an increase in chromosomal aberrations in patients with worn implants. The type of aberration depended on the type of metal alloy in the prosthesis. We have investigated the metal-specific difference in the level of DNA damage (DNA stand breaks and alkali labile sites) induced by culturing human fibroblasts in synovial fluid retrieved at revision arthroplasty. All si...

Second-generation metal-on-metal (M/M) total hip replacements were introduced into clinical use in the late 1980s and demonstrate equivalent survivorship to conventional metal-on-polyethylene prostheses. Wear rates are comparable to those of first-generation designs that survived for a long time in the body. Biological effects from metal ions remain a concern. Patients with both first- and seco...

Cobalt metallosis after revision metal-on-polyethylene total hip arthroplasty for catastrophic failure of ceramic components is uncommon but a potentially devastating complication. Common findings associated with heavy metal toxicity include cardiomyopathy, hypothyroidism, skin rashes, visual disturbances, hearing changes, polycythemia, weakness, fatigue, cognitive deterioration, and neuropathy...

A prospective randomized study was conducted to determine if a design change in the articular surface geometry introduced in the Optetrak total knee to increase prosthetic joint conformity and further reduce polyethylene stress had any impact on implant survival, particularly when the all-polyethylene version of the implant was used. Forty-seven patients undergoing bilateral simultaneous total ...