Metallic debris from metal-on-metal total hip arthroplasty regulates periprosthetic tissues  

作　　者：Christoph H Lohmann Gurpal Singh Hans-Georg Willert Gottfried H Buchhorn 

机构地区：[1]Department of Orthopaedic Surgery, Otto-von-Guericke University [2]University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Health System [3]Department of Orthopaedics, University Hospital Goettingen

出　　处：《World Journal of Orthopedics》2014年第5期660-666,共7页世界骨科杂志（英文版）

摘　　要：The era of metal-on-metal(MoM) total hip arthroplasty has left the orthopaedic community with valuable insights and lessons on periprosthetic tissue reactions to metallic debris. Various terms have been used to describe the tissue reactions. Sometimes the nomenclature can be confusing. We present a review of the concepts introduced by Willert and Semlitsch in 1977,along with further developments made in the understanding of periprosthetic tissue reactions to metallic debris. We propose that periprosthetic tissue reactions be thought of as(1) gross(metallosis, necrosis, cyst formation and pseudotumour);(2) histological(macrophage-dominated, lymphocyte-dominated or mixed);and(3) molecular(expression of inflammatory mediators and cytokines such as interleukin-6 and tumor necrosis factor-alpha). Taper corrosion and modularity are discussed, along with future research directions to elucidate the antigen-presenting pathways and materi-al-specific biomarkers which may allow early detection and intervention in a patient with adverse periprosthetic tissue reactions to metal wear debris.The era of metal-on-metal(MoM) total hip arthroplasty has left the orthopaedic community with valuable insights and lessons on periprosthetic tissue reactions to metallic debris. Various terms have been used to describe the tissue reactions. Sometimes the nomenclature can be confusing. We present a review of the concepts introduced by Willert and Semlitsch in 1977,along with further developments made in the understanding of periprosthetic tissue reactions to metallic debris. We propose that periprosthetic tissue reactions be thought of as(1) gross(metallosis, necrosis, cyst formation and pseudotumour);(2) histological(macrophage-dominated, lymphocyte-dominated or mixed);and(3) molecular(expression of inflammatory mediators and cytokines such as interleukin-6 and tumor necrosis factor-alpha). Taper corrosion and modularity are discussed, along with future research directions to elucidate the antigen-presenting pathways and materi-al-specific biomarkers which may allow early detection and intervention in a patient with adverse periprosthetic tissue reactions to metal wear debris.

关 键 词：PERIPROSTHETIC tissue response METAL-ON-METAL Total hip ARTHROPLASTY Metal DEBRIS Lymphocytedominated Macrophage-dominated TAPER corrosion MODULARITY 

分 类 号：R687.4[医药卫生—骨科学]