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Archive of failed joint replacements provides tips to building a better hip replacement
Date:2/7/2012

e a joint revision surgery at Hospital for Special Surgery, doctors have collected and saved the failed implants for research. At the same time, they have created a web-based system to file information on the implant, such as the manufacturer, and on the patient, such as age, weight and activity level. Doctors at HSS perform roughly 8,000 joint replacement surgeries per year and roughly 10% are revision surgeries, so this database is growing by about 800 specimens per year. Many patients who have had their joint replacement surgeries elsewhere come to Special Surgery to have revision surgery.

In the current study, HSS researchers, who did not have any ties to hip implant manufacturers, examined 46 retrieved metal-on-metal total hip replacements from 44 patients. The most common revision diagnoses were wear-related clinical concerns including osteolysis and adverse soft tissue reactions (16), loosening (11), instability (8) and infection (5). The researchers used scanning electron microscopy to determine the ways the hips were damaged, called damage modes. They found that 98 percent of the cups of the implant and 93 percent of the heads showed moderate to severe scratching. Moderate to severe pitting was found in 43 percent of the cups and 67 percent of the heads. They identified areas near the cups and heads that had completely lost their sheen.

"This study represents one of the largest collections of retrieved metal-on-metal implants," said Douglas Padgett, M.D., chief of the Adult Reconstruction and Joint Replacement Division and chief of the Hip Service at Hospital for Special Surgery. "There appears to be unique damage patterns which to date have not been identified. A follow-on analysis using high resolution laser profiling to quantify damage is in process which may yield further clues."

The patterns and similarities of the damage modes will shed light on the mechanisms behind the damage. "The goal with these hard metal-on-metal bea
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Contact: Phyllis Fisher
phyllis.fisher@gmail.com
212-606-1724
Hospital for Special Surgery
Source:Eurekalert

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