Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris Accumulation
The majority of contemporary total hip arthroplasty (THA) implants are constructed from Ti alloys, which are generally believed to generate fewer adverse local tissue reactions (ALTRs) compared to CoCr alloys. This study presents a case of unusual primary THA failure where a substantial release of T...
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MDPI AG
2024-02-01
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| Series: | Bioengineering |
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| Online Access: | https://www.mdpi.com/2306-5354/11/3/235 |
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| author | Samo K. Fokter Živa Ledinek Milka Kljaić Dujić Igor Novak |
| author_facet | Samo K. Fokter Živa Ledinek Milka Kljaić Dujić Igor Novak |
| author_sort | Samo K. Fokter |
| collection | DOAJ |
| description | The majority of contemporary total hip arthroplasty (THA) implants are constructed from Ti alloys, which are generally believed to generate fewer adverse local tissue reactions (ALTRs) compared to CoCr alloys. This study presents a case of unusual primary THA failure where a substantial release of Ti alloy debris was observed. A 52-year-old active male underwent THA after post-traumatic aseptic necrosis of the femoral head in 2006. Seventeen years after the procedure, the patient presented with groin pain and a restricted range of motion. X-rays revealed the protrusion of the alumina ceramic head through the Ti<sub>6</sub>Al<sub>4</sub>V acetabular cup. Trace element analysis indicated significantly elevated levels of serum Ti, Al, and V. CT and MRI confirmed Ti alloy cup failure and a severe ALTR. During revision surgery, it was found that the worn-out ceramic head was in direct contact with the acetabular cup, having protruded through a central hole it had created over time. No acetabular liner was found. Histological analysis of his tissue samples showed wear-induced synovitis with areas of multinucleated foreign body giant cells and the accumulation of numerous metal particles but no acute inflammatory response. Six months after the revision THA, the patient has experienced favourable outcomes. This case provides an instructive illustration for studying the consequences of the substantial release of Ti alloy debris from orthopedic implants. |
| first_indexed | 2024-04-24T18:32:02Z |
| format | Article |
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| issn | 2306-5354 |
| language | English |
| last_indexed | 2024-04-24T18:32:02Z |
| publishDate | 2024-02-01 |
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| record_format | Article |
| series | Bioengineering |
| spelling | doaj.art-26c3f3e2b6f94ada9da6d1388d7e77b82024-03-27T13:21:50ZengMDPI AGBioengineering2306-53542024-02-0111323510.3390/bioengineering11030235Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris AccumulationSamo K. Fokter0Živa Ledinek1Milka Kljaić Dujić2Igor Novak3Clinical Department of Orthopedic Surgery, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, SloveniaDepartment of Pathology, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, SloveniaDepartment of Radiology, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, SloveniaClinical Department of Orthopedic Surgery, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, SloveniaThe majority of contemporary total hip arthroplasty (THA) implants are constructed from Ti alloys, which are generally believed to generate fewer adverse local tissue reactions (ALTRs) compared to CoCr alloys. This study presents a case of unusual primary THA failure where a substantial release of Ti alloy debris was observed. A 52-year-old active male underwent THA after post-traumatic aseptic necrosis of the femoral head in 2006. Seventeen years after the procedure, the patient presented with groin pain and a restricted range of motion. X-rays revealed the protrusion of the alumina ceramic head through the Ti<sub>6</sub>Al<sub>4</sub>V acetabular cup. Trace element analysis indicated significantly elevated levels of serum Ti, Al, and V. CT and MRI confirmed Ti alloy cup failure and a severe ALTR. During revision surgery, it was found that the worn-out ceramic head was in direct contact with the acetabular cup, having protruded through a central hole it had created over time. No acetabular liner was found. Histological analysis of his tissue samples showed wear-induced synovitis with areas of multinucleated foreign body giant cells and the accumulation of numerous metal particles but no acute inflammatory response. Six months after the revision THA, the patient has experienced favourable outcomes. This case provides an instructive illustration for studying the consequences of the substantial release of Ti alloy debris from orthopedic implants.https://www.mdpi.com/2306-5354/11/3/235total hip arthroplastytitanium alloyorthopedic implantsimplant failureadverse local tissue reactions |
| spellingShingle | Samo K. Fokter Živa Ledinek Milka Kljaić Dujić Igor Novak Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris Accumulation Bioengineering total hip arthroplasty titanium alloy orthopedic implants implant failure adverse local tissue reactions |
| title | Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris Accumulation |
| title_full | Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris Accumulation |
| title_fullStr | Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris Accumulation |
| title_full_unstemmed | Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris Accumulation |
| title_short | Extreme Serum Titanium Concentration Induced by Acetabular Cup Failure: Unveiling a Unique Scenario of Titanium Alloy Debris Accumulation |
| title_sort | extreme serum titanium concentration induced by acetabular cup failure unveiling a unique scenario of titanium alloy debris accumulation |
| topic | total hip arthroplasty titanium alloy orthopedic implants implant failure adverse local tissue reactions |
| url | https://www.mdpi.com/2306-5354/11/3/235 |
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