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Aseptic Loosening Forces Revised Metal Hip Surgeries

Findings suggest adverse reaction to metal wear debris

THURSDAY, June 22 (HealthDay News) -- Aseptic loosening is the primary reason for revisions of Sikomet metal-on-metal total hip replacement surgeries less than a decade after the procedures, according to a pair of reports in the June issue of the Journal of Bone and Joint Surgery.

Ingrid Milosev, Ph.D., of the Orthopaedic Hospital Valdoltra in Ankaran, Slovenia, and colleagues found 34 out of 640 total hip replacements were revised 7.1 years later, 23 for aseptic loosening.

"Aseptic loosening was the major reason for failure of Sikomet metal-on-metal prostheses," the authors write, suggesting "the possibility of a hypersensitivity-like immunological response to wear particles."

In a second study, Panagiotis Korovessis, M.D., Ph.D., of the General Hospital "Agios Andreas" in Patras, Greece, and colleagues found 14 of 217 hip arthroplasties revised, nine due to aseptic loosening. These findings suggest "that periprosthetic osteolysis and aseptic loosening in hips with a metal-on-metal articulation are possibly associated with hypersensitivity to metal debris," the authors write.

In an editorial, Joshua J. Jacobs, M.D., and Nadim J. Hallab, Ph.D., of Rush University Medical Center in Chicago, write that "these studies demonstrate that contemporary alternative bearing surfaces are not a panacea."

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