2011 Perivascular and diffuse lymphocytic inflammation are not specific for failed metal-on-metal hip implants CORR Open Access

Description: Background Several studies suggest that histologic findings from tissues obtained at revision arthroplasty for failed metal-on-metal (MOM) total hip implants may reflect an immune reaction to particles or ions in some patients. However, only a limited number of cases without MOM implants were reported as controls in those studies.
Questions/purposes The purpose of this study is to better define the extent and distribution of morphologic features attributed to an immune reaction in tissues sampled at revision surgery for failed nonMOM THA.
Conclusions Mild lymphocytic inflammation, diffuse and especially perivascular, is common in tissues around failed nonMOM implants. Although extensive inflammation in an inflammatory pseudotumor pattern is rare, it does occur in some cases of failed metal-polyethylene hip arthroplasties. The importance of inflammation is unknown, but the extent of diffuse inflammation shows a positive correlation with metal debris, so it could reflect a reaction to particles or ions in some patients.
Perivascular and diffuse lymphocytic inflammation are not specific for failed metal-on-metal hip implants. Fujishiro T, Moojen DJ, Kobayashi N, Dhert WJ, Bauer TW. Clin Orthop Relat Res. 2011 Apr;469(4):1127-33. (full text)