dc.contributor.author
Bäcker, Henrik Constantin
dc.contributor.author
Wu, Chia H.
dc.contributor.author
Krüger, David
dc.contributor.author
Gwinner, Clemens
dc.contributor.author
Perka, Carsten
dc.contributor.author
Hardt, Sebastian
dc.date.accessioned
2020-12-07T13:05:07Z
dc.date.available
2020-12-07T13:05:07Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/28809
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-28558
dc.description.abstract
Introduction: The effect of different bearings on synovial white blood cell (WBC) count and polymorphonuclear percentage (PMN%) in aspirations remains unclear. Therefore, this study investigates the impact of aseptic Metal-on-Metal (MoM) bearing on synovial fluid.
Methods: We searched our arthroplasty registry for aseptic painful THAs with MoM bearings between 2011 and 2018. Then, a case-matched control group was selected with septic and aseptic Total Hip Arthroplasty (THA) with ceramic on a polyethylene (PE) bearing. The matching criteria consisted of gender, age +/-10 years, and time of aspiration (+/-2years). Periprosthetic Joint Infection (PJI) was defined according to the Infectious Diseases Society of America (IDSA), and Musculoskeletal Infection Society (MSIS) using bacterial cultures, sonication and histology.
Results: In total, 19 patients who underwent hip aspiration with MoM bearing were identified. Five patients had to be excluded due to insufficient synovial fluid obtained (n = 2) or bacterial growth after sonication that was initially negative with the standard microbiological cultures (n = 3). As such, 14 were included. These patients were matched with 14 aseptic and 14 septic THAs with ceramic on a PE bearing, which constituted the control group. The mean serum chrome level was 20.0 ± 15.5 nmol/L and cobalt level 18.4 ± 22.1 nmol/L. The synovial WBC and PMN% varied significantly between MoM bearing group and the aseptic THA ceramic PE group (both p < 0.001), as well as the septic THA group (WBC p = 0.016, PMN% p < 0.001). Furthermore, the septic THA group had significantly higher CRP values than the aseptic MoM group (p = 0.016).
Conclusion: MoM bearing shows significantly higher synovial WBC and PMN% when compared to aseptic THA with ceramic on PE bearing above the MSIS cut-off. This is an important consideration when diagnosing periprosthetic joint infection using the MSIS guidelines.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
metal on metal
en
dc.subject
total hip arthroplasty
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Metal on Metal Bearing in Total Hip Arthroplasty and its Impact on Synovial Cell Count
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
3349
dcterms.bibliographicCitation.doi
10.3390/jcm9103349
dcterms.bibliographicCitation.journaltitle
Journal of Clinical Medicine
dcterms.bibliographicCitation.number
10
dcterms.bibliographicCitation.originalpublishername
MDPI AG
dcterms.bibliographicCitation.volume
9
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
33081071
dcterms.isPartOf.eissn
2077-0383