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Late Hematogenous Total Hip Infection After Revision for Mechanically Assisted Crevice Corrosion With Adverse Local
Andrew D Lachance1, Patricia B Stogsdill2, Brian J McGrory2,3
1Department of Orthopaedic Surgery, Guthrie Clinic, Sayre, PA, USA.
Arthroplasty Today
|November 17, 2022
Summary
Mechanically assisted crevice corrosion in total hip arthroplasty can lead to tissue damage. This damage may increase the long-term risk of late hematogenous bacterial infection years after revision surgery.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Infectious disease
Background:
- Mechanically assisted crevice corrosion (MACC) at the trunnion-bore junction of total hip arthroplasty (THA) is a known cause of adverse local tissue reaction (ALTR).
- ALTR involves inflammatory reactions and tissue necrosis, often leading to complications like infection, pain, and instability after revision surgery.
Observation:
- Two cases are presented where patients developed late hematogenous bacterial infection years after revision surgery for MACC and ALTR.
- This represents a previously unreported complication in patients with THA treated for MACC and ALTR.
Findings:
- The study hypothesizes that MACC-induced tissue necrosis may not fully heal over time.
- This persistent tissue damage could create a long-term nidus for hematogenous bacterial seeding.
Implications:
- Patients with metal-on-polyethylene THA treated for ALTR may be at an elevated long-term risk of hematogenous bacterial infection.
- This finding suggests the need for long-term monitoring and potentially novel preventative strategies for this patient group.
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