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dc.contributor.authorWu, Dongmei
dc.contributor.authorBhalekar, Rohan M.
dc.contributor.authorMarsh, Jordan S.
dc.contributor.authorLangton, David J.
dc.contributor.authorStewart, Alan J.
dc.identifier.citationWu , D , Bhalekar , R M , Marsh , J S , Langton , D J & Stewart , A J 2022 , ' Periarticular metal hypersensitivity complications of hip bearings containing cobalt-chromium ' , EFORT Open Reviews , vol. 7 , no. 11 , pp. 758-771 .
dc.identifier.otherPURE: 282185501
dc.identifier.otherPURE UUID: 0d455786-962e-451e-8707-4250ae714b99
dc.identifier.otherScopus: 85144964337
dc.identifier.otherWOS: 000896786900003
dc.descriptionFunding: The authors gratefully acknowledge the China Scholarship Council for funding a PhD scholarship for DW.en
dc.description.abstract• Hip bearings composed of cobalt-chromium alloy (metal-on-metal bearings) have been one of the most widely used in joint replacement arthroplasty. Unfortunately, these implants can contribute to a complication called aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL); a type IV metal hypersensitivity response around the joint. • Consistently with such bearings, increased metal debris can be found in the surrounding fluids and in remote tissues and organs, due to wear and corrosion. It is hypothesised that metal ions released from the prosthesis (including Co2+) can potentially form haptens with proteins such as serum albumin in synovial fluid that in turn, elicit ALVAL. • Generally, elevated cobalt and chromium levels in synovial fluids may indicate implant failure. However, such measurements cannot be used as a reliable tool to predict the onset of ALVAL. To detect ALVAL, some diagnostic tests, questionnaires and imaging techniques have been used clinically with some success, but a standardised approach is lacking. • At present, guidelines for implant usage and patient management are ambiguous and inconsistent across healthcare authorities. To reduce and better manage the development of ALVAL, further research into the precise molecular mechanism(s) by which ALVAL develops is urgently needed. • Identification of diagnostic and prognostic biomarkers for ALVAL are required, as are more standardised guidelines for surgery and patient management.
dc.relation.ispartofEFORT Open Reviewsen
dc.rightsCopyright: © The authors 2022. Open Access. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.en
dc.subjectMetal-on-metal implanten
dc.subjectMetal ion releaseen
dc.subjectHip replacementen
dc.subjectQR180 Immunologyen
dc.titlePeriarticular metal hypersensitivity complications of hip bearings containing cobalt-chromiumen
dc.typeJournal itemen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. Cellular Medicine Divisionen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Sir James Mackenzie Institute for Early Diagnosisen
dc.contributor.institutionUniversity of St Andrews. Biomedical Sciences Research Complexen
dc.contributor.institutionUniversity of St Andrews. Institute of Behavioural and Neural Sciencesen
dc.description.statusPeer revieweden

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