Failure of Total Hip Clinical Trial
Official title:
Acetabular Bone Vascularity in Metal-on-Metal Revisions
The purpose of this study is to determine if avascular necrosis of the acetabulum is present
in metal-on-metal revisions and to what depth this dead avascular bone occurs.
A convenient sample of a consecutive series of 15 patients treated for metal on metal
acetabular revision surgery will be included.
Patients being treated for metal on metal acetabular revision surgery by a physician at
OrthoCarolina, PA will be screened for eligibility. These patients will be approached by
their surgeon and asked to volunteer their participation in the study. Potential subjects
will meet with a research coordinator to discuss details of the study and those you
volunteer participation will be asked to sign an informed consent prior to the collection of
study data. . Basic demographic information (initials, age, gender, height, weight, BMI),
dates of original index surgery, reason for revision, type of implant being removed, and
standard of care cobalt and chromium metal ion levels will be collected via chart review.
Patients who meet all eligibility criteria will have three biopsies performed at the time of
their revision surgery. A pathologist will note the presence or absence of bone necrosis and
will measure the length (mm) of necrosis, acute inflammation, chronic inflammation, normal
bone, and entire bone specimen in order to obtain a ratio.
Biopsy Protocol:
A bone biopsy is a procedure in which bone samples are removed (with a special instrument
during surgery) and looked at under a microscope for necrosis (tissue death), infection, or
other bone disorders. Once the acetabular hip replacement implants have been removed the
following steps will occur:
- The biopsy needle will be inserted into the bone (3 locations; 2 from ilium, 1 from
pubis or ischium = 3 total).
- The biopsy needle will be withdrawn and firm pressure will be applied to the biopsy
site for a few minutes, until the bleeding has stopped.
- Each bone biopsy sample will be labeled sequentially and by anatomic location (i.e.,
ilium #1, ilium #2)
- The normal bone will be marked on the bone sample.
- The bone biopsy sample will be sent to the lab for examination.
- The acetabulum bone will be reamed so the new implant can be seated.
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Observational Model: Cohort, Time Perspective: Prospective