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the modular neck–head junction. For the purposes of this review, ARMD encompasses other terms found in the literature such as ‘metallosis’, pseudotumour, adverse local tissue reaction (ALTR), and aseptic lymphocyte-dominated vasculitis
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lymphocytic-dominated vasculitis associated lesion (ALVAL), 20 later expanded to adverse local tissue reactions (ALTR) 21 and adverse reactions to metal debris (ARMD) 22 associated with metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) and
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reaction (ALTR) in 85 (38%) cases, aseptic loosening of the stem or acetabular component in 28 (13.86%) cases, acute or chronic dislocations in 31 (15.35%) cases, periprosthetic fractures in 21 (1.4%) cases, deep infections in 10 (4.95%) cases, three
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local tissue reactions (ALTR) in cases where it is important to collectively classify and describe a cohort of adverse reactions associated with artificial CoCr implants, including when vasculitis is absent and/or adverse reactions to metal debris (ARMD
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-infective lesions situated in various locations in the peri-prosthetic tissue. 31 , 32 A pseudotumour is referred to more specifically as an adverse reaction to metal debris (ARMD), and more generally as an adverse local tissue reaction (ALTR). The term
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden
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Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden
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Swedish Hip Arthroplasty Register, Gothenburg, Sweden
Department of Orthopaedics, Prince Philip Hospital, HDUHB, Wales
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Finnish Arthroplasty Register, Helsinki, Finland
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Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
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Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden
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MoXLPE THA. 42 , 44 , 45 This phenomenon has been correlated to groin pain, adverse local tissue reaction (ALTR), THA instability secondary to erosion of joint capsule and abductor musculature 26 , 42 and femoral head-neck dissociation. 46
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reported. 68 , 69 In addition, large metal heads have raised concerns regarding the potential adverse local tissue reactions (ALTR) secondary to corrosion and metal release at the head-neck taper junction. 70 Increasing the head size generates
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. 35 Plummer DR , Berger RA , Paprosky WG , et al. . Diagnosis and management of ALTR secondary to corrosion at the head-heck junction in patients with Metal on Poly bearings . J Arthroplasty 2016 ; 31 : 264 - 268
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School of Health Professions Education (SHE), Maastricht University, Maastricht, the Netherlands
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School of Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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cemented) were included. Articles describing allergic reactions on hip prosthesis and/or cobalt and articles reporting only local problems around the hip such as adverse local tissue reactions (ALTR), ARMD and aseptic lymphocytic vasculitis
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identified: Tribocorrosion-associated adverse local tissue reactions (ALTR) Dissociation of a taper junction Stem fracture Mismatch of a femoral head taper attached to a stem with a different trunnion size 44 , 45 Angular mismatch at the taper