IL-17A–Mediated Immune-Inflammatory Periarticular Mass and Osteolysis From Impingement in Ceramic-On-Ceramic Total Hip Arthroplasty

We present a rare case of symptomatic adverse local tissue reaction in a 54-year-old female patient who had undergone total hip arthroplasty with ceramic-on-ceramic bearing. Inflammatory periarticular mass and osteolysis developed in the absence of cobalt chrome alloy interfaces and a modular neck c...

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Autores principales:	Tsunehito Ishida, MD, PhD, Toshiyuki Tateiwa, MD, PhD, Yasuhito Takahashi, PhD, Reisuke H. Takahashi, MD, PhD, Keiji Sano, MD, PhD, Takaaki Shishido, MD, PhD, Toshinori Masaoka, MD, PhD, Kengo Yamamoto, MD, PhD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Ceramic-on-ceramic THA ALTR Osteolysis IL-17A Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/a8b88d57ed004eb088ab08177a0ccab2
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spelling	oai:doaj.org-article:a8b88d57ed004eb088ab08177a0ccab22021-11-14T04:33:44ZIL-17A–Mediated Immune-Inflammatory Periarticular Mass and Osteolysis From Impingement in Ceramic-On-Ceramic Total Hip Arthroplasty2352-344110.1016/j.artd.2021.06.018https://doaj.org/article/a8b88d57ed004eb088ab08177a0ccab22021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352344121001151https://doaj.org/toc/2352-3441We present a rare case of symptomatic adverse local tissue reaction in a 54-year-old female patient who had undergone total hip arthroplasty with ceramic-on-ceramic bearing. Inflammatory periarticular mass and osteolysis developed in the absence of cobalt chrome alloy interfaces and a modular neck component. On the pathologic images, there was no clear evidence of gross metal staining of tissues, metal corrosion, and ceramic or metal wear particles. However, there were impingement scars on the titanium alloy femoral neck and acetabular cup associated with a high combined anteversion angle of 75° (stem: 40° and cup: 35°), suggesting titanium debris release in vivo. Immunohistochemical staining proved a predominant infiltration of CD4+ T cells and the corresponding IL-17A response to metal. We conclude that neck-rim impingement may lead to the development of adverse local tissue reaction (periarticular mass and osteolysis) due to a metal hypersensitivity with the production of proinflammatory cytokines (IL-17A) by CD4+ T cells even in ceramic-on-ceramic total hip arthroplasty.Tsunehito Ishida, MD, PhDToshiyuki Tateiwa, MD, PhDYasuhito Takahashi, PhDReisuke H. Takahashi, MD, PhDKeiji Sano, MD, PhDTakaaki Shishido, MD, PhDToshinori Masaoka, MD, PhDKengo Yamamoto, MD, PhDElsevierarticleCeramic-on-ceramicTHAALTROsteolysisIL-17AOrthopedic surgeryRD701-811ENArthroplasty Today, Vol 11, Iss , Pp 15-19 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ceramic-on-ceramic THA ALTR Osteolysis IL-17A Orthopedic surgery RD701-811
spellingShingle	Ceramic-on-ceramic THA ALTR Osteolysis IL-17A Orthopedic surgery RD701-811 Tsunehito Ishida, MD, PhD Toshiyuki Tateiwa, MD, PhD Yasuhito Takahashi, PhD Reisuke H. Takahashi, MD, PhD Keiji Sano, MD, PhD Takaaki Shishido, MD, PhD Toshinori Masaoka, MD, PhD Kengo Yamamoto, MD, PhD IL-17A–Mediated Immune-Inflammatory Periarticular Mass and Osteolysis From Impingement in Ceramic-On-Ceramic Total Hip Arthroplasty
description	We present a rare case of symptomatic adverse local tissue reaction in a 54-year-old female patient who had undergone total hip arthroplasty with ceramic-on-ceramic bearing. Inflammatory periarticular mass and osteolysis developed in the absence of cobalt chrome alloy interfaces and a modular neck component. On the pathologic images, there was no clear evidence of gross metal staining of tissues, metal corrosion, and ceramic or metal wear particles. However, there were impingement scars on the titanium alloy femoral neck and acetabular cup associated with a high combined anteversion angle of 75° (stem: 40° and cup: 35°), suggesting titanium debris release in vivo. Immunohistochemical staining proved a predominant infiltration of CD4+ T cells and the corresponding IL-17A response to metal. We conclude that neck-rim impingement may lead to the development of adverse local tissue reaction (periarticular mass and osteolysis) due to a metal hypersensitivity with the production of proinflammatory cytokines (IL-17A) by CD4+ T cells even in ceramic-on-ceramic total hip arthroplasty.
format	article
author	Tsunehito Ishida, MD, PhD Toshiyuki Tateiwa, MD, PhD Yasuhito Takahashi, PhD Reisuke H. Takahashi, MD, PhD Keiji Sano, MD, PhD Takaaki Shishido, MD, PhD Toshinori Masaoka, MD, PhD Kengo Yamamoto, MD, PhD
author_facet	Tsunehito Ishida, MD, PhD Toshiyuki Tateiwa, MD, PhD Yasuhito Takahashi, PhD Reisuke H. Takahashi, MD, PhD Keiji Sano, MD, PhD Takaaki Shishido, MD, PhD Toshinori Masaoka, MD, PhD Kengo Yamamoto, MD, PhD
author_sort	Tsunehito Ishida, MD, PhD
title	IL-17A–Mediated Immune-Inflammatory Periarticular Mass and Osteolysis From Impingement in Ceramic-On-Ceramic Total Hip Arthroplasty
title_short	IL-17A–Mediated Immune-Inflammatory Periarticular Mass and Osteolysis From Impingement in Ceramic-On-Ceramic Total Hip Arthroplasty
title_full	IL-17A–Mediated Immune-Inflammatory Periarticular Mass and Osteolysis From Impingement in Ceramic-On-Ceramic Total Hip Arthroplasty
title_fullStr	IL-17A–Mediated Immune-Inflammatory Periarticular Mass and Osteolysis From Impingement in Ceramic-On-Ceramic Total Hip Arthroplasty
title_full_unstemmed	IL-17A–Mediated Immune-Inflammatory Periarticular Mass and Osteolysis From Impingement in Ceramic-On-Ceramic Total Hip Arthroplasty
title_sort	il-17a–mediated immune-inflammatory periarticular mass and osteolysis from impingement in ceramic-on-ceramic total hip arthroplasty
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/a8b88d57ed004eb088ab08177a0ccab2
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IL-17A–Mediated Immune-Inflammatory Periarticular Mass and Osteolysis From Impingement in Ceramic-On-Ceramic Total Hip Arthroplasty

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