Article entitled, ¿the calpain gene is correlated with metal-on-metal hip replacement failures¿, by joseph j.Kavolus, md, mscr, alexander l.Lazarides, md, christina moore, ms, thorsten m.Seyler, md, phd, samuel s.Wellman, md, david e.Attarian, md, michael p.Bolognesi, md, benjamin a.Alman, md, published in j arthroplasty.2021 jan;36(1):236-241.E3.Doi: 10.1016/j.Arth.2020.07.054.Epub 2020 jul 30.Pmid: 32811707, was reviewed.The authors sought to determine whether certain immunologic genotypes are predictive of the need for revision in patients with metal-on-metal (mom) total hip implants.The study identified a genetic dna single-nucleotide polymorphism (snp), kgp9316441, encoding calpain proteins associated with inflammation and macrophage activation.This snp was associated with significantly increased odds of revision for mom hip revision.Of the 32 hips in the study, 15 were revised for mom disease, and 17 were not (the asymptomatic control group).Of the 15 revised, 7 were depuy asr hips, 6 were depuy pinnacle mom hips, and two were competitor products.Of the 15 revised, 5 presented with pseudotumors, 4 with alval (aseptic lymphocyte-dominant vasculitis associated lesion), and 15 with pain¿the study did not present these symptoms by product, but all were grouped together for the reported revisions.The specific treatments and products revised for each of these revision surgeries was not provided by the authors.The study also identified evidence of osteolysis radiographically for 2 revised patients, and for 2 unrevised patients¿no treatment was specified with regards to this finding.It was also noted that all patients, whether revised or presenting as asymptomatic, had elevations of there serum cobalt metal ions, from a low of 1.9 ug/l to 11 ug/l on the high end, and chromium metal ions from 1.8 ug/l to 13.5 ug/l¿and interestingly, the levels were nearly the same in both the revision and control groups.The study did not provide manufacturer data for femoral components (apart from the asr platform head and sleeve), nor did it break down the information by individual patient, such as through individual demographics¿age and gender.
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