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Keane Tahmaseb GC, Keane AM, Foppiani JA, Myckatyn TM. An Update on Implant-Associated Malignancies and Their Biocompatibility. Int J Mol Sci 2024; 25:4653. [PMID: 38731871 PMCID: PMC11083590 DOI: 10.3390/ijms25094653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/14/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Implanted medical devices are widely used across various medical specialties for numerous applications, ranging from cardiovascular supports to orthopedic prostheses and cosmetic enhancements. However, recent observations have raised concerns about the potential of these implants to induce malignancies in the tissues surrounding them. There have been several case reports documenting the occurrence of cancers adjacent to these devices, prompting a closer examination of their safety. This review delves into the epidemiology, clinical presentations, pathological findings, and hypothesized mechanisms of carcinogenesis related to implanted devices. It also explores how the surgical domain and the intrinsic properties and biocompatibility of the implants might influence the development of these rare but serious malignancies. Understanding these associations is crucial for assessing the risks associated with the use of medical implants, and for developing strategies to mitigate potential adverse outcomes.
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Affiliation(s)
- Grace C. Keane Tahmaseb
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
| | - Alexandra M. Keane
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
| | - Jose A. Foppiani
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
| | - Terence M. Myckatyn
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
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Liu C, Liu R, Tang M, Yang X, Gong X. Role and mechanism of nursing cooperation and tetramethylpyrazine application in post-operative pain in patients undergoing total knee arthroplasty. Exp Ther Med 2019; 17:2366-2372. [PMID: 30867722 DOI: 10.3892/etm.2019.7203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/22/2017] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to investigate the effect of nursing cooperation on the post-operative complication of pain following total knee arthroplasty (TKA) and to explore the effects of tetramethylpyrazine (TMP) application on post-TKA pain. A total of 26 patients who received TKA between June 2014 and March 2016 were enrolled in this study. Nursing cooperation was provided to the patients during the TKA surgery, and pain was evaluated based on the visual analog scale (VAS). In addition, 40 male Sprague Dawley rats were used for the TKA model construction. The rats were randomly separated into 4 groups (sham, TKA, TKA+TMP and TKA+TMP+Interferon γ). Pain tolerance in rats was evaluated by mechanical stimulation. Inflammatory cytokine levels in TKA rat tissue were detected using ELISA. mRNA and protein expression of Janus kinase/signal transducer and activator of transcription 3 (JAK/STAT3) was detected using reverse transcription-polymerase chain reaction and western blot analysis, respectively. The results indicated that nursing cooperation serves a critical function during TKA and was associated with a lower level of pain compared with the control (P<0.05). Furthermore, TMP treatment reduced the level of inflammatory cytokines in the rat tissues, including interleukin (IL)-6, IL-10 and tumor necrosis factor-α in post-TKA (P<0.01). TMP was indicated to alleviate pain in post-TKA through suppressing the JAK/STAT3 signaling pathway. The results of the present study suggest that nursing cooperation is critical to TKA, and TMP may alleviate post-TKA pain through inhibiting the JAK/STAT3 signaling pathway.
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Affiliation(s)
- Chang Liu
- Surgery Center, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Rui Liu
- Department of Hyperbaric Oxygen Therapy, Harbin Children's Hospital, Harbin, Heilongjiang 150010, P.R. China
| | - Meiling Tang
- Surgery Center, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Xinxin Yang
- Surgery Center, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Xiuping Gong
- Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
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Chi-Kin L, Chun-Kit L, Koon-Ho T, Yiu-Chung W. Non-Hodgkin Lymphoma Mimics Infected Total Knee Arthroplasty. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2018. [DOI: 10.1016/j.jotr.2017.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Lymphoma associated with total knee arthroplasty is a rare condition. We report a case of non-Hodgkin lymphoma mimicking an infected total knee arthroplasty. A 73-year-old woman who received left total knee replacement presented with fever and a discharging sinus over her left knee 12 weeks after surgery. The diagnosis of prosthetic joint infection was made and a two-stage revision arthroplasty planned. After implant removal and insertion of an antibiotic spacer in the first-stage operation, culture results of all intraoperative specimens were negative but the pathology report showed diffuse large B-cell lymphoma. She then received chemotherapy and a second-stage reconstruction operation. The wound healed uneventfully and she regained independent mobility.
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Affiliation(s)
- Lo Chi-Kin
- Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, Hong Kong Special Administrative Region
| | - Lai Chun-Kit
- Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, Hong Kong Special Administrative Region
| | - Tsang Koon-Ho
- Department of Pathology, Yan Chai Hospital, Tsuen Wan, Hong Kong Special Administrative Region
| | - Wong Yiu-Chung
- Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, Hong Kong Special Administrative Region
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Sunitsch S, Gilg M, Kashofer K, Leithner A, Liegl-Atzwanger B, Beham-Schmid C. Case Report: Epstein-Barr-Virus negative diffuse large B-cell lymphoma detected in a peri-prosthetic membrane. Diagn Pathol 2016; 11:80. [PMID: 27539226 PMCID: PMC4990836 DOI: 10.1186/s13000-016-0533-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 08/11/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Primary bone lymphomas (PBL) are extremely rare malignant neoplasms. The most commonly described subtype of PBL is diffuse large B-cell lymphoma (DLBCL). DLBCL within peri-prosthetic membrane of a joint is exceedingly rare. To the best of our knowledge this case is the second reported Epstein-Bar-Virus (EBV) negative DLBCL in a peri-prosthetic membrane in the literature. CASE PRESENTATION We report an 80 year old female patient who developed a DLBCL with chronic inflammation in association to a metallic implant in the left knee. This lymphoma in contrast to the usually described DLBCL in the peri-prosthetic membrane was EBV negative by EBER in situ hybridization as well as by polymerase chain reaction (PCR). CONCLUSION This report challenges the concept of DLBCL associated with chronic inflammation and raises the question of other pathogenetic factors involved in the pathogenesis of this rare disease.
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Affiliation(s)
- Sandra Sunitsch
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Magdalena Gilg
- Department of Orthopedics and Orthopedic Surgery, Medical University of Graz, Graz, Austria
| | - Karl Kashofer
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Andreas Leithner
- Department of Orthopedics and Orthopedic Surgery, Medical University of Graz, Graz, Austria
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Ibrahim I, Haughom BD, Fillingham YA, Brown N, Gitelis S. Primary Lymphoma of Bone Complicating Total Knee Arthroplasty: An Unexpected Mode of Prosthesis Failure: A Case Report. JBJS Case Connect 2015; 5:e34. [PMID: 29252596 DOI: 10.2106/jbjs.cc.n.00167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
CASE Primary lymphoma of bone is a rare musculoskeletal malignancy that typically arises in long bones. Few cases of bone lymphoma occurring alongside orthopaedic implants have been reported in the literature. We describe the complex case of a seventy-eight-year-old woman who developed diffuse large B-cell lymphoma of the proximal part of the tibia five years after a successful total knee arthroplasty. CONCLUSION Several studies have suggested a link between orthopaedic implants and genomic instability, although true carcinogenesis remains questionable. Lymphoma complicating joint arthroplasty poses a unique problem for orthopaedic physicians due to diagnostic challenges and the unique implications of disease and treatment-related complications.
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Affiliation(s)
- Ishaq Ibrahim
- Rush University School of Medicine, 600 South Paulina Street, Chicago, IL 60612.
| | - Bryan D Haughom
- Department of Orthopaedic Surgery, Rush University, 1611 West Harrison Boulevard, Suite 200, Chicago, IL 60612. . . .
| | - Yale A Fillingham
- Department of Orthopaedic Surgery, Rush University, 1611 West Harrison Boulevard, Suite 200, Chicago, IL 60612. . . .
| | - Nicholas Brown
- Department of Orthopaedic Surgery, Rush University, 1611 West Harrison Boulevard, Suite 200, Chicago, IL 60612. . . .
| | - Steven Gitelis
- Department of Orthopaedic Surgery, Rush University, 1611 West Harrison Boulevard, Suite 200, Chicago, IL 60612. . . .
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McCammon J, Mascarenhas R, Monument MJ, Elyousfi A, Pilkey B. Large B-cell lymphoma mimicking iliopsoas abscess following open revision of proximal femur infected non-union: a case report. BMC Res Notes 2014; 7:470. [PMID: 25056400 PMCID: PMC4120726 DOI: 10.1186/1756-0500-7-470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 07/15/2014] [Indexed: 11/21/2022] Open
Abstract
Background Extranodal presentation of lymphoma is a rare occurrence. It has been postulated that chronic antigen stimulation may predispose a patient to the development of lymphoma. Case presentation We present a case report of a large extranodal B-cell lymphoma mimicking a postoperative abscess following surgery for an infected proximal femur nonunion in an 80-year-old Caucasian male of Italian descent. Conclusions This case highlights the need to consider malignancy in revision surgery, careful examination of operative specimens and the need for further understanding of the role of metal implants in chronic antigen stimulation.
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Affiliation(s)
- James McCammon
- Section of Orthopedic Surgery, Health Sciences Center, University of Manitoba, Winnipeg, Manitoba, Canada.
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Chaudhry MS, Mather H, Marks A, Naresh K. Diffuse large B cell lymphoma complicating total knee arthroplasty: case report and literature review of the association of diffuse large B cell lymphoma with joint replacement. Acta Haematol 2011; 126:141-6. [PMID: 21734365 DOI: 10.1159/000328202] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 04/07/2011] [Indexed: 12/31/2022]
Abstract
Primary lymphoma of bone is extremely rare. There are increasing reports of lymphoma arising in bone adjacent to metallic prostheses. Herein, we describe the case of a 76-year-old man who developed diffuse large B cell lymphoma in the tibia 3 years after total knee arthroplasty for osteoarthritis. A review of the literature has identified 11 other cases of lymphoma arising in the context of orthopaedic metallic implants. To our knowledge this is the first reported case of a primary lymphoma arising in bone adjacent to a knee prosthesis. Possible pathogenetic mechanisms may include chronic antigenic stimulation of lymphocytes, proliferation of EBV-infected B lymphocytes, and direct mutagenic effects of metallic ions. Further research is required to investigate this intriguing link between metallic orthopaedic prostheses and localized lymphoma.
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