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01-06-2012 | Case Report

Clinical, radiological, histological and retrieval findings of Activ-L and Mobidisc total disc replacements: a study of two patients

Authors: Shennah Austen, Ilona M. Punt, Jack P. M. Cleutjens, Paul C. Willems, Steven M. Kurtz, Daniel W. MacDonald, Lodewijk W. van Rhijn, André van Ooij

Published in: European Spine Journal | Special Issue 4/2012

Abstract

Introduction

This study evaluates the short-term clinical outcome, radiological, histological and device retrieval findings of two patients with second generation lumbar total disc replacement (TDR).

Materials and methods

The first patient had a single level L4-L5 Activ-L TDR, the second patient a L4-L5 Mobidisc and L5-S1 Activ-L TDR. The TDRs were implanted elsewhere and had implantation times between 1.3 and 2.8 years.

Results

Plain radiographs and CT-scanning showed slight subsidence of the Activ-L TDR in both patients and facet joint degeneration. The patients underwent revision surgery because of recurrent back and leg pain. After removal of the TDR and posterolateral fusion, the pain improved. Histological examination revealed large ultrahigh molecular weight polyethylene (UHMWPE) particles and giant cells in the retrieved tissue surrounding the Mobidisc. The particles in the tissue samples of the Activ-L TDR were smaller and contained in macrophages. Retrieval analysis of the UHMWPE cores revealed evidence of minor adhesive and abrasive wear with signs of impingement in both TDR designs.

Conclusion

Although wear was unrelated to the reason for revision, this study demonstrates the presence of UHMWPE particles and inflammatory cells in second generation TDR. Long-term follow-up after TDR is indicated for monitoring wear and implant status.

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Title: Clinical, radiological, histological and retrieval findings of Activ-L and Mobidisc total disc replacements: a study of two patients
Authors: Shennah Austen
Ilona M. Punt
Jack P. M. Cleutjens
Paul C. Willems
Steven M. Kurtz
Daniel W. MacDonald
Lodewijk W. van Rhijn
André van Ooij
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue Special Issue 4/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-011-2141-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical, radiological, histological and retrieval findings of Activ-L and Mobidisc total disc replacements: a study of two patients

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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