{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T08:41:48Z","timestamp":1770280908227,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Metal\u2010on\u2010polyethylene (MoP) total hip arthroplasty (THA) prostheses are known to release metal debris. Basic science studies suggest that metal implants induce a pro\u2010inflammatory response that ultimately chemoattracts leukocytes including macrophages and neutrophils to the surgical site. This raises concern of higher risk of infection with these prostheses through the \u201ctrojan horse\u201d mechanism by which neutrophils and macrophages transport intracellular pathogens from a remote site. This study compared the infection occurrence between MoP and ceramic\u2010on\u2010polyethylene (CoP) implants to determine if a higher infection rate in MoP is present. We reviewed a consecutive series of 6052 CoP and 4550 MoP primary THA\u00a0patients from 2015 to 2019. The occurrence of periprosthetic joint infection at 2 years was defined according to the 2018 ICM definition. Statistical analysis consisted of descriptive statistics, univariate analysis, and regression modeling. When compared to CoP, MoP patients were older, included more females, had a higher body mass index, and more commonly affected by comorbidities according to Elixhauser's score. Total revisions were higher in the MoP group (3.19% vs. 2.41%) The absolute incidence of PJI was higher in MoP (2.40% vs. 1.64%). When we adjusted for confounding factors, MoP was found independently associated with a higher PJI risk. Despite MoP and CoP both being widely used for primary THA, we found a higher incidence of PJI in MoP patients. The association remained significant when controlled for possible confounders. We hypothesize that leukocyte recruitment to these implants may play a role and should be further investigated.<\/jats:p>","DOI":"10.1002\/jor.25230","type":"journal-article","created":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T11:35:08Z","timestamp":1637667308000},"page":"2133-2138","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Ceramic\u2010on\u2010polyethylene hip arthroplasty reduces the risk of postoperative periprosthetic joint infection"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0933-6806","authenticated-orcid":false,"given":"Emanuele","family":"Chisari","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute Thomas Jefferson University Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin 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