{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T12:31:59Z","timestamp":1765974719903,"version":"3.48.0"},"reference-count":49,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the University of Medicine and Pharmacy Carol Davila"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Organ dysfunctions affect the quality of bone and body fluids. This case report seeks links between the underlying conditions of three patients undergoing hip arthroplasty (HA) with uncemented implants, the quality of their bones, and their Ti-6Al-4V orthopaedic implants, on different time spans. Femoral stems are investigated. A brief review supports our findings. Materials and Methods: Cases: two women (F1 35+, F2 80+), and one man (M 65+), all having diabetes, dyslipidaemia, and kidney dysfunction. Samples: a segment of a broken 7-year-old stem, bone with a metallic layer, soft tissue, segments of one spare stem, and synthetic plasma enriched with glucose and urea according to the biochemistry tests of the respective patients. Vast studies show that cholesterol influences bone quality only. The stem pieces were ultrasonicated for 7 h at 37 \u00b0C in synthetic plasma. Scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), and profilometry investigated the Ti-alloy samples, electrochemistry analysed the post-sonication plasma, and histopathology examination was performed on the soft tissue remnants on the broken stem. Results: EDX show that all stem samples are Ti-6Al-4V with minute additions of other elements and hydroxyapatite (HAp) coating. SEM and profilometry analysis are consistent for the roughness in the outer layers of the stems. Electrochemistry on the bone fragment shows migration of vanadium during the 6 months since fracture to revision for M. Conclusions: Stems in altered synthetic plasma are affected by glucose and urea. Metal migration from the prostheses can occur through the chemical interactions between body fluids with abnormal biochemistry and the orthopaedic prostheses, favoured by cracks and concurring with wear following friction during usual movements. Cholesterol influences on the bone quality.<\/jats:p>","DOI":"10.3390\/medicina61122228","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T12:13:03Z","timestamp":1765973583000},"page":"2228","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bone\u2013Ti-Alloy Interaction in Hip Arthroplasty of Patients with Diabetes, Dyslipidaemia, and Kidney Dysfunction: Three Case Reports and Brief Review"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7800-9190","authenticated-orcid":false,"given":"Cosmin Constantin","family":"Baciu","sequence":"first","affiliation":[{"name":"University of Medicine and Pharmacy Carol Davila (UMFCD), Dionisie Lupu Street, No. 37, Sector 2, 050474 Bucharest, Romania"},{"name":"Clinical Emergency Hospital (SCUB), Floreasca Route, No. 8, Sector 1, 014461 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4705-0606","authenticated-orcid":false,"given":"Ana Maria","family":"Iordache","sequence":"additional","affiliation":[{"name":"National Institute of Research and Development for Optoelectronics\u2014INOE 2000, 077125 Magurele, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8034-8549","authenticated-orcid":false,"given":"Teodoru","family":"Soare","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Veterinary Medicine, University of Agronomic Sciences and Veterinary Medicine of Bucharest, Splaiul Independentei Street, No. 105, Sector 5, 050097 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8337-9559","authenticated-orcid":false,"given":"Nicolae Catalin","family":"Zoita","sequence":"additional","affiliation":[{"name":"National Institute of Research and Development for Optoelectronics\u2014INOE 2000, 077125 Magurele, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1609-8001","authenticated-orcid":false,"given":"Cristiana Eugenia Ana","family":"Grigorescu","sequence":"additional","affiliation":[{"name":"National Institute of Research and Development for Optoelectronics\u2014INOE 2000, 077125 Magurele, Romania"},{"name":"SC Histovet SRL, Histovet-Veterinary Laboratory, Sirenelor Street, No. 81, Sector 5, 050855 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mircea Bogdan Maciuceanu","family":"Zarnescu","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy Carol Davila (UMFCD), Dionisie Lupu Street, No. 37, Sector 2, 050474 Bucharest, Romania"},{"name":"Clinical Emergency Hospital (SCUB), Floreasca Route, No. 8, Sector 1, 014461 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"ref_1","first-page":"745","article-title":"Investigation performed at the Department of Orthopaedic Surgery, New York\u2014Presbyterian Hospital, New York, NY","volume":"101","author":"Wintermeyer","year":"2019","journal-title":"J. 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