Adverse Local Tissue Reaction or ALTR
What is Adverse Local Tissue Reaction (ALTR)?
ALTR stands for “Adverse Local Tissue Reaction,” and it’s a type of inflammatory response, similar to an allergy, that can happen in the hip joints of people with Metal-on-Metal (MoM) hip implants.
Some symptoms of ALTR are similar to an infection, like swelling and collections of fluid, but ALTR is not an infection at all. Rather, ALTR is an immune reaction to the metal debris floating around in the surrounding tissue.
What Causes ALTR – Adverse Local Tissue Reaction?
The parts of a MoM hip replacement rub against each other during regular daily use. This causes tiny metal particles to scrape off the implant and enter your body, leading to health consequences, such as ALTR.
When harmful metal debris flakes off the implant, it can trigger your immune system, which causes an intense inflammatory reaction in the tissues surrounding the MoM implant. This inflammation is what doctors call Adverse Local Tissue Reaction or ALTR.
Some doctors believe ALTR is a type of hypersensitivity to metal – kind of like an allergy to metal. However, doctors are not sure what might cause this “allergy.
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Symptoms of ALTR
No two cases of ALTR are quite the same, so the symptoms vary from person to person. In fact, some people experiencing ALTR do not feel any symptoms at all. That being said, there are <ahref=”https: journals.lww.com=”” clinorthop=”” citation=”” 2019=”” 02000=”” what_is_the_clinical_presentation_of_adverse_local.19.aspx”=””>warning signs that you may be suffering ALTR. These warning signs include: </ahref=”https:>
Pain in the hip or groin
Popping or clicking in the hip
Squeaking in the hip
Lumps in the hip or groin
Swelling in the hip or groin
Ringing in your ears
Dementia or Cognitive Decline
Depression and/or Anxiety
If you have a MoM hip implant, and you have suffered from any of the complications or symptoms listed above, you should discuss your concerns with your doctor because your implant may be the cause.
Additionally, you should contact a law firm with experience litigating MoM implants because you may be entitled to compensation.
Maglio Christopher & Toale, P.A. has focused its practice on defective hip replacement cases for over a decade, and we will represent you at no cost unless we recover money from a verdict or settlement.
Common ALTR Complications
Adverse Local Tissue Reaction ALTR has many potential complications. According to a study published in the Clinical Orthopaedics and Related Research journal, patients who received a MoM hip revision due to ALTR, “experience worse patient-reported outcomes, inferior survivorship, and more complications when compared with patients receiving MoM implants who were revised for reasons other than ALTR.” (Galea, et. al). Speak to your doctor if you have any of the symptoms listed below.
If left untreated, ALTR can cause the following conditions:
Bone Death (Osteonecrosis)
Loosening of Implant Components
Fluid Collections Around the Joint
According to a study published in the Clinical Orthopaedics and Related Research journal, patients who received a MoM hip revision due to ALTR, “experience worse patient-reported outcomes, inferior survivorship, and more complications when compared with patients receiving MoM implants who were revised for reasons other than ALTR.” (Galea, et. al).
Anyone with a metal on metal hip can develop ALTR. However, there are certain factors that can increase the risk of ALTR. Some of the risk factors are:
Patients with metal on metal hip replacements in both hips
Patients with total hip resurfacing systems with femoral heads less than or equal to 44m diameter
Patients prescribed corticosteroids
Patients with kidney (renal) problems
Patients who are immunocompromised
Patients who have metal hypersensitivity
Patients with a BMI greater than 40
Patients who participate in high levels of physical activity
How is Adverse Local Tissue Reaction (ALTR) from Metal on Metal Hip Replacements Diagnosed?
The process for diagnosing ALTR is complicated, because no two cases are alike. In general, however, the following methods might be used to help determine if a patient develops ALTR form a metal on metal hip replacement:
Blood metal ion level tests
Clinical Exams (discussing symptoms with your doctors)
How is Adverse Local Tissue Reaction (ALTR) from Metal-on-Metal Hip Replacements Treated?
In most cases, ALTR is treated with hip revision surgery. During revision surgery, your doctor will remove the damaged or loosened MoM implant and replace it with a new model, typically made of different material combinations. In addition, your surgeon will remove any tissue that has decayed or been damaged as a result of ALTR.
Other Reactions Related To Metal on Metal Hips