Biotribocorrosion of metal-on-metal hip replacements: How surface degradation can influence metal ion formation

2013 ◽  
Vol 65 ◽  
pp. 128-137 ◽  
Author(s):  
James Hesketh ◽  
Qingen Meng ◽  
Duncan Dowson ◽  
Anne Neville
Keyword(s):  
Metal Ion ◽  
Surface Degradation ◽  
Ion Formation ◽  
Metal On Metal ◽  
Hip Replacements

scholarly journals Does modularity of metal-on-metal hip implants increase cobalt: chromium ratio?

2019 ◽  
pp. 112070001987363
Author(s):  
Kevin C Ilo ◽  
Karim Aboelmagd ◽  
Harry S Hothi ◽  
Asaad Asaad ◽  
John A Skinner ◽  
...  
Keyword(s):  
Metal Ion ◽  
Hip Implants ◽  
Cobalt Chromium ◽  
Metal Debris ◽  
Material Loss ◽  
Total Hip ◽  
Modular Stem ◽  
Metal On Metal ◽  
Hip Replacements ◽  
Hip Arthroplasties

Background: Blood metal ion levels are used in the surveillance of metal-on-metal (MoM) hip implants. Modular implants contain an extra source of metal debris that may affect the ratio of metal ions in the blood. Methods: This was a retrospective study of 503 patients with hip replacements made by a single manufacturer (Smith & Nephew, Warwick, UK) with the same bearing surface. There were 54 total hip arthroplasties, 35 Birmingham Mid-Head Resections and 414 hip resurfacings. Whole blood metal ion levels and their ratios were analysed to investigate the effect of a modular junction. Results: The cobalt:chromium ratios were greater in the total hip arthroplasty group (mean 2.3:1) when compared to the resurfacings group (mean 1.3:1, p = <0.05) and Birmingham Mid-Head Resection group (mean 1.1:1, p = 0.11). Conclusions: This study demonstrated a trend for a higher cobalt:chromium ratio in patients with MoM total hip replacement that may be due to metal debris from the modular stem-head junction. Further work is required to correlate clinical data with retrieval analysis to confirm the effect of taper material loss on the cobalt:chromium ratio.

An analysis of metal ion levels in the joint fluid of symptomatic patients with metal-on-metal hip replacements

2011 ◽  
Vol 93-B (6) ◽  
pp. 738-745 ◽  
Author(s):  
K. Davda ◽  
F. V. Lali ◽  
B. Sampson ◽  
J. A. Skinner ◽  
A. J. Hart
Keyword(s):  
Metal Ion ◽  
Joint Fluid ◽  
Metal On Metal ◽  
Hip Replacements

Do cobalt and chromium blood metal ion levels normalize after revision of failed metal-on-metal total hip replacements?

2021 ◽  
Author(s):  
Anna Jungwirth-Weinberger ◽  
Carola Hanreich ◽  
Maximilian F. Kasparek ◽  
Lisa Renner ◽  
Wenzel Waldstein ◽  
...  
Keyword(s):  
Metal Ion ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Metal On Metal ◽  
Hip Replacements

scholarly journals Metal Ion Concentrations in Body Fluids after Implantation of Hip Replacements with Metal-on-Metal Bearing – Systematic Review of Clinical and Epidemiological Studies

PLoS ONE ◽  
2013 ◽  
Vol 8 (8) ◽  
pp. e70359 ◽  
Author(s):  
Albrecht Hartmann ◽  
Franziska Hannemann ◽  
Jörg Lützner ◽  
Andreas Seidler ◽  
Hans Drexler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Metal Ion ◽  
Epidemiological Studies ◽  
Body Fluids ◽  
Ion Concentrations ◽  
Metal On Metal ◽  
Hip Replacements

Bearing surfaces

2011 ◽  
Author(s):  
Gordon Blunn
Keyword(s):  
Metal Ion ◽  
Polyethylene Wear ◽  
Ion Release ◽  
Wear Rates ◽  
Metal On Metal ◽  
Metal Ion Release ◽  
Hip Replacements ◽  
Alternative Material ◽  
Catastrophic Fracture ◽  
The 1960S

♦ Traditionally bearings were made from polyethylene and cobalt chrome. These bearings are still most commonly used for knee replacements. In hip replacements due to osteolysis caused by polyethylene wear alternative material combinations at the bearing surface are used♦ Highly cross linked plastics have been developed and have been shown to reduce wear. There are a number of different types available which differ in their performance♦ Metal on metal bearings first used in the 1960s have also been developed and show very low wear rates. These bearings are more susceptible to edge loading and the resulting metal ion release can result in adverse biological reactions leading to failure♦ Whilst ceramic on plastic surfaces have been used for a considerable amount of time the reduction in wear is not as great as with well functioning metal on metal bearings♦ Ceramic on ceramic bearings have been used for a considerable time and show even lower wear rates than metal on metal bearings. In the past there has been an incidence of catastrophic fracture of these bearings but developments in materials technology have considerably reduced these events.

scholarly journals Outcomes of a metal-on-metal total hip replacement system

2014 ◽  
Vol 96 (7) ◽  
pp. 530-535 ◽  
Author(s):  
GS Matharu ◽  
K Theivendran ◽  
PB Pynsent ◽  
L Jeys ◽  
AM Pearson ◽  
...  
Keyword(s):  
Femoral Head ◽  
Metal Ion ◽  
Metal Debris ◽  
Total Hip ◽  
Metal On Metal ◽  
Significant Difference ◽  
Hip Replacements ◽  
Specialist Centre ◽  
Clinical Surveillance ◽  
The Mean

Introduction High short-term failure rates have been reported for a variety of metal-on-metal (MoM) total hip replacements (THRs) owing to adverse reactions to metal debris (ARMD). This has led to the withdrawal of certain poorly performing THRs. This study analysed the outcomes of a MoM THR system. Methods Between 2004 and 2010, 578 uncemented MoM THRs (511 patients, mean age: 60.0 years) were implanted at one specialist centre. The THR system used consisted of the Corail® stem, Pinnacle® cup, Ultamet® liner and Articul/eze® femoral head (all DePuy, Leeds, UK). All patients were recalled for clinical review with imaging performed as necessary. Results The mean follow-up duration was 5.0 years (range: 1.0–9.1 years). Overall, 39 hips (6.7%) in 38 patients (all 36mm femoral head size) underwent revision at a mean time of 3.5 years (range: 0.01–8.3 years) from the index THR with 30 revisions (77%) performed in women. The cumulative eight-year survival rate for all THRs was 88.9% (95% confidence interval [CI]: 78.5–93.4%), with no difference (p=0.053) between male (95.2%, 95% CI: 84.2–98.7%) and female patients (85.3%, 95% CI: 70.2–92.1%) at eight years. Seventeen revisions (44%) were performed for ARMD. There was no significant difference in absolute postoperative Oxford hip scores between men and women (p=0.608). The mean acetabular inclination in unrevised THRs was 44.0°. Forty-seven non-revised THRs (8.7%) had blood metal ion concentrations above recommended thresholds (seven had periprosthetic effusions). Conclusions Although this MoM THR system has not failed as dramatically as other similar designs, we recommend against continued use and advise regular clinical surveillance to identify ARMD early.

scholarly journals Repeated metal ion measurement in patients with bilateral metal on metal (ASR™) hip replacements

2016 ◽  
Vol 102 (2) ◽  
pp. 167-173 ◽  
Author(s):  
A. Reito ◽  
O. Lainiala ◽  
J. Nieminen ◽  
A. Eskelinen
Keyword(s):  
Metal Ion ◽  
Metal On Metal ◽  
Hip Replacements

scholarly journals Whole blood chromium concentration is very rarely elevated independently of whole blood cobalt

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Olli Lainiala ◽  
Mari Karsikas ◽  
Aleksi Reito ◽  
Antti Eskelinen
Keyword(s):  
Whole Blood ◽  
Cost Savings ◽  
Chromium Concentration ◽  
Continuous Variables ◽  
Metal Debris ◽  
Screening Guidelines ◽  
Metal On Metal ◽  
Hip Replacements

AbstractDue to the risk of adverse reactions to metal debris resulting from increased wear of the arthroplasty more than one million metal-on-metal (MoM) hip replacements worldwide are in active follow-up. Follow-up usually includes measurement of both whole blood cobalt (Co) and chromium (Cr) concentrations. Our experience is that Cr is seldom independently elevated. We wanted to ascertain whether blood Cr measurements could be omitted from follow-up protocols without lowering the quality of follow-up. We identified 8438 whole blood Co and Cr measurements performed without or prior to revision surgery. When the cut-off levels 5 µg/L and 7 µg/L were used, Cr was independently elevated in only 0.5% (95% confidence interval, CI, 0.3 to 0.6) and 0.2% (CI 0.1 to 0.3) of the measurements. The models with continuous variables showed that the higher the blood metal concentrations are the lower the percentage of measurements with Cr higher than Co. Our results suggest that whole blood Cr is very rarely independently elevated and therefore the authorities should consider omitting Cr measurements from their screening guidelines of MoM hip replacements. We believe this change in practice would simplify follow-up and lead to cost savings without decreasing the quality of follow-up.

scholarly journals Metal-on-metal total hip arthroplasty: does increasing modularity affect clinical outcome?

2020 ◽  
pp. 112070002097927
Author(s):  
Kevin C Ilo ◽  
Harry S Hothi ◽  
John A Skinner ◽  
Alister J Hart
Keyword(s):  
Metal Ion ◽  
Hip Prosthesis ◽  
Tissue Reaction ◽  
Bearing Surface ◽  
Adverse Local Tissue Reaction ◽  
Material Loss ◽  
Local Tissue ◽  
Local Tissue Reaction ◽  
Metal On Metal ◽  
Modular Implants

Background: Modularity of metal-on-metal (MoM) implants has come under scrutiny due to concerns regarding additional sources of metal debris. This study is a retrieval analysis of implants from the same manufacturer with the same MoM bearing surface. The difference between the implants was presence or absence of modular junctions. Methods: This is a retrospective study of 31 retrieved implants from 31 patients who received a Conserve Wright Medical MoM hip prosthesis. The 31 implants consisted of 16 resurfacings and 15 implants with modular junctions; 4 conventional THAs and 11 modular-neck THAs. Results: 43% of pre-revision MRI scans performed on resurfacing implants and 91% performed on the modular implants illustrated evidence of an adverse local tissue reaction. There was no difference in pre-revision blood metal ion levels or bearing surface wear between the resurfacings and modular implants. The neck-head tapers of the modular group showed low levels of material loss. However, the neck-stem tapers showed increased severity of corrosion and material loss Conclusions: The modular implants had an increased incidence of adverse local tissue reaction. This could be related to the presence of modular junctions, particular the neck-stem junction which showed increased susceptibly to corrosion

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