Diametral Clearance Effect on Friction and Wear Characteristics of a Metal-on-Metal Total Hip Arthroplasty

ASME/STLE 2007 International Joint Tribology Conference, Parts A and B ◽

10.1115/ijtc2007-44484 ◽

2007 ◽

Author(s):

Ming Shen ◽

Birgit Grundmann ◽

Gernot Liebentritt

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Wear Test ◽

Frictional Torque ◽

Acetabular Cup ◽

Total Hip ◽

Hip Simulator ◽

Pendulum Test ◽

Metal On Metal ◽

Friction And Wear Characteristics

Tribological performance of a metal-on-metal total hip arthroplasty was evaluated as a function of the diametral clearance between the femoral head and acetabular cup. Frictional torque results, measured by a pendulum apparatus, suggested that a threshold clearance existed. Below the threshold clearance, frictional torque increased nearly linearly as the clearance decreased. Beyond the threshold, the clearance effect was minimal. The wear results, measured using a hip simulator, showed that a running-in wear was present in the first million cycles. The subsequent steady-state wear rate was very low in all tested clearances. The highest running-in wear was associated with the largest clearance. These results demonstrated the usefulness of combining a pendulum test and a simulator wear test to fully characterize the clearance effect.

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Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty

Case Reports in Orthopedics ◽

10.1155/2017/2594902 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Yasuaki Tamaki ◽

Tomohiro Goto ◽

Takahiko Tsutsui ◽

Tomoya Takasago ◽

Keizo Wada ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Vascular Compression ◽

Acetabular Cup ◽

Primary Metal ◽

Total Hip ◽

Circulatory Disturbance ◽

Metal Head ◽

Metal On Metal ◽

Femoral Vessels

Here we present a case of pseudotumor following total hip arthroplasty (THA) that resulted in a circulatory disturbance caused by compression of the femoral vasculature. A 63-year-old man presented with pain, swelling, and redness of the left leg 5 years after primary metal-on-metal THA using the AML-Plus stem, Pinnacle® acetabular cup, and 36 mm diameter Ultamet™ metal head system (DePuy Orthopaedics, Warsaw, IN). Enhanced computed tomography and magnetic resonance imaging revealed a large cystic lesion extending from the left hip anteriorly to the intrapelvic region and compressing the left femoral vessels. Percutaneous puncture of the lesion yielded a dark red aspirate and the patient was diagnosed to have a pseudotumor causing compression of the femoral vessels. We performed revision surgery to replace the metal head and metal liner with a smaller ceramic head and polyethylene liner without removal of the stem. Corrosion of the head-neck junction was identified intraoperatively with no obvious wear on the bearing surfaces. The left leg swelling and redness improved immediately postoperatively. A large pseudotumor should be kept in mind as a cause of vascular compression with unilateral leg edema in a patient who has undergone metal-on-metal THA.

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Small-head metal on metal total hip arthroplasty is associated with a high rate of complication and reoperation at mid-term follow-up

SAGE Open Medicine ◽

10.1177/20503121211014707 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110147

Author(s):

Nobuhiko Sumiyoshi ◽

Kazuhiro Oinuma ◽

Yoko Miura

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Adverse Reactions ◽

Small Diameter ◽

High Rate ◽

Metal Debris ◽

Total Hip ◽

Metal On Metal ◽

Small Head

Background: Adverse reactions to metal debris are significant complications after metal-on-metal total hip arthroplasty. Recently, late appearances of adverse reactions to metal debris and subsequent need for reoperations have been reported with small-diameter head metal-on-metal devices. We retrospectively investigated mid-term clinical outcomes of small-head metal-on-metal total hip arthroplasty. Methods: We reviewed 159 hips in 139 patients who had a small-head metal-on-metal total hip arthroplasty (M2a Taper; Biomet, Warsaw, IN) with a minimum 5-year follow-up and documented postoperative complications. Results: Focal osteolysis in either the femur or acetabulum was observed in 12 hips (7.5%, 44 months after surgery on average), with pseudotumor observed in 8 hips (5%, 120 months after surgery on average). Four hips (2.5%) had dislocations (84 months after surgery on average) and six hips (3.8%, 122 months after surgery on average) underwent reoperation. Conclusion: Small-head metal-on-metal total hip arthroplasty is associated with a high degree of complications at mid-term follow-up period. Considering this, we discourage the use of metal-on-metal total hip arthroplasty regardless of head size.

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CT-based automated planning of acetabular cup for total hip arthroplasty (THA) based on hybrid use of two statistical atlases

International Journal of Computer Assisted Radiology and Surgery ◽

10.1007/s11548-016-1428-x ◽

2016 ◽

Vol 11 (12) ◽

pp. 2253-2271 ◽

Cited By ~ 4

Author(s):

Yoshiyuki Kagiyama ◽

Itaru Otomaru ◽

Masaki Takao ◽

Nobuhiko Sugano ◽

Masahiko Nakamoto ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Automated Planning ◽

Acetabular Cup ◽

Total Hip

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Assessment of an Orthopaedic Templating Software Package for Uncemented Total Hip Arthroplasty

The Journal of Hip Surgery ◽

10.1055/s-0040-1716575 ◽

2020 ◽

Vol 4 (04) ◽

pp. 155-157

Author(s):

Michael Newman ◽

David Hartwright

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Acetabular Cup ◽

Total Hip ◽

Pelvic Radiograph ◽

Uncemented Total Hip Arthroplasty ◽

Femoral Stems ◽

Hip Arthroplasties ◽

Acetabular Components ◽

Insight Into

AbstractThe aim of this study was to assess a large, single-surgeon dataset of uncemented total hip arthroplasties that had been templated using software. This assessment compared preoperative templated predictions with what was implanted with regard to (1) femoral prosthesis size and (2) acetabular cup size. The operation notes for two types of uncemented total hip arthroplasty performed by a single surgeon between January 9, 2008, and March 21, 2019, were assessed. The data were refined so that only those that were fully templated on a correctly calibrated pelvic radiograph were included. This provided a total of 153 cases. The predicted software template was compared with actual implanted component sizes. With regard to the femoral stems, the templating software was exactly correct in 45.75% of cases and was accurate to within one size in 87.59% of cases. With regard to the acetabular component, the templating software was exactly correct in 52.94% of cases and was accurate to within one size (2 mm) in 86.94% of cases. Templating software offers an accurate prediction of the size of uncemented femoral and acetabular components. In addition, the benefits of templating include cognitive rehearsal, insight into potentially challenging aspects of surgery, and highlighting intraoperative issues where there is a large intraoperative deviation from what is templated. This study demonstrates the congruence and reproducibility of templating software when compared with other smaller studies performed in the literature.

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