Development and problems of metal-on-metal hip arthroplasty

Abstract

For over 40 years, the metal-on-polyethylene bearing has dominated the field of total hip replacement. Problems of wear, osteolysis (dissolution of bone), and ultimately failure of prostheses have led to the development of alternative bearing surfaces. Metal-on-metal hip resurfacing has taken current orthopaedic surgery almost by storm. However, metal ion release following metal-on-metal hip resurfacing remains a major cause for concern. This article looks into the development and examines problems and issues surrounding metal-on-metal resurfacing arthroplasty.

Metal sensitivity in patients before and after total knee arthroplasty (TKA): comparison between ceramic surfaced oxidized zirconium and cobalt-chromium implants

“…In contrast to THA [21][22][23], there are relatively few publications regarding metal ion exposure after TKA [24], and our investigation suggested a substantial elevation of serum metal ions in the Co-Cr group. There is no traceable Ni in the OxZr, and our data of the OxZr group implied that Co and Cr ion releases also seem to be reduced during short operative period.…”

Tribological behavior of a Ta-based coating on a Co–Cr–Mo alloy

“…On the other hand, several issues are still unresolved, such as wear and adverse tissue responses, which heighten the risk of implants loosening [1][2][3][4]. During the last ten years, particular attention was paid to metal on metal (MoM) coupling for arthroprosthesis, because of lower volumetric wear compared to metal on polyethylene (MoP) coupling, as well as higher durability than ceramic on ceramic (CoC) coupling [5][6][7][8]. Mechanical and chemical degradation of joint devices (MoP or MoM) leads to polyethylene and metal debris formation, which means release of metal particulate and ions [9][10][11][12].…”

Tribology and corrosion in hip joint replacements: materials and engineering

“…The biological and clinical data have been assessed by Brown et al (2006), shetty andvillar (2006), Bhamra and Case (2006), Cobb andschmalzried (2006) andvisuri et al (2006). The scandinavian registers are particularly helpful for studies in this field.…”