Fixation and osteolysis with Metasul metal-on-metal articulation

Dorr, Lawrence D.; Wan, Zhinian; Sirianni, Leigh Ellen; Boutary, Myriam; Chandran, Shaun E.

doi:10.1016/j.arth.2004.02.039

Cited by 18 publications

(10 citation statements)

References 16 publications

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“…27 The absence of osteolysis in our series echoes the similar findings for other ceramic-on-ceramic THRs 28,29 and for metal-on-metal articulations. 30 Compared with baseline values, the BMD changed in all zones of the acetabulum. There was an increase in the BMD in zone 1 adjacent to the prosthetic rim, and a reduction in the central pelvic zone, suggesting that when loaded the fully-fixed acetabular component transfers most of the load peripherally near the rim, and stress shielding of the medial cancellous bone occurs.…”

Section: Discussionmentioning

confidence: 88%

The results of a proximally-coated cementless femoral component in total hip replacement

2008

The Journal of Bone and Joint Surgery. British volume

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This study reviewed the results of a cementless anatomical femoral component to give immediate post-operative stability, and with a narrow distal section in order not to contact the femoral cortex in the diaphysis, ensuring exclusively metaphyseal loading. A total of 471 patients (601 hips) who had a total hip replacement between March 1995 and February 2002 were included in the study. There were 297 men and 174 women. The mean age at the time of operation was 52.7 years (28 to 63). Clinical and radiological evaluation were performed at each follow-up. Bone densitometry was carried out on all patients two weeks after operation and at the final follow-up examination. The mean follow-up was 8.8 years (5 to 12). The mean pre-operative Harris hip score was 41 points (16 to 54), which improved to a mean of 96 (68 to 100) at the final follow-up. No patient complained of thigh pain at any stage. No acetabular or femoral osteolysis was observed and no hip required revision for aseptic loosening of either component. Deep infection occurred in two hips (0.3%) which required revision. One hip (0.2%) required revision of the acetabular component for recurrent dislocation. Bone mineral densitometry revealed a minimal bone loss in the proximal femur. This cementless anatomical femoral component with metaphyseal loading but without distal fixation produced satisfactory fixation and encourages proximal femoral loading.

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Section: Discussionmentioning

confidence: 88%

The results of a proximally-coated cementless femoral component in total hip replacement

2008

The Journal of Bone and Joint Surgery. British volume

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“…A recent study of 96 Metasul metal-on-metal implants revealed no incidence of osteolysis after (more than 0.2 per cent) Co-Cr alloy; ASTMF1537; DePuy] upon fibroblast viability have been investiimplantation for 5-11 years [44] and analyses of ex vivo samples have also demonstrated a similar lack gated. Particles were generated in a physiological hip joint simulator with water as the lubricant under of osteolytic activity associated with metal-on-metal implants.…”

Section: Introductionmentioning

confidence: 89%

Biological effects of clinically relevant wear particles from metal-on-metal hip prostheses

Brown

Fisher

Ingham

2006

Proc Inst Mech Eng H

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The problems of osteolysis and late aseptic loosening associated with ultra-high molecular weight polyethylene (UHMWPE) particles has lead to a renewed interest in metal-on-metal prostheses. Wear particles generated by modern Co-Cr-on-Co-Cr prostheses are nanometre in size (range: 10-120 nm; mean: about 40 nm), an order of magnitude smaller than the size of UHMWPE known to be critical for activation of osteolytic cytokines by macrophages. Co-Cr wear particles will induce osteolytic cytokine production by human macrophages, but only at high volumetric concentrations. Unlike UHMWPE, Co-Cr particles are not inert. Co-Cr particles have the potential to release metal ions; they may be toxic to cells, induce deoxyribonucleic acid damage or cause host hypersensitivity. The nanometre size range of Co-Cr wear particles means that they may be disseminated widely in the body. The potential for metal-on-metal bearings to induce adverse effects clinically will be dependent upon the rate of wear. What constitutes a safe wear rate for modern metal-on-metal bearings is unknown. However, the wear of metal-on-metal prostheses is critically dependent upon the design and, in particular, the carbon content of the alloy, the radial clearance, and the head diameter. Thus, the potential for adverse biological reactions associated with metal-on-metal bearings can be reduced by selection of appropriately designed implants.

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“…Although a hypersensitivity reaction attributable to Co and Cr debris has been suggested [5,7,21] as a potential cause for failure of THAs with high-carbide bearings, there are no evidence-based data for this reaction in low-carbide MOM bearings. Therefore we investigated whether there were differences in immunologic hypersensitivity reactions in retrievals from revised THAs with COP versus MOM bearing couples.…”

Section: Discussionmentioning

confidence: 92%

“…These authors [16,22] suggested some characteristics of low-carbide bearings might be involved in the increased rate of periprosthetic osteolysis as no osteolysis has been associated with highcarbide bearings [5][6][7]21] and because the only substantial difference between low-and high-carbide bearings is the carbon content in the bearing. Particle size and morphologic features are not affected by carbide content [8], which implies the increased wear rate of low-carbide and lowcarbide/high-carbide combinations might be related to a higher number of particles released in the periprosthetic tissue, thus contributing to the development of osteolysis.…”

Section: Introductionmentioning

confidence: 96%

Immunologic Adverse Reaction Associated with Low-carbide Metal-on-metal Bearings in Total Hip Arthroplasty

Aroukatos

Repanti

Repantis

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Fixation and osteolysis with Metasul metal-on-metal articulation

Cited by 18 publications

References 16 publications

The results of a proximally-coated cementless femoral component in total hip replacement

The results of a proximally-coated cementless femoral component in total hip replacement

Biological effects of clinically relevant wear particles from metal-on-metal hip prostheses

Immunologic Adverse Reaction Associated with Low-carbide Metal-on-metal Bearings in Total Hip Arthroplasty

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