Metal on Metal Surface Replacement of the Hip

Schmalzried, Thomas P.; Fowble, Vincent A.; Ure, Keith J.; Amstutz, Harlan C.

doi:10.1097/00003086-199608001-00011

Cited by 77 publications

(21 citation statements)

References 14 publications

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“…Few studies appeared to assess the co-morbidity of the patients. Only four published studies, [6][7][8]24,37,42 one industry submission 22 and one unpublished single prosthesis study (Villar R, Cambridge Hip and Knee Unit: personal communication, 2001) had samples that were considered to be homogeneous in terms of disease/diagnosis. The control of bias in study design was generally poor in all studies.…”

Section: Methodological Quality Of Studiesmentioning

confidence: 99%

“…Of the eight metal-on-metal hip resurfacing arthroplasty studies, [20][21][22]24,37,41,42 (Oswestry Outcome Centre, The Robert Jones and Agnes Hunt Orthopaedic and District Hospital: personal communication, 2001) five gave a clear definition of the study question and outcome 21,22,24,37,42 and six clearly described the procedure. 21,22,24,37,42 The studies were rated poorly in two dimensions: the description of the study sample and the control of bias in the study design.…”

Section: Metal-on-metal Hip Resurfacing Arthroplastymentioning

confidence: 99%

“…21,22,24,37,42 The studies were rated poorly in two dimensions: the description of the study sample and the control of bias in the study design. None of the studies had a control group or controlled adequately for confounding factors.…”

Section: Metal-on-metal Hip Resurfacing Arthroplastymentioning

confidence: 99%

“…Four published studies, 24,37,41,42 three industry submissions to NICE, [20][21][22] and one unpublished report (Oswestry Outcome Centre, The Robert Jones and Agnes Hunt Orthopaedic and District Hospital: personal communication, 2001) that investigated metal-on-metal hip resurfacing arthroplasty were identified and, as reported in chapter 2, all involved young patients. The outcomes for more than one prosthesis were reported in all four published studies, two different types of prosthesis were considered in three studies, 24,37,41 and four different prostheses were considered in one.…”

Section: Design Issuesmentioning

confidence: 99%

“…The outcomes for more than one prosthesis were reported in all four published studies, two different types of prosthesis were considered in three studies, 24,37,41 and four different prostheses were considered in one. 42 The length of follow-up was less than 5 years for all studies, with one of the groups from the study by McMinn and colleagues, 42 having an average follow-up of 8.3 months.…”

Section: Design Issuesmentioning

confidence: 99%

See 4 more Smart Citations

A systematic review of the effectiveness and cost-effectiveness of metal-on-metal hip resurfacing arthroplasty for treatment of hip disease

Vale

Wyness

McCormack

et al. 2002

Health Technol Assess

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Section: Methodological Quality Of Studiesmentioning

confidence: 99%

Section: Metal-on-metal Hip Resurfacing Arthroplastymentioning

confidence: 99%

Section: Metal-on-metal Hip Resurfacing Arthroplastymentioning

confidence: 99%

Section: Design Issuesmentioning

confidence: 99%

Section: Design Issuesmentioning

confidence: 99%

See 3 more Smart Citations

A systematic review of the effectiveness and cost-effectiveness of metal-on-metal hip resurfacing arthroplasty for treatment of hip disease

Vale

Wyness

McCormack

et al. 2002

Health Technol Assess

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Femoral cementing technique for hip resurfacing arthroplasty

Bitsch

Heisel

Silva

et al. 2007

Journal Orthopaedic Research

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The resurgence of metal-metal bearings has renewed interest in hip resurfacing, but a paucity of information exists regarding femoral cementing technique. We developed a laboratory model in which 72 open-cell foam specimens were used to simulate bone. Analyses of two cement viscosities, two foam porosities, and six cementing techniques were performed: manual cement application only, manual application and filling of one quarter of the component with cement, filling of half of the component, manual application and half component filling, full component filling, and manual application and full component filling. For manual application, cement was pressurized into the foam by rolling the finger tips. For component filling, a defined quantity of cement was poured into the component before pressing it onto the foam. Specimens were cut into quarters, and cement penetration was quantified in seven areas: top, chamfer, wall, interior area, and proximal, medial, and distal stem. The manual technique showed a 3-mm thick, even cement penetration of the outer fixation surface (top ¼ 26 AE 0 mm 2 , chamfer ¼ 14.9 AE 0.2 mm 2 , wall ¼ 55.6 AE 5.2 mm 2 ). None of the other techniques showed a significantly higher penetration in these areas. Large differences were found between all techniques at the medial stem (27.7 AE 17.5 mm 2 , p < 0.001) and the interior area (128.5 AE 69.6 mm 2 , p ¼ 0.013). An increasing degree of penetration occurred from manual cement application to manual application and full component filling. Sixteen specimens showed incomplete seating, which occurred with all techniques except the manual technique. The manual technique consistently gave an approximately 3-mm thick even cement penetration over the outer fixation area. Pouring any cement into the shell resulted in variable degrees of deeper penetration and a risk of incomplete seating, which have been associated with bone necrosis and early fracture.

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Quality, but not quantity of physical activity is associated with metal ion concentrations in unilateral hip resurfacing

Jelsma

Schotanus

Kuijk³

et al. 2020

Journal Orthopaedic Research

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Little is known about the influence of physical activity (PA) on metal ion concentrations in subjects with metal‐on‐metal hip arthroplasty. Implant wear is thought to be a function of use and thus of patient activity levels. It is hypothesized that daily habitual PA of patients with hip resurfacing arthroplasty (HRA) is associated with metal ion concentrations. Therefore a study was conducted in patients with a unilateral HRA at 10‐years follow‐up. Blood metal ion concentrations were determined. An acceleration‐based activity monitor was used to measure PA in daily life. The cohort consisted of 12 males (75%) and 4 females (25%) with a median age at surgery of 55.5 ± 9.7 years [43.0–67.9] and a median follow‐up of 9.9 ± 1.0 years [9.1–10.9]. The median cobalt and chromium ion concentrations were 25 ± 13 and 38 ± 28 nmol/L. A significant association between sit‐stand transfers and high‐intensity peaks with cobalt ion concentrations were found. Regarding PA and metal ion concentrations as a proxy of wear in HRA, specific activities like transfers or qualitative aspects of activity behavior like intensity, seem to matter more than the quantity of low‐intensity activities like walking or cycling. This suggests that patients may safely engage in such activities to achieve important general health benefits and quality of life.

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Metal on Metal Surface Replacement of the Hip

Cited by 77 publications

References 14 publications

A systematic review of the effectiveness and cost-effectiveness of metal-on-metal hip resurfacing arthroplasty for treatment of hip disease

A systematic review of the effectiveness and cost-effectiveness of metal-on-metal hip resurfacing arthroplasty for treatment of hip disease

Femoral cementing technique for hip resurfacing arthroplasty

Quality, but not quantity of physical activity is associated with metal ion concentrations in unilateral hip resurfacing

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