Metal Release in Patients Who Have Had a Primary Total Hip Arthroplasty. A Prospective, Controlled, Longitudinal Study*

Jacobs, Joshua J.; Skipor, Anastasia K.; Patterson, Leslie; Hallab, Nadim J.; Paprosky, Wayne G.; Black, Jonathan; Galante, Jorge O.

doi:10.2106/00004623-199810000-00006

Cited by 549 publications

(339 citation statements)

References 28 publications

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“…In addition, there were four cases (7%) of metallosis directly associated with degradation of the second junction that contributed to revision of the device. Several studies show degradation products from metallic devices may have deleterious local and systemic biologic and clinical effects over the short and long term [13,14,20] (Table 6). Metal release likely emanates from modular head-neck junctions, rather than passive surface dissolution [14].…”

Section: Resultsmentioning

confidence: 99%

“…These studies are in direct contrast to our study where revision of some devices can be attributed to degradation at the neck-stem taper junction. Modularity may come at a cost, with the neck-stem junction showing greater fretting and crevice corrosion compared to the head-neck junction and as a consequence increased metallic debris and soluble metallic ions, both locally and systemically [13,27]. Clinically, eight of the retrieved devices had metallosis with two cases of ALVALs and one case of neck loosening/retroversion.…”

Section: Resultsmentioning

confidence: 99%

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Proximal Component Modularity in THA—At What Cost?: An Implant Retrieval Study

Kop

Keogh

Swarts

2012

Clinical Orthopaedics &Amp; Related Research

130

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Background While modular femoral heads have been used in THA for decades, a recent innovation is a second neck-stem taper junction. Clinical advantages include intraoperative adjustment of leg length, femoral anteversion, and easier revision, all providing flexibility to the surgeon; however, there have been reports of catastrophic fracture, cold welding, and corrosion and fretting of the modular junction.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Proximal Component Modularity in THA—At What Cost?: An Implant Retrieval Study

Kop

Keogh

Swarts

2012

Clinical Orthopaedics &Amp; Related Research

130

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“…Suspicions about a possible causal association between joint replacements and cancer are largely concerned with the effects of metal implants (Sunderman, 1989;Jacobs et al, 1998;Urban et al, 2000). It has been suspected that minute, free-roaming particles, resulting from wear and tear, could have carcinogenic effects and, in particular, might increase the risk of lymphoma, leukaemia and cancer of the urinary tract.…”

Section: Discussionmentioning

confidence: 99%

“…There has been long-standing interest in whether prolonged contact between body tissue and plastic and metal prostheses does increase the risk of cancer. Corrosion and normal wear and tear of prostheses are known to liberate polyethylene and metallic particles (Sunderman, 1989;Jacobs et al, 1998;Urban et al, 2000). If these have any pathological effect, it is thought that the corrosion products are most likely to affect the haematopoietic, lymphatic and urinary systems.…”

mentioning

confidence: 99%

Cancer following hip and knee arthroplasty: record linkage study

et al. 2005

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Concerns have been raised that degradation of implants used in hip and knee arthroplasty may lead to an increased risk of some cancers, particularly those of the haematopoietic, lymphatic and urinary systems. We used linked statistical records of hospital admissions and deaths to compare cancer rates in cohorts of people who had undergone hip or knee arthroplasty with a comparison cohort. We did not find an elevated risk for cancer, overall, in either the hip or knee cohort or in both combined (rate ratio for both combined 0.99; 95% confidence intervals 0.95 -1.02), or for haematopoietic, lymphatic or urinary system cancers. There was also no elevation in risk of cancer more than 10 years after arthroplasty. Our findings add to the evidence that arthroplasty is safe in respect of cancer risk.

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“…The better lubrication regime observed with large-diameter MOM bearings with low clearance allows for a thicker fluid film which completely separates the articular surfaces, generating less wear [22,35]. Despite the increased surface area available for corrosion [19,40], the potentially reduced surface wear may diminish the production of metal ions. Nonetheless, concerns have been raised regarding increased postoperative serum metal ion concentrations [20].…”

Section: Introductionmentioning

confidence: 99%

Do Ion Levels In Hip Resurfacing Differ From Metal-on-metal THA at Midterm?

Moroni

Savarino

Hoque

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Metal-on-metal Birmingham hip resurfacing (MOM-BHR) is an alternative to metal-on-metal total hip arthroplasty (MOM-THA), especially for young and/or active patients. However, wear resulting in increased serum ion levels is a concern. Questions/purposes We asked whether (1) serum chromium (Cr), cobalt (Co), and molybdenum (Mo) concentrations would differ between patients with either MOM-BHR or MOM-THA at 5 years, (2) confounding factors such as gender would influence ion levels; and (3) ion levels would differ at 2 and 5 years for each implant type. Patients and Methods Ions were measured in two groups with either MOM-BHR (n = 20) or MOM-THA (n = 35) and a mean 5-year followup, and two groups with either MOM-BHR (n = 15) or MOM-THA (n = 25) and a mean 2-year followup. Forty-eight healthy blood donors were recruited for reference values. Results At 5 years, there were no differences in ion levels between patients with MOM-BHR or MOM-THA. Gender was a confounding factor, and in the MOM-BHR group at 5 years, Cr concentrations were greater in females compared with those of males. Mean ion levels were similar in patients with 2 and 5 years of followup for each implant type. Ion levels in patients were sevenfold to 10-fold higher than in controls. Conclusions As the metal ion concentrations in the serum at 5 years were in the range reported in the literature, we do not believe concerns regarding excessive metal ion levels after MOM-BHR are justified. Level of Evidence Level III, therapeutic study. See the Guidelines for Authors for a complete description of level of evidence.

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Metal Release in Patients Who Have Had a Primary Total Hip Arthroplasty. A Prospective, Controlled, Longitudinal Study*

Cited by 549 publications

References 28 publications

Proximal Component Modularity in THA—At What Cost?: An Implant Retrieval Study

Proximal Component Modularity in THA—At What Cost?: An Implant Retrieval Study

Cancer following hip and knee arthroplasty: record linkage study

Do Ion Levels In Hip Resurfacing Differ From Metal-on-metal THA at Midterm?

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