What Happens to Serum Metal Ion Levels After a Metal-on-Metal Bearing is Removed?

Ball, Scott T.; Severns, Dustyn; Linn, Michael S.; Meyer, R. Scott; Swenson, F. Craig

doi:10.1016/j.arth.2013.06.040

Cited by 23 publications

(14 citation statements)

References 13 publications

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“…Ball et al performed a similar study of serum metal ion decline after revision of metal on metal hip arthroplasty in 25 patients. The authors reported a drop in serum cobalt and chromium levels of 80% by 6 weeks and of 90% by 12 weeks [12]. Their study did not include any bilateral patients, though they included a single patient that had undergone a prior initial stage of a bilateral metal on metal THA revision.…”

Section: Discussionmentioning

confidence: 92%

Short-Term Metal Ion Trends Following Removal of Recalled Modular Neck Femoral Stems

Barlow

Assini

Boles

et al. 2015

The Journal of Arthroplasty

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Section: Discussionmentioning

confidence: 92%

Short-Term Metal Ion Trends Following Removal of Recalled Modular Neck Femoral Stems

Barlow

Assini

Boles

et al. 2015

The Journal of Arthroplasty

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“…Twelve articles remained after 198 articles were screened [4,11,12,18,24,28,30,34,38,43,44,48] (Fig. 3).…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…The most frequently reported methods for treating a failed stemmed MoM THA were acetabular revision for modular and nonmodular acetabular components, liner insert exchange for modular acetabular components, and full revision of the femoral and acetabular components (Table 3) [4,24,28,30,34,48]. The mean followup for these articles ranged from 3 to 33 months.…”

Section: Mom Wear In Tha/hrmentioning

confidence: 99%

“…Regardless of the surgical procedure, the majority of patients demonstrated improvements in their symptoms. For patients undergoing revision for elevated serum cobalt and chromium, there were two reports of normalization of blood levels with up to 90% return by 12 weeks [4,30]. However, most other studies emphasized complications and rerevisions, especially when a pseudotumor was present [28,34,48].…”

Section: Mom Wear In Tha/hrmentioning

confidence: 99%

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The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

Engh

Padgett

2014

Clin Orthop Relat Res

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Background Wear and corrosion occurring in patients with hip and knee arthroplasty are common causes of failure leading to revision surgery. A variety of surgical approaches to these problems have been described, with varying efficacy. Polyethylene wear, metal-on-metal (MoM) hip bearing wear, and problems associated with modular taper corrosion are the areas of greatest clinical impact; results of revisions for these problems are likely to dictate a large portion of revision resources for the foreseeable future, and so they call for specific study. Questions/purposes We identified the most frequently reported procedures to treat hip polyethylene wear, knee polyethylene wear, MoM wear after THA, and modular taper corrosion and determined the timing and reasons these failed. Methods We performed systematic reviews of the published literature on the four topics using MEDLINE 1 and Embase in October 2013; searches were supplemented by hand searches of bibliographies. Prespecified criteria resulted in the identification of 38 relevant articles, of which 33 were either case reports or Level IV evidence. Followup was generally at short term and ranged from 0.2 to 8 years. Results The most frequently reported procedures for treating clinically important wear were a partial or complete revision. When treating polyethylene wear, the more frequently reported reasons for hip and knee rerevisions were loosening, continued wear, and instability. Soft tissue reactions were more common and occasionally extensive in patients with MoM or modular taper corrosion. Patients with soft tissue reactions had more complications and higher rerevision rates. Conclusions Studies with longer followup and higher levels of evidence are needed to direct the treatment of wear and corrosion. When soft tissue damage secondary to MoM wear or taper corrosion is present, the results of treatment can be poor. There is an urgent need to better understand these two mechanisms of failure.

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“…Studies have demonstrated a peak in blood cobalt levels at 6-mo post implantation and chromium levels at 9-mo, followed by a steady decline over time [17,18] . Following revision of a MOM implant to an alternative bearing, blood ion levels reduce but do not normalise in the postoperative period [19,20] . Component design and positioning has been shown to be associated with increased wear and as a result raised metal ion levels [21][22][23][24][25] .…”

Section: Metal Debris -A Cause For Concern?mentioning

confidence: 99%

Management of metal-on-metal hip implant patients: Who, when and how to revise?

Berber

Skinner

Hart

2016

WJO

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What Happens to Serum Metal Ion Levels After a Metal-on-Metal Bearing is Removed?

Cited by 23 publications

References 13 publications

Short-Term Metal Ion Trends Following Removal of Recalled Modular Neck Femoral Stems

Short-Term Metal Ion Trends Following Removal of Recalled Modular Neck Femoral Stems

The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

Management of metal-on-metal hip implant patients: Who, when and how to revise?

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