Development and validation of a second-generation metal-on-metal bearing*1Laboratory studies and analysis of retrievals

Rieker, C; Schön, R.; Köttig, P.

doi:10.1016/s0883-5403(04)00516-9

Cited by 47 publications

(44 citation statements)

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“…Our MoM retrieval studies noted similar stripe damage in retrieved MoM [6,9,10], although other groups disavowed their existence [34]. Conventional MoM teaching is that the release of small surface carbides creates 0.5 to 5-lm wide scratches as a ''self-polishing'' mechanism [65,69,73]. Nevertheless, one MoM retrieval study noted the presence of 100-lm wide scratches.…”

Section: Introductionsupporting

confidence: 56%

Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

Clarke

Lazennec

Savisaar

et al. 2013

Clin Orthop Relat Res

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Background Concerns have been raised about the sequelae of metal-on-metal (MoM) bearings in total hip arthroplasty (THA). However, retrieval studies, which offer the best insight into the clinically relevant mechanisms of MoM wear, have followed predictable trends to date such as indicting cobalt-chromium (CoCr) metallurgy, cup design, high conformity between the head and cup, ''steep cups,'' ''microseparation,'' and ''edge wear.'' Questions/purposes We wished to evaluate a set of retrieved 28-mm MoM THA for signs of (1) cup-to-stem impingement; (2) normal wear pattern and concomitant stripe damage on femoral heads that would signify adverse wear mechanics; and (3) well-defined evidence of thirdbody scratches on bearings that would indicate large abrasive particles had circulated the joint space. Methods Ten 28-mm MOM retrievals were selected on the basis that femoral stems were included. Revision surgeries at 3 to 8 years were for pain, osteolysis, and cup loosening. CoCr stems and the MoM bearings were produced by one vendor and Ti6Al4V stems by a second vendor. All but two cases had been fixed with bone cement. We looked for patterns of normal wear and impingement signs on femoral necks and cup rims. We looked for adverse wear defined as stripe damage that was visually apparent on each bearing. Wear patterns were examined microscopically to determine the nature of abrasions and signs of metal transfer. Graphical models recreated femoral neck and cup designs to precisely correlate impingement sites on femoral necks to cup positions and head stripe patterns.

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Section: Introductionsupporting

confidence: 56%

Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

Clarke

Lazennec

Savisaar

et al. 2013

Clin Orthop Relat Res

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“…Minimizing osteolysis and preservation of the bone stock is of particular importance in the younger population; it should be considered as a primary goal because these patients may need more than one prosthesis during their lifetime and the failure of the first one should not make the second or the third one too uncertain. Resistance to wear and limitation of osteolysis could also be obtained with a metal-on-metal combination [37]. However, theoretical concerns remain on these bearing surfaces because cobalt and chromium have been linked to carcinogenicity, mutagenicity, and hypersensitivity [15,43,45].…”

Section: Posttraumatic Arthritis 18mentioning

confidence: 99%

Alumina-on-Alumina Hip Arthroplasty in Patients Younger Than 30 Years Old

Nizard

Pourreyron

Raould

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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THA in patients younger than 30 years old presents challenges: the initial technical challenge relates to the initial disease that often causes deformities making reconstruction difficult, while the long-term challenge is wear and subsequent osteolysis and component loosening. Ceramic-on-ceramic prostheses may represent a valuable option to reduce wear. We retrospectively studied 101 patients (132 hips) with ceramic-on-ceramic prostheses implanted from 1977 to 2004. As a result of the long span of time, different implant designs and modes of fixation were used. The average age of the patients was 23.4 ± 5 years (range, 13-30 years), and the main indication for THA was femoral head necrosis. The minimum followup was 1 year (mean, 6.9 years; range, 1-26.5 years). We documented 17 revisions (13%) for aseptic loosening. Twelve were for isolated acetabular loosening, two for isolated femoral loosening, and three for loosening of both components. Survivorship was 82.1% at 10 years and 72.4% at 15 years. Inferior survivorship was observed for THA performed after secondary arthritis related to slipped capital epiphysis or trauma. Limited osteolysis was observed in one hip. The main limiting factor in this series was the fixation of the acetabular component. However, improvements in the design and in the mode of fixation of this component should enhance long-term results.

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“…Although we had one hip (0.7%) with a dislocation, there have been no reoperations for dislocation in our series. Implant-to-implant impingement, while being noted in some MOM series with smaller heads, was not seen in this series with a 36-mm head [8,22].…”

Section: Discussionmentioning

confidence: 44%

“…One current estimate suggests they are used in 35% of total hip arthroplasties performed in the United States [2]. Hip simulators demonstrate MOM bearings have lower wear volume than metal-on-polyethylene bearings and the amount of wear decreases as head size increases [9,22]. Therefore manufacturers have developed MOM bearings with larger head diameters than is possible with other bearing surfaces.…”

Section: Introductionmentioning

confidence: 99%

Metal-on-Metal Hip Arthroplasty: Does Early Clinical Outcome Justify the Chance of an Adverse Local Tissue Reaction?

Engh

2010

Clinical Orthopaedics &Amp; Related Research

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Larger diameter metal-on-metal (MOM) bearing hips offer the possibility of low wear and reduced risk of dislocation. We reviewed the first 126 patients (131 hips) who had a large-head (36-mm) MOM bearing surface to report the early clinical outcome and especially to determine the occurrence of dislocation and wear-related concerns. The minimum followup was 5 years (mean, 5.6 years; range, 5-7 years). We found a 98% survivorship free of component revision. No hips had been revised for dislocation. Three hips (2%) had small femoral osteolytic lesions. Because this series of patients did not completely represent our experience with this bearing surface, we queried our database for the 828 patients (945 hips)

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Development and validation of a second-generation metal-on-metal bearing*1Laboratory studies and analysis of retrievals

Cited by 47 publications

References 0 publications

Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

Alumina-on-Alumina Hip Arthroplasty in Patients Younger Than 30 Years Old

Metal-on-Metal Hip Arthroplasty: Does Early Clinical Outcome Justify the Chance of an Adverse Local Tissue Reaction?

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