Elevated Serum Concentrations of Cobalt, Chromium, Nickel, and Manganese After Metal-On-Metal Alloarthroplasty of the Hip: A Prospective Randomized Study

Dahlstrand, Henrik; Stark, André; Anissian, Lucas; Hailer, Nils P

doi:10.1016/j.arth.2008.07.019

Cited by 45 publications

(28 citation statements)

References 30 publications

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“…Therefore, it is important to distinguish between smaller-diameter MOM THA and LD-MOM THA. Furthermore, it is axiomatic that not all MOM articulations are necessarily the same due to differences not only in head sizes but also in geometry, sphericity, metallurgy, surface finish, method of fabrication, and acetabular design [1,2,15,22,27,36,43,56]. Thus, the potential benefits of MOM THA may be offset by the above concerns.…”

Section: Introductionmentioning

confidence: 96%

“…A 2010 American Association of Hip and Knee Surgeons survey demonstrated MOM bearings were routinely used in 68% of the society's respondents [4]. However, this enthusiasm is tempered by concerns over metal ion release [25,32,42,43], pseudotumors [10] in the form of adverse local tissue reactions (ALTRs) [24] or aseptic lymphocyte-dominated vasculitis-associated lesions [9], hypersensitivity [30], metallosis [38,53], osteolysis [15,47], and pain [3,45].…”

Section: Introductionmentioning

confidence: 99%

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Low Incidence of Groin Pain and Early Failure with Large Metal Articulation Total Hip Arthroplasty

Meding

Keating

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Large-diameter metal-on-metal articulations reportedly improve stability and wear in THAs. However, some reports suggest some patients have unexplained hip and early failures with these implants. Thus, the potential benefits may be offset by these concerns. However, the incidence of these problems is not clearly established. Questions/purposes We therefore assessed hip pain, function, osteolysis, and complications in patients with large-diameter metal-on-metal THA. Patients and Methods We retrospectively reviewed 611 patients who had 681 large-diameter metal-on-metal THAs with the same cup and head design. The average age at operation was 62 years, 53% of the THAs were in men, and the average body mass index was 32 kg/m 2 . The diagnosis was osteoarthritis in 92% of the THAs. The minimum followup was 24 months (mean, 37 months; range, 24-60 months). Results Nine of the 611 patients (1.5%) experienced moderate or severe pain in the hip region that we considered to be coming from an extraarticular source in each case. Harris hip scores for pain averaged 42 points. Total Harris hip scores averaged 93 points. Cup abduction averaged 42°, and cup anteversion averaged 26°. There were no infections. Three cups (0.4%) were considered radiographically loose. All were secondary to inadequate seating of the shell. Conclusion Our observations suggest with this implant the concerns of higher incidences of groin pain, early failures, and adverse tissue reactions were not confirmed. Early successes or failures with large-diameter metal-onmetal articulations may be implant specific.

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Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Low Incidence of Groin Pain and Early Failure with Large Metal Articulation Total Hip Arthroplasty

Meding

Keating

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Systemic ion levels, therefore, parallel the peri-prosthetic burden of metal debris and are a marker for bearing performance ( 8 ). However, even in patients with a well-performing metal-on-metal prosthesis, the average cobalt and chromium ion levels exceed those in patients with metal-on-plastic hips ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

Systemic Disease After Hip Replacement: Aeromedical Implications of Arthroprosthetic Cobaltism

Sotos¹,

Tower²

2013

Aviation, Space, and Environmental Medicine

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This case illustrates the potential for a hip prosthesis to occultly impair safe functioning of aviators. Based on this case and others, we suggest modifications to aeromedical policy relating to waiver requests after hip replacement, including routine monitoring of serum cobalt and chromium levels in recipients of metal-on-metal hip prostheses. The evaluation of aviators having an elevated cobalt level is also discussed.

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“…Although some authors have described this reaction to be characteristic of and largely limited to MoM bearings [13,29], it has been previously described with other surface types to a lesser extent [17,26,39]. All metallic implants in a biologic milieu corrode and release ions [22], but higher levels are found with MoM compared to MoP bearings [12,32]. In addition, histologic examination of periprosthetic tissue and neocapsules have found a higher prevalence of PVLI in MoM than non-MoM implants [38].…”

Section: Introductionmentioning

confidence: 84%

Perivascular Lymphocytic Infiltration Is Not Limited to Metal-on-Metal Bearings

Lombardi²,

Berend

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Elevated Serum Concentrations of Cobalt, Chromium, Nickel, and Manganese After Metal-On-Metal Alloarthroplasty of the Hip: A Prospective Randomized Study

Cited by 45 publications

References 30 publications

Low Incidence of Groin Pain and Early Failure with Large Metal Articulation Total Hip Arthroplasty

Low Incidence of Groin Pain and Early Failure with Large Metal Articulation Total Hip Arthroplasty

Systemic Disease After Hip Replacement: Aeromedical Implications of Arthroprosthetic Cobaltism

Perivascular Lymphocytic Infiltration Is Not Limited to Metal-on-Metal Bearings

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