Retrieval Analysis of Modern Knee Tumor Megaendoprosthesis Shows Considerable Volumetric Metal Wear Generated at the Rotating Hinge

Bormann, Therese; Jäger, Sebastian; Kretzer, Jan Philippe; Nebel, Laura; Clarius, Lucas; Omlor, Georg; Bitsch, Rudi G.; Lehner, Burkhard

doi:10.3390/ma13071519

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…Retrieval analysis has shown considerable volumetric metal wear in this type of coupling. 13 allocation is shown in a consolidated standards of Reporting Trials (CONSORT) flow diagram (figure 1). A total of 38 patients were excluded and 25 did not agree to the studybased blood testing and were therefore not included in this study but consented to general data collection, in accordance with the Institutional Review Board statement (figure 1).…”

Section: Methodsmentioning

confidence: 99%

Critically high metal ion levels found in metal-on-metal modular hinged knee arthroplasty

Gramlich

Hofmann

Kress

et al. 2022

The Bone & Joint Journal

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Aims This study compared the cobalt and chromium serum ion concentration of patients treated with two different metal-on-metal (MoM) hinged total knee arthroplasty (TKA) systems, as well as a titanium nitride (TiN)-coated variant. Methods A total of 63 patients (65 implants) were treated using either a MoM-coated (n = 29) or TiN-coated (n = 7) hinged TKA (GenuX mobile bearing, MUTARS; Implantcast, Germany) versus the BPKS (Brehm, Germany) hinged TKA (n = 27), in which the weight placed on the MoM hinge is diffused through a polyethylene (PE) inlay, reducing the direct load on the MoM hinge. Serum cobalt and chromium ion concentrations were assessed after minimum follow-up of 12 months, as well as functional outcome and quality of life. Results No differences in mean age (69 years, 40 to 86), mean age adapted Charlson Comorbidity Index (3.1 (SD 1.4)), mean BMI (29.2 kg/m2 (SD 5.8)), or number of other implants were observed between groups. Significant improvements in outcome scores and pain levels were achieved for all groups, and there was no difference in quality of life (12-Item Short-Form Health Survey questionnaire (SF-12)). Mean cobalt and chromium ion levels were significantly higher for the GenuX versus the BPKS hinged TKA (GenuX vs BPKS: cobalt: 16.3 vs 9.4 µg/l; chromium: 9.5 vs 5.2 µg/l). The TiN-coated implants did not appear to confer improvement in the metal ion levels. Metal ion concentrations above 7 µg/l were detected in 81%(29/36) of GenuX patients versus 41% (11/27) in the BPKS group. No GenuX patients had normal levels under 2 µg/l, versus 22% of BPKS patients. No significant reduction in outcome scores was observed regardless of the metal ion levels, whereas higher work-related activity was correlated with higher chromium concentrations. Conclusion Hinged TKA, using MoM hinges, resulted in critically high cobalt and chromium ion concentrations. The BPKS hinged TKA showed significantly lower metal ion concentrations compared with the GenuX TKA. No benefits were observed using TiN coating. The different weightbearing mechanics might influence the wear of the component materials. Higher workloads and physical activity could influence chromium levels. Cite this article: Bone Joint J 2022;104-B(3):376–385.

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Section: Methodsmentioning

confidence: 99%

Critically high metal ion levels found in metal-on-metal modular hinged knee arthroplasty

Gramlich

Hofmann

Kress

et al. 2022

The Bone & Joint Journal

View full text Add to dashboard Cite

show abstract

“…The main aspects that are addressed in this Special Issue are related to new materials, the design and manufacturing considerations of implants [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ], implant wear and its potential clinical consequences [ 11 , 12 , 13 , 14 , 15 , 16 ], implant fixation [ 17 , 18 , 19 ], infection-related material aspects [ 20 , 21 ] and taper-related research topics [ 22 , 23 , 24 ].…”

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confidence: 99%