The Relationship Between Activity and Ions in Patients with Metal-on-Metal Bearing Hip Prostheses

Heisel, Christian; Silva, Maurício; Skipor, Anastasia K.; Jacobs, Joshua J.; Schmalzried, Thomas P.

doi:10.2106/jbjs.d.01820

Cited by 103 publications

(66 citation statements)

References 21 publications

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“…1). We do not have an explanation for the results observed in this patient; a previous study [19] suggested it was not a variable in ion release. Clinical interpretation of increased ion levels is difficult because the in vivo threshold limit is still unknown.…”

Section: Discussioncontrasting

confidence: 77%

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Does Ion Release Differ Between Hip Resurfacing and Metal-on-metal THA?

Moroni

Savarino

Cadossi

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Modern metal-on-metal hip resurfacing was introduced as a bone-preserving method of joint reconstruction for young and active patients; however, the large diameter of the bearing surfaces is of concern for potential increased metal ion release. We hypothesized there were no differences in serum concentrations of chromium, cobalt, and molybdenum between patients who had metalon-metal hip resurfacing (Group A; average head diameter, 48 mm; median followup, 24 months) and patients who had 28-mm metal-on-metal THA (Group B; median followup, 25 months). Serum concentrations also were compared with concentrations in healthy subjects. We identified no differences in ion levels between Groups A and B. A distinction was made according to gender. Women showed a higher chromium release in Group A whereas men had a higher cobalt release in Group B. Values obtained from Group A were higher than those of the control subjects. Our data suggest metal-on-metal bearings for THA should not be rejected because of concern regarding potential increased metal ion release; however, patients with elevated ion levels, even without loosening or toxicity, could be at higher risk and should be followed up periodically. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussioncontrasting

confidence: 77%

“…Two patients in Group A were involved in lowimpact sport activities (jogging and weight lifting, once a week). The activity level was not considered a confounding variable based on a previous study [19].…”

Section: Methodsmentioning

confidence: 99%

Does Ion Release Differ Between Hip Resurfacing and Metal-on-metal THA?

Moroni

Savarino

Cadossi

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…The study cohort included 7 patients with bilateral THA; their creatinine clearance was similar to the values of patients with unilateral THA. Furthermore, the steady-state metal ion levels appear to be insensitive to short-term changes in activity level (Heisel et al 2005).…”

Section: Mom Hip Resurfacing Arthroplastymentioning

confidence: 99%

Metal-on-metal hip resurfacing arthroplasty: A review of periprosthetic biological reactions

et al. 2008

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“…Although MOM-THA is in widespread use [24], concerns remain regarding wear and corrosion of the bearing surfaces and the subsequent increase in serum metal ion levels [2,8,10,18,28]. All metal implants corrode at a rate which is determined partly by their surface area [4].…”

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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The Relationship Between Activity and Ions in Patients with Metal-on-Metal Bearing Hip Prostheses

Cited by 103 publications

References 21 publications

Does Ion Release Differ Between Hip Resurfacing and Metal-on-metal THA?

Does Ion Release Differ Between Hip Resurfacing and Metal-on-metal THA?

Metal-on-metal hip resurfacing arthroplasty: A review of periprosthetic biological reactions

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

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