title: Metal Ion release with large-diameter metal-on-metal hip arthroplasty.
abstract: Preoperative and postoperative ion concentrations were measured in 29 metal-on-metal, large-diameter head total hip arthroplasty (LDH-THA) patients. Mean chromium, cobalt (Co), and titanium levels from LDH-THA were 1.3, 2.2, and 2.7 μg/L at 12 months. The open femoral head design showed significantly higher Co concentrations than the closed design (3.0 vs 1.8 μg/L, P = .037). Compared with previously published ion levels from a hip resurfacing system presenting the same bearing characteristics, Co levels were significantly higher in LDH-THA (2.2 vs 0.7 μg/L, P < .001). This study has demonstrated that the addition of a sleeve with modular junctions and an open femoral head design of LDH-THA causes more Co release than bearing surface wear (157% and 67%, respectively). Even if no pathologic metal ion threshold level has been determined, efforts should be made to minimize its release. We recommend modification or abandonment of the modular junction and femoral head open design for this specific LDH-THA system.
authors.affiliation: Surgery Department of Maisonneuve Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Pascal-André
authors.initials: PA
authors.lastname: Vendittoli
authors.forename: Traian
authors.initials: T
authors.lastname: Amzica
authors.forename: Alain G
authors.initials: AG
authors.lastname: Roy
authors.forename: Daniel
authors.initials: D
authors.lastname: Lusignan
authors.forename: Julien
authors.initials: J
authors.lastname: Girard
authors.forename: Martin
authors.initials: M
authors.lastname: Lavigne
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D002857:Chromium / Q000097:blood*; D003035:Cobalt / Q000097:blood*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008670:Metals; D011446:Prospective Studies; D011474:Prosthesis Design; D014025:Titanium / Q000097:blood*; D055815:Young Adult
chemical_list: D008670:Metals; D002857:Chromium; D003035:Cobalt; D014025:Titanium