Modern metal-on-metal hip implants.
This Technology Overview was prepared using systematic review methodology and summarizes the findings of studies published as of July 15, 2011, on modern metal-on-metal hip implants. Analyses conducted on outcomes by two joint registries indicate that patients who receive metal-on-metal total hip arthroplasty (THA) and hip resurfacing are at greater risk for revision than are patients who receive THA using a different bearing surface combination. Data from these registries also indicate that larger femoral head components have higher revision rates and risk of revision and that older age is associated with increased revision risks of large-head metal-on-metal THA. Several studies noted a correlation between suboptimal hip implant positioning and higher wear rates, local metal debris release, and consequent local tissue reactions to metal debris. In addition, several studies reported elevated serum metal ion concentrations in patients with metal-on-metal hip articulations, although the clinical significance of these elevated ion concentrations remains unknown.
Department of Orthopaedic Surgery, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco Medical Center, San Francisco, CA, USA.
Kevin J
KJ
Bozic
James
J
Browne
Chris J
CJ
Dangles
Paul A
PA
Manner
Adolph J
AJ
Yates
Kristy L
KL
Weber
Kevin M
KM
Boyer
Paul
P
Zemaitis
Anne
A
Woznica
Charles M
CM
Turkelson
Janet L
JL
Wies
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D006622:Hip Prosthesis; D006801:Humans; D008670:Metals; D011474:Prosthesis Design; D012086:Reoperation
D008670:Metals