Reducing Metal Ion Release Following Hip Resurfacing Arthroplasty

2011 ◽  
Vol 42 (2) ◽  
pp. 169-180 ◽  
Author(s):  
David J. Langton ◽  
Thomas J. Joyce ◽  
Navjeet Mangat ◽  
James Lord ◽  
Maarten Van Orsouw ◽  
...  
Keyword(s):  
Metal Ion ◽  
Hip Resurfacing ◽  
Ion Release ◽  
Hip Resurfacing Arthroplasty ◽  
Resurfacing Arthroplasty ◽  
Metal Ion Release

scholarly journals Outcomes after the conversion of metal-on-metal hip resurfacing arthroplasty to ceramic-on-ceramic total hip arthroplasty: A retrospective observational study with a mean 10-year follow-up

2020 ◽  
Author(s):  
Weiguang Yu ◽  
Mao Shuai ◽  
Jinluan Lin ◽  
Baomin Chen ◽  
Mingdong Zhao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Metal Ion ◽  
Hip Resurfacing ◽  
Hip Resurfacing Arthroplasty ◽  
Resurfacing Arthroplasty ◽  
Metal On Metal ◽  
The Mean ◽  
Ceramic On Ceramic

Abstract Background The purpose of this retrospective study was to assess clinical outcomes following failed metal-on-metal hip resurfacing arthroplasty (MoM-HRA) revised using ceramic-on-ceramic total hip arthroplasty (CoC-THA) via the direct anterior approach (DAA).Methods Data involving 112 patients (112 hips) with failed primary MoM-HRA that was revised using CoC-THA via the DAA during 2006 - 2018 were retrospectively analysed. The mean age was 54.6 years (45–63 years). Frequent surgical indications for conversion were aseptic loosening and femoral neck fracture. The primary endpoint was the Postel-Merle d’Aubigne functional score (PMA). Secondary endpoints were the major orthopaedic complication rate and serum metal ion levels (chromium and cobalt).Results The mean follow-up time was 10 years (range, 4 - 13 years). The mean PMA improved from 9 (4-14) to 16 (13-18) (p = 0.001). Six patients had undergone a re-revision intervention. Fourteen incidents of aseptic loosening and four periprosthetic fractures were observed. A consistent decline in mean serum metal ion levels was detected [chromium decreased from 36.6 μg/L (12.5-76.5 μg/L) prior to conversion to 2.6 μg/L (0.1-13.5 μg/L) at final follow-up (p = 0.001), cobalt decreased from 37.5 μg/L (6.7-93.2 μg/L) to 2.2 μg/L (1.2-18.4 μg/L) (p =0.003)].Conclusion Failed primary MoM-HRA converted to CoC-THA using the DAA yielded acceptable clinical outcomes.

Blood metal ion concentrations after hip resurfacing arthroplasty

2009 ◽  
Vol 91-B (10) ◽  
pp. 1287-1295 ◽  
Author(s):  
D. J. Langton ◽  
A. P. Sprowson ◽  
T. J. Joyce ◽  
M. Reed ◽  
I. Carluke ◽  
...  
Keyword(s):  
Metal Ion ◽  
Hip Resurfacing ◽  
Hip Resurfacing Arthroplasty ◽  
Ion Concentrations ◽  
Resurfacing Arthroplasty

Characterization of the Running-in Period in Total Hip Resurfacing Arthroplasty: An in Vivo and in Vitro Metal Ion Analysis

2008 ◽  
Vol 90 (Suppl 3) ◽  
pp. 125-133 ◽  
Author(s):  
Christian Heisel ◽  
Nikolaus Streich ◽  
Michael Krachler ◽  
Eike Jakubowitz ◽  
J Philippe Kretzer
Keyword(s):  
Metal Ion ◽  
Hip Resurfacing ◽  
Hip Resurfacing Arthroplasty ◽  
Total Hip ◽  
Resurfacing Arthroplasty ◽  
Metal Ion Analysis ◽  
Ion Analysis

scholarly journals Failure of an ACCIS metal-on-metal hip resurfacing prosthesis: A case report

2017 ◽  
Vol 231 (12) ◽  
pp. 1188-1194 ◽  
Author(s):  
Martin C Bone ◽  
Andrew Naylor
Keyword(s):  
Wear Rate ◽  
Metal Ion ◽  
Hip Prosthesis ◽  
Sudden Change ◽  
Hip Resurfacing ◽  
Niobium Nitride ◽  
Acetabular Cup ◽  
Ion Release ◽  
Metal Ion Release ◽  
Measuring Machine

The introduction of coatings on joint replacements was intended to reduce wear volumes, prevent corrosion and reduce metal ion release. However, retrieval analysis to confirm their in vivo performance has been limited. The aim of study was to examine the coating on a retrieved hip prosthesis to determine whether substantial damage or wear had occurred. A single advanced ceramic-coated implant systems titanium niobium nitride-coated hip resurfacing prosthesis was retrieved for examination. Wear volumes and surface roughness were measured to quantify the damage to the articulating surfaces. The coating had been completely removed from substantial parts of both the femoral head and the acetabular cup, corresponding to areas of wear as measured by a coordinate measuring machine. The total wear rate (61 mm3/year) was high and corresponded with the high metal ion levels recorded pre-operatively (83 ppb chromium and 110 ppb cobalt). Roughness data indicated that the coating has a lower roughness than the substrate and substantially lower than the boundary between the coating and the substrate. The wear rate is very high and it is likely that damage to the coating resulted in accelerated wear of the prosthesis. No sudden change between the boundary of the substrate and the coating was observed that would indicate delamination or failure of the coating substrate interface layer. While coatings may offer some theoretical benefits, they may also result in catastrophic failure of the prosthesis.

Component Position and Metal Ion Levels in Computer-Navigated Hip Resurfacing Arthroplasty

2017 ◽  
Vol 32 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Stephen M. Mann ◽  
Manuela Kunz ◽  
Randy E. Ellis ◽  
John F. Rudan
Keyword(s):  
Metal Ion ◽  
Hip Resurfacing ◽  
Component Position ◽  
Hip Resurfacing Arthroplasty ◽  
Resurfacing Arthroplasty

Hip resurfacing arthroplasty in young patients: international high-volume centres’ report on the outcome of 11,382 metal-on-metal hip resurfacing arthroplasties in patients ⩽50 years at surgery

2020 ◽  
pp. 112070002095735
Author(s):  
Catherine Van Der Straeten
Keyword(s):  
Metal Ion ◽  
Articular Surface ◽  
Young Patients ◽  
Hip Resurfacing ◽  
Hip Resurfacing Arthroplasty ◽  
Resurfacing Arthroplasty ◽  
Metal On Metal ◽  
Implant Survivorship ◽  
Articular Surface Replacement ◽  
Tissue Reactions

Background: Total hip arthroplasty (THA) in patients younger than 50 years poses significant challenges including postoperative limitations of activity and higher failure rates. Sub-par outcomes of hip resurfacing arthroplasty (HRA) in registries remain controversial due to multiple confounders. Favourable HRA results in some studies are often regarded as irreproducible. The aim of this study is to analyse HRA outcomes in a large international cohort. Patients and methods: We compiled a database of 11,382 HRA patients ⩽50 years from an international group of 27 experienced HRA centres from 13 countries. 18 different metal-on-metal (MoM) HRA designs were included with a mean follow-up of 7.6 years. Outcomes were implant survivorship, revision rates, causes for revision, clinical scores and metal ion levels. Outcomes were compared between genders, sizes, implant types and pre-operative diagnoses. Results: Overall cumulative Kaplan-Meier survivorship was 88.9% at 22 years (95% CI: 88.3–89.5%). 2 HRA designs (DePuy Articular Surface Replacement (ASR), and Corin Cormet Hip Resurfacing System (CORMET)) led to inferior results while all others yielded similar survivorships. Excluding ASR and CORMET, implant survivorship in 11,063 cases was 95% at 10 years and 90% at 22 years. In men, implant survivorship was excellent: 99% at 10 years and 92.5% at 21 years. In females, implant survivorship was 90% at 10 years and 81.3% at 22 years. The overall revision rate was 3.6% with most common reasons for revision being implant loosening and adverse local tissue reactions. The best survivorship was found in patients with osteoarthritis (95% CI, 92.1–93.3% at 22 years), the poorest was among dysplastic hips (78.3%; 95% CI, 76.5–80.1% at 20 years, p < 0.001). Conclusions: Comparable revision rates demonstrated here may mitigate some concerns for safety and longevity of MoM HRA implants. Higher demands for activity and functionality in younger patients make HRA a potential alternative to THA.

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