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  • Book
  • © 2014

Metal-on-Metal Bearings

A Clinical Practicum

  • Presents an historical overview of the use of metal-on-metal articulations
  • Collects for the first time the information necessary to assess clinically and biologically relevant patient outcomes
  • Addresses the practical questions that are being raised by surgeons, researchers, and engineers
  • Features contributions by acknowledged leaders in their fields
  • Describes what the clinician needs to know in order to practice evidence-based medicine
  • Projects directions for clinical, biological, and biomechanical research efforts
  • Includes supplementary material: sn.pub/extras

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Table of contents (11 chapters)

  1. Front Matter

    Pages i-x
  2. Introduction

    1. Front Matter

      Pages 1-1
    2. Overview of Metal-on-Metal Implants

      • Lynne C. Jones, Warren O. Haggard, A. Seth Greenwald
      Pages 3-11
  3. Clinical

    1. Front Matter

      Pages 21-21
    2. Metal Reactivity: Its Influence on Primary and Revision Outcomes

      • George Grammatopoulos, Hemant Pandit, Adrian Low, David Murray
      Pages 39-62
    3. Metal Sensitivity: Is It Possible to Determine Clinically?

      • Nadim J. Hallab, Paul H. Wooley
      Pages 83-106
  4. Biology

    1. Front Matter

      Pages 107-107
    2. Wound Healing, Chronic Inflammation, and Immune Responses

      • Paul H. Wooley, Nadim J. Hallab
      Pages 109-133
    3. Benign Responses to Orthopaedic Implants: Really?

      • H. John Cooper, Joshua J. Jacobs
      Pages 135-151
    4. What Does the Histology Tell Us?

      • Thomas W. Bauer
      Pages 153-162
  5. Biomechanics

    1. Front Matter

      Pages 163-163
    2. Why Metal-on-Metal: What Laboratory Tests Have Shown Us

      • Peter Thomas, Burkhard Summer, Marc Thomsen, Veit Krenn, Jan Philippe Kretzer
      Pages 165-172
    3. What Do the Retrievals Really Tell Us?

      • Robin Pourzal, Robert M. Urban, Markus A. Wimmer
      Pages 173-193
  6. Back Matter

    Pages 195-200

About this book

This book addresses the background and significance of the factors potentially influencing the clinical and biological outcomes of metal-on-metal hip implants. Metal-on-metal bearings were introduced and evaluated as an alternative to other bearing couples, particularly metal-on-polyethylene, due to their enhanced wear resistance as determined in laboratory testing. Initially, reports of short-term clinical outcomes were favorable and an increasing number of metal-on-metal prostheses were implanted. Subsequently, isolated case findings describing adverse tissue responses around the articulation became the harbinger of an increasing number of reports describing pseudotumors and other significant lymphocytic-based responses associated with metal-on-metal prostheses. Questions have been raised as to whether this is an implant, design, or patient-specific response. The reasons why some patients have a negative biological response and pathology while others do not remain to be determined, but tens of thousands of patients in the US, the UK, and around the world are considered to be at risk. Leading researchers and clinicians describe the issues related to the nature of the biological and pathological responses and the protocols that should be followed to determine if an adverse response is occurring. This book is essential reading for researchers, engineers, and orthopaedic surgeons who are involved in the design, evaluation, and implantation of metal-on-metal prostheses.

Editors and Affiliations

  • Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, USA

    Lynne C. Jones

  • Department of Biomedical Engineering, University of Memphis, Memphis, USA

    Warren O. Haggard

  • Orthopaedic Research Laboratories Lutheran Hospital, Cleveland Clinic, Cleveland, USA

    A. Seth Greenwald

Bibliographic Information

Buy it now

Buying options

eBook USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Other ways to access