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Why Metal-on-Metal: What Laboratory Tests Have Shown Us

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Metal-on-Metal Bearings

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Abstract

A large number of metal-on-metal (MoM) bearings have been implanted in the form of conventional and resurfacing hip arthroplasty. Their metallurgy was promising toughness, corrosion resistance and low-wear rate as compared to metal-on-polyethylene bearings. Hip simulator wear studies showed that wear rate was increasing with insufficient lubrification, variations in component position, equatorial contact, impingement or increased cup inclination angle. In MoM arthroplasty increased Co and Cr blood levels have been observed. Despite some controversial discussion on threshold levels for local and systemic adverse effects, increasing clinical experience on the spectrum of adverse reactions have drawn attention to MoM pairings in general and the need for more study and assessment of this MoM bearing couple.

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References

  1. Chan FW, Bobyn JD, Medley JB, Krygier JJ, Tanzer M (1999) The Otto Aufranc Award. Wear and lubrication of metal-on-metal hip implants. Clin Orthop Relat Res (369):10–24 (Epub 1999/12/28)

    Article  Google Scholar 

  2. Davies AP, Willert HG, Campbell PA, Learmonth ID, Case CP (2005) An unusual lymphocytic perivascular infiltration in tissues around contemporary metal-on-metal joint replacements. J Bone Joint Surg Am 87(1):18–27 (Epub 2005/01/07)

    Article  CAS  Google Scholar 

  3. Delaunay C, Petit I, Learmonth ID, Oger P, Vendittoli PA (2010) Metal-on-metal bearings total hip arthroplasty: the cobalt and chromium ions release concern. Orthop Traumatol Surg Res 96(8):894–904 (Epub 2010/09/14)

    Article  CAS  Google Scholar 

  4. Dowson D, Hardaker C, Flett M, Isaac GH (2004) A hip joint simulator study of the performance of metal-on-metal joints: Part II: design. J Arthroplasty 19(8 Suppl 3):124–30 (Epub 2004/12/04)

    Google Scholar 

  5. Granchi D, Cenni E, Trisolino G, Giunti A, Baldini N (2006) Sensitivity to implant materials in patients undergoing total hip replacement. J Biomed Mater Res B Appl Biomater 77(2):257–64 (Epub 2005/11/03)

    Google Scholar 

  6. Hallab NJ, Anderson S, Stafford T, Glant T, Jacobs JJ (2005) Lymphocyte responses in patients with total hip arthroplasty. J Orthop Res 23(2):384–91

    Article  CAS  Google Scholar 

  7. Hannemann F, Hartmann A, Schmitt J, Lutzner J, Seidler A, Campbell P et al (2013) European multidisciplinary consensus statement on the use and monitoring of metal-on-metal bearings for total hip replacement and hip resurfacing. Orthop Traumatol Surg Res 99(3):263–71 (Epub 2013/03/20)

    Article  CAS  Google Scholar 

  8. Hart AJ, Sabah SA, Bandi AS, Maggiore P, Tarassoli P, Sampson B et al (2011) Sensitivity and specificity of blood cobalt and chromium metal ions for predicting failure of metal-on-metal hip replacement. J Bone Joint Surg Br 93(10):1308–13 (Epub 2011/10/05)

    CAS  Google Scholar 

  9. Hart AJ, Muirhead-Allwood S, Porter M, Matthies A, Ilo K, Maggiore P et al (2013) Which factors determine the wear rate of large-diameter metal-on-metal hip replacements? Multivariate analysis of two hundred and seventy-six components. J Bone Joint Surg Am 95(8):678–85 (Epub 2013/04/19)

    Article  CAS  Google Scholar 

  10. Kamali A, Hussain A, Li C, Pamu J, Daniel J, Ziaee H et al (2010) Tribological performance of various CoCr microstructures in metal-on-metal bearings: the development of a more physiological protocol in vitro. J Bone Joint Surg Br 92(5):717–25 (Epub 2010/05/04)

    CAS  Google Scholar 

  11. Krenn V, Morawietz L, Kienapfel H, Ascherl R, Matziolis G, Hassenpflug J et al (2013) Erweiterte Konsensusklassifikation: Histopathologische Klassifikation von Gelenkendoprothesen-assoziierten Erkrankungen. Z Rheumatol 72(4):383–392 (Epub 2013/03/01, Revised consensus classification: histopathological classification of diseases associated with joint endoprostheses)

    Google Scholar 

  12. Kretzer JP (2010) Biotribology of total hip replacement: the metal-on-metal articulation. In: Davim JP (ed) Biotribology. ISTE and Wiley, London and Hoboken

    Google Scholar 

  13. Kretzer JP, Kleinhans JA, Jakubowitz E, Thomsen M, Heisel C (2009) A meta-analysis of design- and manufacturing-related parameters influencing the wear behavior of metal-on-metal hip joint replacements. J Orthop Res 27(11):1473–80 (Epub 2009/05/28)

    Article  Google Scholar 

  14. Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005–2030. J Bone Joint Surg Am 89(4):780–5 (Epub 2007/04/04)

    Article  Google Scholar 

  15. Langton DJ, Sidaginamale RP, Joyce TJ, Natu S, Blain P, Jefferson RD et al (2013) The clinical implications of elevated blood metal ion concentrations in asymptomatic patients with MoM hip resurfacings: a cohort study. BMJ Open 3(3) (Epub 2013/03/14)

    Google Scholar 

  16. Larsson S, Lawyer P, Garellick G, Lindahl B, Lundstrom M (2012) Use of 13 disease registries in 5 countries demonstrates the potential to use outcome data to improve health care’s value. Health Aff (Millwood) 31(1):220–7 (Epub 2011/12/14)

    Article  Google Scholar 

  17. Lingen CV, Ettema H, Timmer J, Jong GD, Verheyen C (2013) Clinical manifestations in ten patients with asymptomatic metal-on-metal hip arthroplasty with very high cobalt levels. Hip Int. doi:10.5301/hipint.50000540 (Epub 2013/07/03)

    Google Scholar 

  18. Lombardi AV Jr, Barrack RL, Berend KR, Cuckler JM, Jacobs JJ, Mont MA et al (2012) The Hip Society: algorithmic approach to diagnosis and management of metal-on-metal arthroplasty. J Bone Joint Surg Br 94(11 Suppl A):14–8 (Epub 2012/11/09)

    Google Scholar 

  19. Looney RJ, Schwarz EM, Boyd A, O’Keefe RJ (2006) Periprosthetic osteolysis: an immunologist’s update. Curr Opin Rheumatol 18(1):80–7 (Epub 2005/12/14)

    Article  Google Scholar 

  20. McKellop HA (2007) The lexicon of polyethylene wear in artificial joints. BioMaterials 28(34):5049–57 (Epub 2007/08/21)

    Article  CAS  Google Scholar 

  21. Morawietz L, Tiddens O, Mueller M, Tohtz S, Gansukh T, Schroeder JH et al (2009) Twenty-three neutrophil granulocytes in 10 high-power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening. Histopathology 54(7):847–53 (Epub 2009/07/29)

    Article  Google Scholar 

  22. Smith AJ, Dieppe P, Howard PW, Blom AW (2012) Failure rates of metal-on-metal hip resurfacings: analysis of data from the National Joint Registry for England and Wales. Lancet 380(9855):1759–66 (Epub 2012/10/06)

    Article  Google Scholar 

  23. Thomas P, Braathen LR, Dorig M, Aubock J, Nestle F, Werfel T et al (2009) Increased metal allergy in patients with failed metal-on-metal hip arthroplasty and peri-implant T-lymphocytic inflammation. Allergy 64(8):1157–65

    Article  CAS  Google Scholar 

  24. Willert HG, Buchhorn GH, Fayyazi A, Flury R, Windler M, Koster G et al (2005) Metal-on-metal bearings and hypersensitivity in patients with artificial hip joints. A clinical and histomorphological study. J Bone Joint Surg Am 87(1):28–36

    Article  Google Scholar 

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Acknowledgment

The authors—in particular J. P. Kretzer—want to acknowledge ISTE, London and John Wiley & Sons, Hoboken for the kind permission for reusing figures from previously published material [12].

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Authors and Affiliations

  1. Clinic for Dermatology and Allergology, Ludwig-Maximilians-University, Frauenlobstr. 9–11, 80337, Munich, Germany

    Peter Thomas & Burkhard Summer

  2. Clinics for Orthopedics and Trauma Surgery, DRK-Hospital and City Hospital, Baden-Baden, Germany

    Marc Thomsen

  3. MVZ for Cytology, Histology and Molecular Diagnostic, Trier, Germany

    Veit Krenn

  4. Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Department of Orthopedics, Trauma Surgery and Paraplegiology, Heidelberg University Hospital, Heidelberg, Germany

    Jan Philippe Kretzer

Authors
  1. Peter Thomas
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  2. Burkhard Summer
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  3. Marc Thomsen
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  4. Veit Krenn
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  5. Jan Philippe Kretzer
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Corresponding author

Correspondence to Peter Thomas .

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Editors and Affiliations

  1. Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, USA

    Lynne C. Jones

  2. Department of Biomedical Engineering, University of Memphis, Memphis, Tennessee, USA

    Warren O. Haggard

  3. Orthopaedic Research Laboratories Lutheran Hospital, Cleveland Clinic, Cleveland, Ohio, USA

    A. Seth Greenwald

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Thomas, P., Summer, B., Thomsen, M., Krenn, V., Kretzer, J. (2014). Why Metal-on-Metal: What Laboratory Tests Have Shown Us. In: Jones, L., Haggard, W., Greenwald, A. (eds) Metal-on-Metal Bearings. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8999-3_10

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