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Tribology in Total Hip Arthroplasty pp 121–132Cite as

Retrieval Wear Analysis of Metal-on-Metal Hip Resurfacing Implants Revised Due to Pseudotumours

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Abstract

Pseudotumours (soft-tissue masses relating to the hip joint) following metal-on-metal hip resurfacing arthroplasty (MoMHRA) have been associated with elevated serum and hip aspirate metal ion levels, suggesting that pseudotumours occur when there is increased wear. We aimed to quantify in vivo wear of implants revised for pseudotumours (8) and a control group of implants (22) revised for other reasons of failure.

In comparison with the non-pseudotumour implant group, the pseudotumour implant group was associated with: (1) significantly higher median linear wear rate of the femoral component: 8.1 mm/year (range 2.75–25.4 mm/year) vs. 1.79 mm/year (range 0.82–4.15 mm/year), p  =  0.002; and (2) significantly higher median linear wear rate of the acetabular component: 7.36 mm/year (range 1.61–24.9 mm/year) vs. 1.28 mm/year (range 0.18–3.33 mm/year), p  =  0.001. Wear on the acetabular cup components in the pseudotumour group always involved the edge, indicating edge-loading of the bearing.

This study provides the first direct evidence that pseudotumour is associated with increased wear at the MoM articulation. Furthermore, edge-loading with the loss of fluid film lubrication may be an important wear generation mechanism in patients with pseudotumour.

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Authors and Affiliations

  1. Adult Reconstructive Surgery Unit, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRJ 1126, Boston, MA, 02116, USA

    Young-Min Kwon

  2. Implant Development Centre (IDC), Smith and Nephew Orthopaedics Ltd, Aurora House, Spa Park, Harrison Way, Leamington Spa, CV31 3HL, UK

    Amir Kamali

  3. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Headington, OX3 7LD, UK

    Harinderjit S. Gill

  4. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Headington, OX3 7LD, UK

    David W. Murray

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  1. Young-Min Kwon
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  2. Harinderjit S. Gill
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  4. Amir Kamali
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Correspondence to Young-Min Kwon .

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  1. , 2nd Orthopaedic Department, Orthopaedic Hospital Vienna-Speising, Speisinger Straße 109, Vienna, 1130, Austria

    Karl Knahr

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Kwon, YM., Gill, H.S., Murray, D.W., Kamali, A. (2011). Retrieval Wear Analysis of Metal-on-Metal Hip Resurfacing Implants Revised Due to Pseudotumours. In: Knahr, K. (eds) Tribology in Total Hip Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-19429-0_11

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  • DOI: https://doi.org/10.1007/978-3-642-19429-0_11

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