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Total Hip Arthroplasty pp 141–151Cite as

Aseptic Loosening of Metal-on-Metal (MOM) Total Hip Arthroplasties (THA) with Large-Diameter Heads

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Abstract

Large-diameter metal-on-metal (MOM) bearing surfaces evolved directly from the success of hip surface replacement using MOM bearing surfaces. In cases of failed femoral components with well-fixed acetabular components, large-diameter bearing surfaces served well as revision implants compatible with standard stems to avoid cup revision. Reduced dislocation rates with large-diameter bearings and potentially reduced wear (Lombardi et al. 2011) due to increased fluid-film lubrication prompted their use in primary THA. However, unacceptably high revision rates, early aseptic loosening, adverse tissue reactions and pseudotumour formation and increased metal ion release have been observed in large-diameter MOM THAs (Smith et al. 2012; Bolland et al. 2011; Langton et al. 2010; Barrett et al. 2012; Hasegawa et al. 2012; Bosker et al. 2012; Berton et al. 2010; Matthies et al. 2011). This has been observed as a class effect and is not implant specific. The possible reasons for this phenomenon are failure to achieve optimum fluid-film lubrication, edge loading, increased torque from the large head as well as corrosion and wear at the cone-taper interface leading to deposition of large amounts of metal wear debris in the periprosthetic tissues.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Otto-von-Guericke-University, Magdeburg, Germany

    Christoph H. Lohmann, G. Singh, G. Goldau, T. Müller & H. Meyer

  2. University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Health System, Singapore, Singapore

    G. Singh

  3. Institute for Mechanical Engineering, Magdeburg-Stendal University of Applied Sciences, Magdeburg, Germany

    B. Feuerstein

  4. Department of Orthopaedic Surgery, Loretto Hospital, Freiburg, Germany

    M. Rütschi

Authors
  1. Christoph H. Lohmann
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  2. G. Singh
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  3. G. Goldau
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  4. T. Müller
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  5. B. Feuerstein
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  6. M. Rütschi
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  7. H. Meyer
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Corresponding author

Correspondence to Christoph H. Lohmann .

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Editors and Affiliations

  1. Orthopaedic Hospital Vienna-Speising, Speisinger Str. 109, Vienna, 1130, Austria

    Karl Knahr

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Lohmann, C.H. et al. (2013). Aseptic Loosening of Metal-on-Metal (MOM) Total Hip Arthroplasties (THA) with Large-Diameter Heads. In: Knahr, K. (eds) Total Hip Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35653-7_13

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  • DOI: https://doi.org/10.1007/978-3-642-35653-7_13

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