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A Clinicopathological Study of Metal-on-Metal Hips Revised for Suspected Adverse Reactions to Metal Debris

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Total Hip Arthroplasty

Abstract

Total hip replacement (THR) is well established as the most successful surgical procedure for the long-term alleviation of pain and disability in patients with arthritis of the hip joint (Learmonth et al. 2007). A total of 68,907 primary hip replacements were performed in England and Wales during 2010 (National Joint Registry 2011). In recent times metal-on-metal (MoM) bearings for THR have gradually been reintroduced, mainly because of the substantially lower wear rates compared to that of metal-on-polyethylene articulations and the decreased wear rates with increasing head diameters (Fisher et al. 2006). This has subsequently led to a resurgence of MoM hip resurfacing in young and active patients with hip arthritis (Amstutz et al. 2004; Treacy et al. 2011). Hip resurfacing has the added advantages of femoral bone preservation and the potential ease of future revision (Ball et al. 2007; Matharu et al. 2012a). In carefully selected patients excellent medium- to long-term survival has been reported for MoM hip resurfacing by the designer surgeons (McMinn et al. 2011; Treacy et al. 2011) and independent centres (Coulter et al. 2012; Holland et al. 2012; Murray et al. 2012).

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Abbreviations

ALVAL:

aseptic lymphocytic vasculitis and associated lesions

ARMD:

adverse reaction to metal debris

MHRA:

Medicines and Healthcare products Regulatory Agency

MoM:

metal-on-metal

THR:

total hip replacement

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Acknowledgement

The authors received funding from Smith & Nephew PLC which was used to undertake the work presented in this manuscript.

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Authors and Affiliations

  1. Department of Arthroplasty, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK

    Gulraj S. Matharu, Matthew P. Revell, Vaiyapuri Sumathi, Paul B. Pynsent & Peter A. Revell

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  1. Gulraj S. Matharu
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  2. Matthew P. Revell
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  3. Vaiyapuri Sumathi
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  4. Paul B. Pynsent
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  5. Peter A. Revell
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Corresponding author

Correspondence to Matthew P. Revell .

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Editors and Affiliations

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

    Karl Knahr

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Matharu, G.S., Revell, M.P., Sumathi, V., Pynsent, P.B., Revell, P.A. (2013). A Clinicopathological Study of Metal-on-Metal Hips Revised for Suspected Adverse Reactions to Metal Debris. In: Knahr, K. (eds) Total Hip Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35653-7_6

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  • DOI: https://doi.org/10.1007/978-3-642-35653-7_6

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  • Publisher Name: Springer, Berlin, Heidelberg

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