Metal-on-metal total hip arthroplasty: is there still a role in 2016?

Current Reviews in Musculoskeletal Medicine
Edward J SilvermanNeil P Sheth

Abstract

The use of metal-on-metal (MoM) bearings in total hip arthroplasty (THA) was popularized due to its enhanced wear profile and the ability to use large femoral heads to reduce post-operative instability. However, enthusiasm for the bearing declined following serious complications encountered at the primary articulation. This review discusses the development of MoM and the subsequent unexpected downstream challenges, most notably elevated serum metal ion levels, aseptic lymphocyte-dominated vasculitis-associated lesions (ALVAL), pseudotumor formation, and subsequent soft tissue and bone destruction. Both patient centered risk factors as well as component design led to high early failure rates resulting in product recalls and an overall decline in the use of MoM. In 2016, there is not a role for large-head MoM bearing in THA. Alternatively, the bearing has shown promise in hip resurfacing procedures for carefully selected patients.

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Citations

Oct 21, 2016·International Orthopaedics·Ming Han Lincoln Liow, Young-Min Kwon
Nov 28, 2018·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Jetse JelsmaBernd Grimm
Nov 21, 2019·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Vincent P GaleaHenrik Malchau
Dec 1, 2019·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·Feng LiuWenhua Du
Apr 3, 2020·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Gerard A KellyDavid E Beverland
Sep 22, 2020·ANZ Journal of Surgery·Annabelle L C ChoongPeter F M Choong
Oct 19, 2019·Khirurgiia·V V LubchakM I Shubnyakov
Nov 14, 2017·Critical Reviews in Toxicology·Donatella GranchiNicola Baldini
Nov 27, 2021·Bone & Joint Open·Christian M WightEmil Schemitsch

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