The role of metal ions in metal-on-metal total hip replacement
Abstract Role of Metal Ions in Metal on Metal Total Hip Replacement Metal-on-metal (MoM) total hip replacement (THR) offered theoretical advantages of decreased wear and increased functional outcomes. MoM bearings have been associated with sterile inflammatory masses and significant soft tissue destruction with poorer outcomes following revision surgery. The natural history of adverse reactions to metal debris (ARMD) is unknown, but may represent contributions from bearing surface wear, taper junction wear, and corrosion. Immunological and genetic factors may influence susceptibility to development of ARMD. Between 1997 and 2004, 652 Ultima TPS THRs (DePuy) were implanted in 545 patients who went on to experience a high rate of early implant failure (13.8%). Management of these patients has evolved beyond regular clinical follow up with plain radiographs to include surveillance monitoring of trends in levels of blood metal ions and staging of disease using metal artefact reduction (MAR) MRI. This study investigated:
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