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Does bearing size influence metal ion levels in large-head metal-on-metal total hip arthroplasty? A comparison of three total hip systems

BACKGROUND: The purpose of the study was twofold: first, to determine whether there is a statistically significant difference in the metal ion levels among three different large-head metal-on-metal (MOM) total hip systems. The second objective was to assess whether position of the implanted prosthes...

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Autores principales: Smith, James, Lee, David, Bali, Kamal, Railton, Pam, Kinniburgh, David, Faris, Peter, Marshall, Deborah, Burkart, Brian, Powell, James
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916311/
https://www.ncbi.nlm.nih.gov/pubmed/24472283
http://dx.doi.org/10.1186/1749-799X-9-3
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author Smith, James
Lee, David
Bali, Kamal
Railton, Pam
Kinniburgh, David
Faris, Peter
Marshall, Deborah
Burkart, Brian
Powell, James
author_facet Smith, James
Lee, David
Bali, Kamal
Railton, Pam
Kinniburgh, David
Faris, Peter
Marshall, Deborah
Burkart, Brian
Powell, James
author_sort Smith, James
collection PubMed
description BACKGROUND: The purpose of the study was twofold: first, to determine whether there is a statistically significant difference in the metal ion levels among three different large-head metal-on-metal (MOM) total hip systems. The second objective was to assess whether position of the implanted prostheses, patient demographics or factors such as activity levels influence overall blood metal ion levels and whether there is a difference in the functional outcomes between the systems. METHODS: In a cross-sectional cohort study, three different metal-on-metal total hip systems were assessed: two monoblock heads, the Durom socket (Zimmer, Warsaw, IN, USA) and the Birmingham socket (Smith and Nephew, Memphis, TN, USA), and one modular metal-on-metal total hip system (Pinnacle, Depuy Orthopedics, Warsaw, IN, USA). Fifty-four patients were recruited, with a mean age of 59.7 years and a mean follow-up time of 41 months (12 to 60). Patients were evaluated clinically, radiologically and biochemically. Statistical analysis was performed on all collected data to assess any differences between the three groups in terms of overall blood metal ion levels and also to identify whether there was any other factor within the group demographics and outcomes that could influence the mean levels of Co and Cr. RESULTS: Although the functional outcome scores were similar in all three groups, the blood metal ion levels in the larger monoblock large heads (Durom, Birmingham sockets) were significantly raised compared with those of the Pinnacle group. In addition, the metal ion levels were not found to have a statistically significant relationship to the anteversion or abduction angles as measured on the radiographs. CONCLUSIONS: When considering a MOM THR, the use of a monoblock large-head system leads to higher elevations in whole blood metal ions and offers no advantage over a smaller head modular system.
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spelling pubmed-39163112014-02-07 Does bearing size influence metal ion levels in large-head metal-on-metal total hip arthroplasty? A comparison of three total hip systems Smith, James Lee, David Bali, Kamal Railton, Pam Kinniburgh, David Faris, Peter Marshall, Deborah Burkart, Brian Powell, James J Orthop Surg Res Research Article BACKGROUND: The purpose of the study was twofold: first, to determine whether there is a statistically significant difference in the metal ion levels among three different large-head metal-on-metal (MOM) total hip systems. The second objective was to assess whether position of the implanted prostheses, patient demographics or factors such as activity levels influence overall blood metal ion levels and whether there is a difference in the functional outcomes between the systems. METHODS: In a cross-sectional cohort study, three different metal-on-metal total hip systems were assessed: two monoblock heads, the Durom socket (Zimmer, Warsaw, IN, USA) and the Birmingham socket (Smith and Nephew, Memphis, TN, USA), and one modular metal-on-metal total hip system (Pinnacle, Depuy Orthopedics, Warsaw, IN, USA). Fifty-four patients were recruited, with a mean age of 59.7 years and a mean follow-up time of 41 months (12 to 60). Patients were evaluated clinically, radiologically and biochemically. Statistical analysis was performed on all collected data to assess any differences between the three groups in terms of overall blood metal ion levels and also to identify whether there was any other factor within the group demographics and outcomes that could influence the mean levels of Co and Cr. RESULTS: Although the functional outcome scores were similar in all three groups, the blood metal ion levels in the larger monoblock large heads (Durom, Birmingham sockets) were significantly raised compared with those of the Pinnacle group. In addition, the metal ion levels were not found to have a statistically significant relationship to the anteversion or abduction angles as measured on the radiographs. CONCLUSIONS: When considering a MOM THR, the use of a monoblock large-head system leads to higher elevations in whole blood metal ions and offers no advantage over a smaller head modular system. BioMed Central 2014-01-28 /pmc/articles/PMC3916311/ /pubmed/24472283 http://dx.doi.org/10.1186/1749-799X-9-3 Text en Copyright © 2014 Smith et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Research Article
Smith, James
Lee, David
Bali, Kamal
Railton, Pam
Kinniburgh, David
Faris, Peter
Marshall, Deborah
Burkart, Brian
Powell, James
Does bearing size influence metal ion levels in large-head metal-on-metal total hip arthroplasty? A comparison of three total hip systems
title Does bearing size influence metal ion levels in large-head metal-on-metal total hip arthroplasty? A comparison of three total hip systems
title_full Does bearing size influence metal ion levels in large-head metal-on-metal total hip arthroplasty? A comparison of three total hip systems
title_fullStr Does bearing size influence metal ion levels in large-head metal-on-metal total hip arthroplasty? A comparison of three total hip systems
title_full_unstemmed Does bearing size influence metal ion levels in large-head metal-on-metal total hip arthroplasty? A comparison of three total hip systems
title_short Does bearing size influence metal ion levels in large-head metal-on-metal total hip arthroplasty? A comparison of three total hip systems
title_sort does bearing size influence metal ion levels in large-head metal-on-metal total hip arthroplasty? a comparison of three total hip systems
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916311/
https://www.ncbi.nlm.nih.gov/pubmed/24472283
http://dx.doi.org/10.1186/1749-799X-9-3
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