The Journal of Arthroplasty
Volume 26, Issue 2 , Pages 282-288, February 2011

Metal Ion Release With Large-Diameter Metal-on-Metal Hip Arthroplasty

  • Pascal-André Vendittoli, MD, MSc, FRCS(C)

      Affiliations

    • Surgery Department of Maisonneuve Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada
    • Corresponding Author InformationReprint requets: Pascal-André Vendittoli, 5415 boul L'Assomption, Montreal, Québec, Canada H1T 2M4.
    • ,
  • Traian Amzica, MD

      Affiliations

    • Surgery Department of Maisonneuve Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada
    • ,
  • Alain G. Roy, MD, FRSC(C)

      Affiliations

    • Surgery Department of Maisonneuve Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada
    • ,
  • Daniel Lusignan, RN

      Affiliations

    • Surgery Department of Maisonneuve Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada
    • ,
  • Julien Girard, MD

      Affiliations

    • Orthopaedic Service C, Roger Salengro Hospital, CHRU de Lille, France
    • ,
  • Martin Lavigne, MD, FRCS(C)

      Affiliations

    • Surgery Department of Maisonneuve Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada

Received 11 April 2009; accepted 10 December 2009. published online 08 March 2010.

Abstract 

Preoperative and postoperative ion concentrations were measured in 29 metal-on-metal, large-diameter head total hip arthroplasty (LDH-THA) patients. Mean chromium, cobalt (Co), and titanium levels from LDH-THA were 1.3, 2.2, and 2.7 μg/L at 12 months. The open femoral head design showed significantly higher Co concentrations than the closed design (3.0 vs 1.8 μg/L, P = .037). Compared with previously published ion levels from a hip resurfacing system presenting the same bearing characteristics, Co levels were significantly higher in LDH-THA (2.2 vs 0.7 μg/L, P < .001). This study has demonstrated that the addition of a sleeve with modular junctions and an open femoral head design of LDH-THA causes more Co release than bearing surface wear (157% and 67%, respectively). Even if no pathologic metal ion threshold level has been determined, efforts should be made to minimize its release. We recommend modification or abandonment of the modular junction and femoral head open design for this specific LDH-THA system.

Keywords: metal-on-metal articulation, large-diameter components, total hip arthroplasty, metal ion release, resurfacing, corrosion

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 No benefits or funds were received in support of the study.

PII: S0883-5403(09)00582-8

doi:10.1016/j.arth.2009.12.013

The Journal of Arthroplasty
Volume 26, Issue 2 , Pages 282-288, February 2011

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