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Introduction In the wake of the Poly Implant Prosthèse breast implant and the metal-on-metal incidents, the inherent flaws of European regulatory systems for medical products and devices have been highlighted once again. 1 In lieu of the
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lymphocytic-dominated vasculitis associated lesion (ALVAL), 20 later expanded to adverse local tissue reactions (ALTR) 21 and adverse reactions to metal debris (ARMD) 22 associated with metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) and
School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Australia
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. Fig. 1 Funnel plot of primary total conventional hip replacement (excluding large-head metal-on-metal, all diagnoses, revision for prosthesis dislocation within 2 years). The Australian Orthopaedic Association has recommended access of a
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loosening? According to the recommendations provided by the multidisciplinary consensus statement on the use and monitoring of metal-on-metal (MoM) bearings for THA and hip resurfacing, radiographs should be performed in all patients during follow
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’ surfaces, there would be a reduction in the risk of dislocation which would be particularly advantageous in younger patients. Unfortunately, this new concept and design was not rigorously tested prior to widespread adoption and use. One particular metal-on-metal
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
Swedish Hip Arthroplasty Register, Gothenburg, Sweden
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Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
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Swedish Hip Arthroplasty Register, Gothenburg, Sweden
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Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
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groin pain. We excluded hip arthroplasties with metal-on-metal (MoM) bearings due to a limited number of MoMs being used lately ( Fig. 2 ). We also excluded dual mobility acetabular components since this bearing concept is predominantly used in patients
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, raised serum metal ion levels, magnetic resonance imaging (MRI), and ultimately intraoperative and histological findings. ARMD was first noted in metal-on-metal (MoM) THR, occurring between bearing surfaces and also as a result of fretting corrosion at
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reactions; Co, cobalt; COC, ceramic-on-ceramic; COP, ceramic-on-plastic; Cr, chromium; Fe, iron; Mn, manganese; Mo, molybdenum; MOM, metal-on-metal; MOP, metal-on-plastic; Ni, nickel; NR, not recorded; THR, total hip replacement; Ti, titanium; TJR, total
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( 5 ), wear problems with highly crystalline phase-modified polyethylene ( 6 ) and toxicological surface contamination on porous-coated sockets ( 7 ). Innovative procedures such as hip resurfacing and large metal-on-metal hip joint bearings ( 8 ) ( Fig
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that “we should offer effective treatment based on the best available evidence”. 7 Anyway the lesson learnt by the metal-on-metal THA experience have made all the stakeholders more careful in the introduction of hip implants onto the market and
