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Lubricants 2017, 5(3), 37;

Current Insights Regarding Metal-on-Metal Bearings for Hip Arthroplasty

Musculoskeletal Sciences and Technology, Imperial College London, London SW7 2AZ, UK
Metal-on-Metal bearings for hip arthroplasty: Cobalt-chromium-molybdenum alloy articulating against itself.
Received: 5 August 2017 / Revised: 30 August 2017 / Accepted: 9 September 2017 / Published: 11 September 2017
(This article belongs to the Special Issue Tribological Performance of Artificial Joints 2017)
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Modern small diameter metal-on-metal (MoM) bearings for total hip arthroplasty (THA) have been developed in the nineteen-eighties to address the problem of polyethylene wear related osteolysis. Subsequently large diameter MoM hip resurfacings (HRA) were designed for young and active patients to preserve bone and avoid dislocation. Large diameter MoM THA were originally meant as an easy femoral component-only revision solution for femoral neck fractures in HRA, but were then advocated for primary THA as well. In the last decade however, increasing numbers of revisions for adverse local tissues reactions (ALTR) to metal debris have been reported. These ALTR are due to excessive wear of the MoM bearings, usually related to malpositioning of the components leading to edge loading, or in rare cases to metal sensitivity. Besides the immunological reactions, metal particles and ions have a potential local and systemic toxicity. Wear and tribocorrosion at the taper-trunnion connections of MoM THA but also THA with polyethylene and ceramic bearings have also been recognized as a cause of ALTR with extensive tissue destruction. Despite the fact that the long-term survivorship and functional results of certain MoM HRA are excellent and better than THA in the young and active patients group, MoM bearings have become very unpopular and are likely to be replaced by bearing couples of other materials. View Full-Text
Keywords: metal-on-metal bearings; hip arthroplasty; hip resurfacing; wear particles; metal ions; edge loading; toxicity metal-on-metal bearings; hip arthroplasty; hip resurfacing; wear particles; metal ions; edge loading; toxicity

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Van Der Straeten, C. Current Insights Regarding Metal-on-Metal Bearings for Hip Arthroplasty. Lubricants 2017, 5, 37.

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