Ion release in patients with metal-on-metal hip bearings in total joint replacement: A comparison with metal-on-polyethylene bearings

L. Savarino, D. Granchi, G. Ciapetti, E. Cenni, A. Nardi Pantoli, R. Rotini, C. A. Veronesi, N. Baldini, A. Giunti

Research output: Contribution to journalArticle

158 Citations (Scopus)

Abstract

Polyethylene (PE) wear has been shown to be a problem in long-term joint replacement using metal-on-PE bearing. The use of metallic heads articulating with metallic cups could solve this problem: success will be enhanced if wear and corrosion of the articulating surfaces are maintained at a low level. New models with metal-on-metal bearing have been proposed, to be used mainly for young subjects: such coupling seems to have a reduced release, but it is unclear yet if the medium-term corrosion rate is really negligible or, on the contrary, it is significantly higher than in the metal-on-PE bearing. Aim of our study was the comparison of ion release in the serum of two groups of patients who had the same type of stable cementless prosthesis, but different bearing: twenty-six patients with metal-on-metal (Group A) and fifteen patients with metal-on-PE bearing (Group B) were examined. The follow-up was 14-38 months for group A and 18-34 months for group B. The serum concentration of chromium (Cr), cobalt (Co) and molybdenum (Mo) was measured. Twenty-two patients before surgery were used for comparison (Group C). The reference values were obtained from a population of twenty-two healthy subjects (Group D). Our findings indicate that metal-on-metal bearings produce a significantly higher systemic release of cobalt and chromium (ng/ml) when compared with levels found in metal-on-PE, pre-surgery and reference groups. Such a high release should induce to improve the bearing materials or, at least, to study the biologic fate of metal ions and consequently their long-term effects. In such a way a risk-to-benefit ratio for the patient could be established.

Original languageEnglish
Pages (from-to)467-474
Number of pages8
JournalJournal of Biomedical Materials Research
Volume63
Issue number5
DOIs
Publication statusPublished - 2002

Fingerprint

Replacement Arthroplasties
Bearings (structural)
Polyethylene
Polyethylenes
Hip
Metals
Ions
Corrosion
Chromium
Cobalt
Surgery
Wear of materials
Molybdenum
Corrosion rate
Serum
Metal ions
Prostheses and Implants

Keywords

  • Bearing
  • Corrosion
  • Implant
  • Metal ions
  • Metal-on-metal

ASJC Scopus subject areas

  • Biomedical Engineering
  • Biomaterials

Cite this

Ion release in patients with metal-on-metal hip bearings in total joint replacement : A comparison with metal-on-polyethylene bearings. / Savarino, L.; Granchi, D.; Ciapetti, G.; Cenni, E.; Nardi Pantoli, A.; Rotini, R.; Veronesi, C. A.; Baldini, N.; Giunti, A.

In: Journal of Biomedical Materials Research, Vol. 63, No. 5, 2002, p. 467-474.

Research output: Contribution to journalArticle

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abstract = "Polyethylene (PE) wear has been shown to be a problem in long-term joint replacement using metal-on-PE bearing. The use of metallic heads articulating with metallic cups could solve this problem: success will be enhanced if wear and corrosion of the articulating surfaces are maintained at a low level. New models with metal-on-metal bearing have been proposed, to be used mainly for young subjects: such coupling seems to have a reduced release, but it is unclear yet if the medium-term corrosion rate is really negligible or, on the contrary, it is significantly higher than in the metal-on-PE bearing. Aim of our study was the comparison of ion release in the serum of two groups of patients who had the same type of stable cementless prosthesis, but different bearing: twenty-six patients with metal-on-metal (Group A) and fifteen patients with metal-on-PE bearing (Group B) were examined. The follow-up was 14-38 months for group A and 18-34 months for group B. The serum concentration of chromium (Cr), cobalt (Co) and molybdenum (Mo) was measured. Twenty-two patients before surgery were used for comparison (Group C). The reference values were obtained from a population of twenty-two healthy subjects (Group D). Our findings indicate that metal-on-metal bearings produce a significantly higher systemic release of cobalt and chromium (ng/ml) when compared with levels found in metal-on-PE, pre-surgery and reference groups. Such a high release should induce to improve the bearing materials or, at least, to study the biologic fate of metal ions and consequently their long-term effects. In such a way a risk-to-benefit ratio for the patient could be established.",
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AU - Ciapetti, G.

AU - Cenni, E.

AU - Nardi Pantoli, A.

AU - Rotini, R.

AU - Veronesi, C. A.

AU - Baldini, N.

AU - Giunti, A.

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AB - Polyethylene (PE) wear has been shown to be a problem in long-term joint replacement using metal-on-PE bearing. The use of metallic heads articulating with metallic cups could solve this problem: success will be enhanced if wear and corrosion of the articulating surfaces are maintained at a low level. New models with metal-on-metal bearing have been proposed, to be used mainly for young subjects: such coupling seems to have a reduced release, but it is unclear yet if the medium-term corrosion rate is really negligible or, on the contrary, it is significantly higher than in the metal-on-PE bearing. Aim of our study was the comparison of ion release in the serum of two groups of patients who had the same type of stable cementless prosthesis, but different bearing: twenty-six patients with metal-on-metal (Group A) and fifteen patients with metal-on-PE bearing (Group B) were examined. The follow-up was 14-38 months for group A and 18-34 months for group B. The serum concentration of chromium (Cr), cobalt (Co) and molybdenum (Mo) was measured. Twenty-two patients before surgery were used for comparison (Group C). The reference values were obtained from a population of twenty-two healthy subjects (Group D). Our findings indicate that metal-on-metal bearings produce a significantly higher systemic release of cobalt and chromium (ng/ml) when compared with levels found in metal-on-PE, pre-surgery and reference groups. Such a high release should induce to improve the bearing materials or, at least, to study the biologic fate of metal ions and consequently their long-term effects. In such a way a risk-to-benefit ratio for the patient could be established.

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