New couplings, old problems: Is there a role for ceramic-on-metal hip arthroplasty?

Matteo Cadossi, Antonio Mazzotti, Nicola Baldini, Sandro Giannini, Lucia Savarino

Research output: Contribution to journalArticle

Abstract

Ceramic-on-metal (CoM) total hip arthroplasty (THA) theoretically combines both the advantages of ceramic-on-ceramic (CoC) and metal-on-metal (MoM) bearings: negligible rupture risk of the liner with a limited ion release. As primary endpoint, we asked whether serum cobalt, chromium and molybdenum concentrations in 20 CoM-THA patients at an average of 3-years follow-up were higher than those measured in the pre-operative population and correlate with clinical/radiological parameters. As secondary endpoint, we wanted to verify whether ion levels in CoM-THA patients were different from those obtained in a similar cohort of 29 MoM-THA patients at the same average follow-up. Ion values were measured by atomic absorption spectrometry. Functional outcome was assessed with Harris Hip Score and UCLA scale. Presence of radiographic radiolucencies around the implant, and acetabular inclination angle were evaluated. Chromium and cobalt levels in CoM-THA patients were significantly higher (p <0.001) at 3-years follow-up than before surgery. Molybdenum concentrations were not significantly different (p = 0.45). No signs of implant loosening were recorded. Functional outcome was excellent with HHS and UCLA scale rising from 50 and 3.6 pre-operatively to 90.8 and 6.3, respectively at 3-years follow-up (p <0.001). Chromium serum levels were significantly lower in CoM-THA than in MoM-THA group (p = 0.02) while cobalt values, even if lower, did not reach statistically significance (p = 0.054). Our results show that CoM-THA patients achieve excellent clinical outcome with a limited chromium release at 3-years follow-up.

Original languageEnglish
Pages (from-to)204-209
Number of pages6
JournalJournal of Biomedical Materials Research - Part B Applied Biomaterials
Volume104
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

Fingerprint

Arthroplasty
Ceramics
Hip
Metals
Chromium
Cobalt
Molybdenum
Ions
Bearings (structural)
Atomic absorption spectrometry
Serum
Surgery
Rupture
Spectrum Analysis

Keywords

  • ceramic-on-metal coupling
  • chromium
  • cobalt
  • ion release
  • total hip arthroplasty

ASJC Scopus subject areas

  • Biomedical Engineering
  • Biomaterials

Cite this

New couplings, old problems : Is there a role for ceramic-on-metal hip arthroplasty? / Cadossi, Matteo; Mazzotti, Antonio; Baldini, Nicola; Giannini, Sandro; Savarino, Lucia.

In: Journal of Biomedical Materials Research - Part B Applied Biomaterials, Vol. 104, No. 1, 01.01.2016, p. 204-209.

Research output: Contribution to journalArticle

Cadossi, Matteo ; Mazzotti, Antonio ; Baldini, Nicola ; Giannini, Sandro ; Savarino, Lucia. / New couplings, old problems : Is there a role for ceramic-on-metal hip arthroplasty?. In: Journal of Biomedical Materials Research - Part B Applied Biomaterials. 2016 ; Vol. 104, No. 1. pp. 204-209.
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