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Metal-on-metal total hip arthroplasty: is there still a role in 2016?

  • Hip: Metal-on-Metal (J Cooper, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

The use of metal-on-metal (MoM) bearings in total hip arthroplasty (THA) was popularized due to its enhanced wear profile and the ability to use large femoral heads to reduce post-operative instability. However, enthusiasm for the bearing declined following serious complications encountered at the primary articulation. This review discusses the development of MoM and the subsequent unexpected downstream challenges, most notably elevated serum metal ion levels, aseptic lymphocyte-dominated vasculitis-associated lesions (ALVAL), pseudotumor formation, and subsequent soft tissue and bone destruction. Both patient centered risk factors as well as component design led to high early failure rates resulting in product recalls and an overall decline in the use of MoM. In 2016, there is not a role for large-head MoM bearing in THA. Alternatively, the bearing has shown promise in hip resurfacing procedures for carefully selected patients.

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Authors and Affiliations

  1. Department of Orthopaedics, The University of Pennsylvania Health System, 800 Spruce Street, Philadelphia, PA, 19107, USA

    Edward J. Silverman, Blair Ashley & Neil P. Sheth

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  1. Edward J. Silverman
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  2. Blair Ashley
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  3. Neil P. Sheth
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Correspondence to Edward J. Silverman.

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Edward J. Silverman, Blair Ashley, and Neil P. Sheth declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Hip: Metal-on-Metal

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Silverman, E.J., Ashley, B. & Sheth, N.P. Metal-on-metal total hip arthroplasty: is there still a role in 2016?. Curr Rev Musculoskelet Med 9, 93–96 (2016). https://doi.org/10.1007/s12178-016-9323-1

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  • DOI: https://doi.org/10.1007/s12178-016-9323-1

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