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Benign Responses to Orthopaedic Implants: Really?

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Metal-on-Metal Bearings

Abstract

Metal wear particles generated by metal-on-metal (MoM) bearings may be widely disseminated into the local periprosthetic tissues and throughout the body, resulting in measurable increases in metal ion levels in serum, erythrocytes, and urine. There is increasing recognition that these metal degradation products have both local and systemic biologic implications for the patient and may lead to a range of adverse biological reactions including local soft tissue toxicity, bone loss, and an array of systemic and immunologic effects. Metal hypersensitivity responses can also cause similar reactions in the absence of high wear. Additional concerns exist regarding corrosion at modular junctions in orthopaedic implants, as this process can also lead to release of metal debris that in many cases may be greater than that seen at the bearing surface. A vast amount of effort has gone into understanding these effects in the past decade, and the orthopaedic community is just beginning to understand their scope. This chapter reviews the available evidence on the biological implications of metal degradation products released from both articular and nonarticular sources. In addition, the potential role of metal debris-induced immunologic and cellular responses in the pathogenesis of these reactions is discussed to the extent that it is understood.

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References

  1. Adam MK, Claude IA, Harry ER, Arun SS (2008) Human macrophage response to UHMWPE, TiAlV, CoCr, and alumina particles: analysis of multiple cytokines using protein arrays. J Biomed Mater Res A 84:464–474

    Google Scholar 

  2. Akbar M, Brewer JM, Grant MH (2011) Effect of chromium and cobalt ions on primary human lymphocytes in vitro. J Immunotoxicol 8:140–149

    CAS  Google Scholar 

  3. Andrews RE, Shah KM, Wilkinson JM, Gartland A (2011) Effects of cobalt and chromium ions at clinically equivalent concentrations after metal-on-metal hip replacement on human osteoblasts and osteoclasts: implications for skeletal health. Bone 49:717–723

    CAS  Google Scholar 

  4. Anissian L, Stark A, Dahlstrand H, Granberg B, Good V, Bucht E (2002) Cobalt ions influence proliferation and function of human osteoblast-like cells. Acta Orthop Scand 73:369–374

    Google Scholar 

  5. Antoniou J, Zukor DJ, Mwale F, Minarik W, Petit A, Huk OL (2008) Metal ion levels in the blood of patients after hip resurfacing: a comparison between twenty-eight and thirty-six-millimeter-head metal-on-metal prostheses. J Bone Joint Surg Am 90(Suppl 3):142–148

    Google Scholar 

  6. Anwar HA, Aldam CH, Visuvanathan S, Hart AJ (2007) The effect of metal ions in solution on bacterial growth compared with wear particles from hip replacements. J Bone Joint Surg Br 89(12):1655–1659

    CAS  Google Scholar 

  7. Aroukatos P, Repanti M, Repantis T, Bravou V, Korovessis P (2010) Immunologic adverse reaction associated with low-carbide metal-on-metal bearings in total hip arthroplasty. Clin Orthop Relat Res 468:2135–2142

    Google Scholar 

  8. Back D, Young DA, Shimmin AJ (2005) How do cobalt and chromium levels change after metal-on-metal hip resurfacing? Clin Orthop Relat Res 438:177–181

    Google Scholar 

  9. Beaulé PE, Campbell P, Mirra J, Hooper JC, Schmalzried TP (2001) Osteolysis in a cementless, second generation metal-on-metal hip replacement. Clin Orthop Relat Res 386:159–165

    Google Scholar 

  10. Bernstein M, Walsh A, Petit A, Zukor DJ, Antoniou J (2011) Femoral head size does not affect ion values in metal-on-metal total hips. Clin Orthop Relat Res 469:1642–1650

    Google Scholar 

  11. Bhabra G, Sood A, Fisher B, Cartwright L, Saunders M, Evans WH, Surprenant A, Lopez-Castejon G, Mann S, Davis SA, Hails LA, Ingham E, Verkade P, Lane J, Heesom K, Newson R, Case CP (2009) Nanoparticles can cause DNA damage across a cellular barrier. Nat Nanotechnol 4:876–883

    CAS  Google Scholar 

  12. Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ (2009) The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am 91(1):128–133

    Google Scholar 

  13. Braunstein V, Sprecher CM, Wimmer MA, Milz S, Taeger G (2009) Influence of head size on the development of metallic wear and on the characteristics of carbon layers in metal-on-metal hip joints. Acta Orthop 80:283–290

    Google Scholar 

  14. Brodner W, Bitzan P, Meisinger V, Kaider A, Gottsauner-Wolf F, Kotz R (2003) Serum cobalt levels after metal-on-metal total hip arthroplasty. J Bone Joint Surg Am 85-A(11):2168–2173

    Google Scholar 

  15. Brodner W, Grohs JG, Bancher-Todesca D, Dorotka R, Meisinger V, Gottsauner-Wolf F, Kotz R (2004) Does the placenta inhibit the passage of chromium and cobalt after metal-on-metal total hip arthroplasty? J Arthroplasty 19(Suppl 3):102–106

    Google Scholar 

  16. Caicedo MS, Desai R, McAllister K, Reddy A, Jacobs JJ, Hallab NJ (2009) Soluble and particulate Co-Cr-Mo alloy implant metals activate the inflammasome danger signaling pathway in human macrophages: a novel mechanism for implant debris reactivity. J Orthop Res 27:847–854

    CAS  Google Scholar 

  17. Campbell P, McKellop H, Alim R, Mirra J, Nutt S, Dorr L, Amstutz HC (1999) Metal-on-metal hip replacements: wear performance and cellular response to wear particles. In: Disegi JA, Kennedy RL, Pilliar RM (eds) Cobalt-base alloys for biomedical applications. American Society for Testing and Materials, Philadelphia, pp 193–209 (ASTM STP 1365)

    Google Scholar 

  18. Campbell P, Ebramzadeh E, Nelson S, Takamura K, De Smet K, Amstutz HC (2010) Histological features of pseudotumor-like tissues from metal-on-metal hips. Clin Orthop Relat Res 468:2321–2327

    Google Scholar 

  19. Campbell PA, Wang M, Amstutz HC, Goodman SB (2002) Positive cytokine production in failed metal-on-metal total hip replacements. Acta Orthop 73:506–512

    Google Scholar 

  20. Carrothers AD, Gilbert RE, Jaiswal A, Richardson JB (2010) Birmingham hip resurfacing: the prevalence of failure. J Bone Joint Surg Br 92B:1344–1350

    Google Scholar 

  21. Catelas I, Bobyn JD, Medley JB, Krygier JJ, Zukor DJ, Huk OL (2003) Size, shape, and composition of wear particles from metal-metal hip simulator testing: effects of alloy and number of loading cycles. J Biomed Mater Res A 67:312–327

    Google Scholar 

  22. Cooper HJ, Della Valla CJ, Berger RA, Tetreault M, Paprosky WG, Sporer SM, Jacobs JJ (2012) Corrosion at the head-neck taper as a cause for adverse local tissue reactions in total hip arthroplasty. J Bone Joint Surg Am 94A:1655–1661

    Google Scholar 

  23. Cooper HJ, Urban RM, Wixson RL, Meneghini RM, Jacobs JJ (2013) Adverse local tissue reaction arising from corrosion at the neck-body junction in dual-taper femoral stems with a CoCr modular neck. J Bone Joint Surg Am 95(10):865–872

    Google Scholar 

  24. Corradi M, Daniel J, Ziaee H, Alinovi R, Mutti A, McMinn DJ (2011) Early markers of nephrotoxicity in patients with metal-on-metal hip arthroplasty. Clin Orthop Relat Res 469:1651–1659

    Google Scholar 

  25. Daniel J, Ziaee H, Salama A, Pradhan C, McMinn DJ (2006) The effect of the diameter of metal-on-metal bearings on systemic exposure to cobalt and chromium. J Bone Joint Surg Br 88(4):443–448

    CAS  Google Scholar 

  26. Daniel J, Ziaee H, Pradhan C, Pynsent PB, McMinn DJW (2007) Blood and urine metal ion levels in young and active patients after Birmhingham hip resurfacing arthroplasty: four year results of a prospective longitudinal study. J Bone Joint Surg Br 89(2):169–173

    CAS  Google Scholar 

  27. Davies AP, Willert HG, Campbell PA, Learmonth ID, Case CP (2005) An unusual lymphocytic perivascular infiltration in tissues around contemporary metal-on-metal joint replacements. J Bone Joint Surg Am 87(1):18–27

    CAS  Google Scholar 

  28. De Haan R, Pattyn C, Gill HS, Murray DW, Campbell PA, De Smet K (2008) Correlation between inclination of the acetabular component and metal ion levels in metal-on-metal hip resurfacing replacement. J Bone Joint Surg Br 90(10):1291–1297

    CAS  Google Scholar 

  29. Della Valle AG, Ruzo PS, Li S, Pellicci P, Sculco TP, Salvati EA (2001) Dislodgment of polyethylene liners in first and second generation Harris-Galante acetabular components. A report of eighteen cases. J Bone Joint Surg Am 83-A(4):553–559

    Google Scholar 

  30. De Smet K, De Haan R, Calistri A, Campbell PA, Ebramzadeh E, Pattyn C, Gill HS (2008) Metal ion measurement as a diagnostic tool to identify problems with metal-on-metal hip resurfacing. J Bone Joint Surg Am 90(Suppl 4):202–208

    Google Scholar 

  31. Desy NM, Bergeron SG, Petit A, Huk OL, Antoniou J (2011) Surgical variables influence metal ion levels after hip resurfacing. Clin Orthop Relat Res 469:1635–1641

    Google Scholar 

  32. Doherty AT, Howell RT, Ellis LA, Bisbinas I, Learmonth ID, Newson R, Case CP (2001) Increased chromosome translocations and aneuploidy in peripheral blood lymphocytes of patients having revision arthroplasty of the hip. J Bone Joint Surg Br 83(7):1075–1081

    CAS  Google Scholar 

  33. Donell ST, Darrah C, Nolan JF, Wimhurst J, Toms A, Barker TH, Case CP, Tucker JK (2010) Early failure of the Ultima metal-on-metal total hip replacement in the presence of normal plain radiographs. J Bone Joint Surg Br 92(11):1501–1508 (Norwich Metal-on-Metal Study Group)

    CAS  Google Scholar 

  34. Doorn PF, Campbell PA, Worrall J, Benya PD, McKellop HA, Amstutz HC (1998) Metal wear particle characterization from metal on metal total hip replacements: transmission electron microscopy study of periprosthetic tissues and isolated particles. J Biomed Mater Res 42:103–111

    CAS  Google Scholar 

  35. Engh CA Jr, MacDonald SJ, Sritulanondha S, Thompson A, Naudie D, Engh CA (2009) John Charnley award: metal ion levels after metal-on-metal total hip arthroplasty: a randomized trial. Clin Orthop Relat Res 467:101–111

    Google Scholar 

  36. Eswaramoorthy V, Moonot P, Kalairajah Y, Biant LC, Field RE (2008) The Metasul metal-on-metal articulation in primary total hip replacement: clinical and radiological results at ten years. J Bone Joint Surg Br 90(10):1278–1283

    CAS  Google Scholar 

  37. Firkins PJ, Tipper JL, Saadatzadeh MR, Ingham E, Stone MH, Farrar R, Fisher J (2001) Quantitative analysis of wear and wear debris from metal-on-metal hip prostheses tested in a physiological hip joint simulator. Biomed Mater Eng 11:143–157

    CAS  Google Scholar 

  38. Fleury C, Petit A, Mwale F, Antoniou J, Zukor DJ, Tabrizian M, Huk OL (2006) Effect of cobalt and chromium ions on human MG-63 osteoblasts in vitro: morphology, cytotoxicity, and oxidative stress. BioMaterials 27:3351–3360

    CAS  Google Scholar 

  39. Garbuz DS, Tanzer M, Greidanus NV, Masri BA, Duncan CP (2010) The John Charnley Award: metal-on-metal hip resurfacing versus large-diameter head metal-on-metal total hip arthroplasty: a randomized clinical trial. Clin Orthop Relat Res 468:318–325

    Google Scholar 

  40. Gilani SH, Alibhai Y (1990) Teratogenicity of metals to chick embryos. J Toxicol Environ Health 30:23–31

    CAS  Google Scholar 

  41. Gill IP, Webb J, Sloan K, Beaver RJ (2012) Corrosion at the neck-stem junction as a cause of metal ion release and pseudotumour formation. J Bone Joint Surg Br 94:895–900

    CAS  Google Scholar 

  42. Glyn-Jones S, Pandit H, Kwon YM, Doll H, Gill HS, Murray DW (2009) Risk factors for inflammatory pseudotumour formation following hip resurfacing. J Bone Joint Surg Br 91(12):1566–1574

    CAS  Google Scholar 

  43. Gratton SEA, Ropp PA, Pohlhaus PD, Luft JC, Madden VJ, Napier ME, DiSimone JM (2008) The effect of particle design on cellular internalization pathways. Proc Natl Acad Sc USA 105:11613–11618

    CAS  Google Scholar 

  44. Griffin WL, Nanson CJ, Springer BD, Davies MA, Fehring TK (2010) Reduced articular surface of one-piece cups: a cause of runaway wear and early failure. Clin Orthop Relat Res 468:2328–2332

    Google Scholar 

  45. Haddad FS, Thakrar RR, Hart AJ, Skinner JA, Nargol AV, Nolan JF, Gill HS, Murray DW, Blom AW, Case CP (2011) Metal-on-metal bearings: the evidence so far. J Bone Joint Surg Br 93(5):572–579

    CAS  Google Scholar 

  46. Hallab N, Merritt K, Jacobs JJ (2001) Metal sensitivity in patients with orthopaedic implants. J Bone Joint Surg Am 83-A(3):428–436

    CAS  Google Scholar 

  47. Hallab NJ, Anderson S, Caicedo M, Skipor A, Campbell P, Jacobs JJ (2004) Immune responses correlate with serum-metal in metal-on-metal hip arthroplasty. J Arthroplasty 19(Suppl 3):88–93

    Google Scholar 

  48. Hallab NJ, Anderson S, Staffort T, Glant T, Jacobs JJ (2005) Lymphocyte responses in patients with total hip arthroplasty. J Orthop Res 23:384–391

    CAS  Google Scholar 

  49. Hart AJ, Hester T, Sinclair K, Powell JJ, Goodship AE, Pele L, Fersht NL, Skinner J (2006) The association between metal ions from hip resurfacing and reduced T-cell counts. J Bone Joint Surg Br 88(4):449–454

    CAS  Google Scholar 

  50. Hart AJ, Buddhdev P, Winship P, Faria N, Powell JJ, Skinner JA (2008) Cup inclination angle of greater than 50 degrees increases whole blood concentrations of cobalt and chromium ions after metal-on-metal hip resurfacing. Hip Int 18:212–219

    CAS  Google Scholar 

  51. Hart AJ, Skinner JA, Winship P, Faria N, Kulinskaya E, Webster D, Muirhead-Allwood S, Aldam CH, Anwar H, Powell JJ (2009) Circulating levels of cobalt and chromium from metal-on-metal hip replacement are associated with CD8+ T-cell lymphopenia. J Bone Joint Surg Br 91(12):835–842

    CAS  Google Scholar 

  52. Hart AJ, Skinner JA, Henckel J, Sampson B, Gordon F (2011) Insufficient acetabular version increases blood metal ion levels after metal-on-metal hip resurfacing. Clin Orthop Relat Res 469:2590–2597

    Google Scholar 

  53. Hart AJ, Ilo K, Underwood R, Cann P, Henckel J, Lewis A, Cobb J, Skinner J (2011) The relationship between the angle of version and rate of wear of retrieved metal-on-metal resurfacings: a prospective, CT-based study. J Bone Joint Surg Br 93(3):315–320

    CAS  Google Scholar 

  54. Hart AJ, Satchithananda K, Liddle AD, Sabah SA, McRobbie D, Henckel J, Cobb JP, Skinner JA, Mitchell AW (2012) Pseudotumors in association with well-functioning metal-on-metal hip prostheses: a case-control study using three-dimensional computed tomography and magnetic resonance imaging. J Bone Joint Surg Am 94:317–325

    Google Scholar 

  55. Heath JC, Freeman MA, Swanson SA (1971) Carcinogenic properties of wear particles from prostheses made in cobalt-chromium alloy. Lancet 1:564–566

    CAS  Google Scholar 

  56. Heisel C, Silva M, Skipor AK, Jacobs JJ, Schmalzried TP (2005) The relationship between activity and ions in patients with metal-on-metal bearing hip prostheses. J Bone Joint Surg Am 87(4):781–787

    Google Scholar 

  57. Holloway I, Walter WL, Zicat B, Walter WK (2009) Osteolysis with a cementless second generation metal-on-metal cup in total hip replacement. Int Orthop 33:1537–1542

    Google Scholar 

  58. Hosman AH, van der Mei HC, Bulstra SK, Busscher HJ, Neut D (2010) Effects of metal-on-metal wear on the host immune system and infection in hip arthroplasty. Acta Orthop 81:526–534

    Google Scholar 

  59. Huber M, Reinisch G, Zenz P, Zweymüller K, Lintner F (2010) Postmortem study of femoral osteolysis associated with metal-on-metal articulation in total hip replacement: an analysis of nine cases. J Bone Joint Surg Am 92(8):1720–1731

    Google Scholar 

  60. Hur CI, Yoon TR, Cho SG, Song EK, Seon JK (2008) Serum ion level after metal-on-metal THA in patients with renal failure. Clin Orthop Relat Res 466:696–699

    Google Scholar 

  61. Ikeda T, Takahashi K, Kabata T, Sakagoshi D, Tomita K, Yamada M (2010) Polyneuropathy caused by cobalt-chromium metallosis after total hip replacement. Muscle Nerve 42:140–143

    Google Scholar 

  62. Jacobs JJ, Skipor AK, Doorn PF, Campbell P, Schmalzried TP, Black J, Amstutz HC (1996) Cobalt and chromium concentrations in patients with metal on metal total hip replacements. Clin Orthop Relat Res 1996(329 Suppl):S256–S263

    Google Scholar 

  63. Jacobs JJ, Skipor AK, Patterson LM, Hallab NJ, Paprosky WG, Black J, Galante JO (1998) Metal release in patients who have had a primary total hip arthroplasty. A prospective, controlled, longitudinal study. J Bone Joint Surg Am 80(10):1447–1458

    CAS  Google Scholar 

  64. Jacobs JJ, Gilbert JL, Urban RM (1998) Current concepts review: corrosion of metal orthopaedic implants. J Bone Joint Surg Am 80(2):268–282

    CAS  Google Scholar 

  65. Jacobs JJ, Hallab NJ, Skipor AK, Urban RM (2003) Metal degradation products: a cause for concern in metal-metal bearings? Clin Orthop Relat Res 417:139–147

    Google Scholar 

  66. Jones HW, Wimhurst J, Macnair R, Derbishire B, Chirodian N, Toms A, Cahir J (2011) High early failure rate with a large head metal on metal hip replacement: the importance of MRI imaging, Abstract. J Bone Joint Surg Br 93-B(Suppl IV):545

    Google Scholar 

  67. Kanojia RK, Junaid M, Murthy RC (1996) Chromium induced teratogenicity in female rat. Toxicol Lett 89:207–213

    CAS  Google Scholar 

  68. Khan RJ, Wimhurst J, Foroughi S, Toms A (2009) The natural history of metallosis from catastrophic failure of a polyethylene liner in a total hip. J Arthroplasty 24(1144):e1–e4

    Google Scholar 

  69. Kop AM, Keogh C, Swarts E (2012) Proximal component modularity in THA—at what cost?: an implant retrieval study. Clin Orthop Relat Res 470:1885–1894

    CAS  Google Scholar 

  70. Korovessis P, Petsinis G, Repanti M, Repantis T (2006) Metallosis after contemporary metal-on-metal total hip arthroplasty: five- to nine-year follow-up. J Bone Joint Surg Am 88(6):1183–1191

    CAS  Google Scholar 

  71. Kwon YM, Xia Z, Glyn-Jones S, Beard D, Gill HS, Murray DW (2009) Dose-dependent cytotoxicity of clinically relevant cobalt nanoparticles and ions on macrophages in vitro. Biomed Mater 4:25018

    Google Scholar 

  72. Kwon YM, Glyn-Jones S, Simpson DJ, Kamali A, McLardy-Smith P, Gill HS, Murray DW (2010) Analysis of wear of retrieved metal-on-metal hip resurfacing implants revised due to pseudotumours. J Bone Joint Surg Br 92(3):356–361

    Google Scholar 

  73. Kwon YM, Ostlere SJ, McLardy-Smith P, Athanasou NA, Gill HS, Murray DW (2011) “Asymptomatic” pseudotumors after metal-on-metal hip resurfacing arthroplasty: prevalence and metal ion study. J Arthroplasty 26:511–518

    Google Scholar 

  74. Ladon D, Doherty A, Newson R, Turner J, Bhamra M, Case CP (2004) Changes in metal levels and chromosome aberrations in the peripheral blood of patients after metal-on-metal hip arthroplasty. J Arthroplasty 19(Suppl 3):78–83

    Google Scholar 

  75. Langton DJ, Jameson SS, Joyce TJ, Webb J, Nargol AV (2008) The effect of component size and orientation on the concentrations of metal ions after resurfacing arthroplasty of the hip. J Bone Joint Surg Br 90(9):1143–1151

    CAS  Google Scholar 

  76. Langton DJ, Sprowson AP, Joyce TJ, Reed M, Carluke I, Partington P, Nargol AV (2009) Blood metal ion concentrations after hip resurfacing arthroplasty: a comparative study of articular surface replacement and Birmingham Hip Resurfacing arthroplasties. J Bone Joint Surg Br 91(10):1287–1295

    CAS  Google Scholar 

  77. Langton DJ, Jameson SS, Joyce TJ, Hallab NJ, Natu S, Nargol AV (2010) Early failure of metal-on-metal bearings in hip resurfacing and large-diameter total hip replacement: a consequence of excess wear. J Bone Joint Surg Br 92(1):38–46

    CAS  Google Scholar 

  78. Langton DJ, Joyce TJ, Jameson SS, Lord J, Orsouw MV, Holland JP, Nargol AVF, De Smet KA (2011) Adverse reaction to metal debris following hip resurfacing: the influence of component type, orientation, and volumetric wear. J Bone Joint Surg Br 93(2):164–171

    CAS  Google Scholar 

  79. Langton DJ, Jameson SS, Joyce TJ, Gandhi JN, Sidaginamale R, Mereddy P, Lord J, Nargol AV (2011) Accelerating failure rate of the ASR total hip replacement. J Bone Joint Surg Br 93(8):1011–1016

    CAS  Google Scholar 

  80. Liao Y, Pourzal R, Wimmer MA, Jacobs JJ, Fischer A, Marks LD (2011) Graphitic tribological layers in metal-on-metal hip replacements. Science 334:1687–1690

    CAS  Google Scholar 

  81. Lindgren JU, Brismar BH, Wikstrom AC (2011) Adverse reaction to metal release from a modular metal-on-polyethylene hip prosthesis. J Bone Joint Surg Br 93(10):1427–1430

    CAS  Google Scholar 

  82. Lohmann CH, Schwartz Z, Köster G, Jahn U, Buchhorn GH, MacDougall MJ, Casasola D, Liu Y, Sylvia VL, Dean DD, Boyan BD (2000) Phagocytosis of wear debris by osteoblasts affects differentiation and local factor production in a manner dependent on particle composition. BioMaterials 21:551–561

    CAS  Google Scholar 

  83. Mabilleau G, Kwon YM, Pandit H, Murray DW, Sabokbar A (2008) Metal-on-metal hip resurfacing arthroplasty: a review of periprosthetic biological reactions. Acta Orthop 79:734–747.

    Google Scholar 

  84. MacDonald SJ, McCalden RW, Chess DG, Bourne RB, Rorabeck CH, Cleland D, Leung F (2003) Metal-on-metal versus polyethylene in hip arthroplasty: a randomized clinical trial. Clin Orthop Relat Res 406:282–296

    Google Scholar 

  85. Mahendra G, Pandit H, Kliskey K, Murray D, Gill HS, Athanasou N (2009) Necrotic and inflammatory changes in metal-on-metal resurfacing hip arthroplasties. Acta Orthop 80:653–659

    Google Scholar 

  86. Malchau H, Herberts P, Eisler T, Garellick G, Soderman P (2002) The Swedish total hip replacement register. J Bone Joint Surg Am 84-A (Suppl 2):2–20

    Google Scholar 

  87. Malizos K, Roidis NT, Poultsides L, Basdekis G, Moraitis T, Xenakis T (2009) Protrusio of a ceramic femoral head through the acetabular metallic shell, extensive metallosis and ‘bubble sign’. Orthopedics 32:128

    Google Scholar 

  88. Malviya A, Holland JP (2009) Pseudotumours associated with metal-on-metal hip resurfacing: 10-year Newcastle experience. Acta Orthop Belg 75:477–483

    Google Scholar 

  89. Mao X, Wong A, Crawford R (2011) Cobalt toxicity—an emerging clinical problem in patients with metal-on-metal hip prostheses? Med J Aust 194:649–651

    Google Scholar 

  90. Mao X, Tay G, Godbolt D, Crawford R (2012) Pseudotumor in a well-fixed metal-on-polyethylene uncemented hip arthroplasty. J Arthroplasty 27:493.e13–e17

    Google Scholar 

  91. Martin SF (2004) T lymphocyte-mediated immune responses to chemical haptens and metal ions: implications for allergic and autoimmune disease. Int Arch Allergy Immunol 134:186–198

    CAS  Google Scholar 

  92. Matsuda Y, Yamamuro T, Kasai R, Matsusue Y, Okumura H (1992) Severe metallosis due to abnormal abrasion of the femoral head in a dual bearing hip prosthesis. A case report. J Arthroplasty 7 (Suppl):439–445

    Google Scholar 

  93. Matziolis G, Perka C, Disch A (2003) Massive metallosis after revision of a fractured ceramic head onto a metal head. Arch Orthop Trauma Surg 123:48–50

    Google Scholar 

  94. Meftah M, Nicolaou N, Rodrigúez JA (2010) Metal allergy response to femoral head-neck corrosion after total hip replacement. Curr Orthop Pract 21:530–533

    Google Scholar 

  95. Memoli VA, Urban RM, Alroy J, Galante JO (1986) Malignant neoplasms associated with orthopedic implant materials in rats. J Orthop Res 4:346–355

    CAS  Google Scholar 

  96. Miki H, Sugano N, Yamamura M, Nakamura N, Nishii T, Yoshikawa H (2006) Serious metallosis of a metal head due to fragmented ceramic screws in a cemented THA. Arch Orthop Trauma Surg 126(3):192–196

    Google Scholar 

  97. Milosev I, Trebse R, Kovac S, Cör A, Pisot V (2006) Survivorship and retrieval analysis of Sikomet metal-on-metal total hip replacements at a mean of seven years. J Bone Joint Surg Am 88(6):1173–1182

    Google Scholar 

  98. Moroni A, Savarino L, Cadossi M, Baldini N, Giannini S (2008) Does ion release differ between hip resurfacing and metal-on-metal THA? Clin Orthop Relat Res 466:700–707

    Google Scholar 

  99. Moroni A, Savarino L, Hoque M, Cadossi M, Baldini N (2011) Do ion levels in hip resurfacing differ from metal-on-metal THA at midterm? Clin Orthop Relat Res 469:180–187

    CAS  Google Scholar 

  100. Neumann DR, Thaler C, Hitzl W, Huber M, Hofstädter T, Dorn U (2010) Long-term results of a contemporary metal-on-metal total hip arthroplasty: a 10-year follow-up study. J Arthroplasty 25:700–708

    Google Scholar 

  101. Nikolaou V, Petit A, Huk O, Zukor D, Bergeron S, Antoniou J. (2011) Semen metal ion levels and sperm quality in patients with metal on metal total hip replacement. J Bone Joint Surg Br 93-B(Supp II):130 (Abstract, papers presented at EFORTʼs 11th Congress)

    Google Scholar 

  102. Ogunwale B, Schmidt-Ott A, Meek RM, Brewer JM (2009) Investigating the immunologic effects of CoCr nanoparticles. Clin Orthop Relat Res 467:3010–3016

    Google Scholar 

  103. Oldenburg M, Wegner R, Baur X (2009) Severe cobalt intoxication due to prosthesis wear in repeated total hip arthroplasty. J Arthroplasty 24(825):e15–e20

    Google Scholar 

  104. Onega T, Baron J, MacKenzie T (2006) Cancer after total joint arthroplasty: a meta-analysis. Cancer Epidemiol Biomarkers Prev 15:1532–1537

    Google Scholar 

  105. Pandit H, Glyn-Jones S, McLardy-Smith P, Gundle R, Whitwell D, Gibbons CL, Ostlere S, Athanasou N, Gill HS, Murray DW (2008) Pseudotumours associated with metal-on-metal hip resurfacings. J Bone Joint Surg Br 90(7):847–851

    CAS  Google Scholar 

  106. Papageorgiou I, Brown C, Schins R, Singh S, Newson R, Davis S, Fisher J, Ingham E, Case CP (2007) The effect of nano- and micron-sized particles of cobalt-chromium alloy on human fibroblasts in vitro. BioMaterials 28:2946–2958

    CAS  Google Scholar 

  107. Park YS, Moon YW, Lim SJ, Yang JM, Ahn G, Choi YL (2005) Early osteolysis following second-generation metal-on-metal hip replacement. J Bone Joint Surg Am 87(7):1515–1521

    Google Scholar 

  108. Pattyn CA, Lauwagie SN, Verdonk RC (2011) Whole blood metal ion concentrations in correlation with activity level in three different metal-on-metal bearings. J Arthroplasty 26:58–64

    Google Scholar 

  109. Prosser GH, Yates PJ, Wood DJ, Graves SE, de Steiger RN, Miller LN (2010) Outcome of primary resurfacing hip replacement: evaluation of risk factors for early revision. Acta Orthop 81:66–71

    Google Scholar 

  110. Rieker CB, Köttig P, Schön R, Windler M, Wyss UP (1998) Clinical wear performance of metal-on-metal hip arthroplasties. In: Jacobs JJ, Craig TL (eds) Alternative bearing surfaces in total joint replacement. American Society for Testing and Materials, Philadelphia, pp 144–156 (ASTM STP 1346)

    Google Scholar 

  111. Rizzetti MC, Liberini P, Zarattini G, Catalani S, Pazzaglia U, Apostoli P, Padovan A (2009) Loss of sight and sound. Could it be the hip? Lancet 373:1052

    Google Scholar 

  112. Saito S, Ishii T, Mori S, Hosaka K, Ootaki M, Tokuhashi Y (2010) Long-term results of Metasul metal-on-metal total hip arthroplasty. Orthopedics 33:548

    Google Scholar 

  113. Savarino L, Stea S, Granchi D, Visentin M, Ciapetti G, Donati ME, Rollo G, Zinghi G, Pizzoferrato A, Montanaro L, Toni A (2000) Sister chromatid exchanges and ion release in patients wearing fracture fixation devices. J Biomed Mater Res 50:21–26

    CAS  Google Scholar 

  114. Savarino L, Greco M, Cenni E, Cavasinni L, Rotini R, Baldini N, Giunti A (2006) Differences in ion release after ceramic-on-ceramic and metal-on-metal total hip replacement. Medium-term follow-up. J Bone Joint Surg Br 88(4):472–476

    CAS  Google Scholar 

  115. Schaffer AW, Pilger A, Engelhardt C, Zweymueller K, Ruediger HW (1999) Increased blood cobalt and chromium after total hip replacement. J Toxicol Clin Toxicol 37:839–844

    CAS  Google Scholar 

  116. Schirrmacher UO (1967) Case of cobalt poisoning. Br Med J 1:544–545

    CAS  Google Scholar 

  117. Schmalzried T (2009) Metal-metal bearing surfaces in hip arthroplasty. Orthopedics 32(9):ii

    Google Scholar 

  118. Sieber HP, Rieker CB, Köttig P (1999) Analysis of 118 second-generation metal-on-metal retrieved hip implants. J Bone Joint Surg Br 81(1):46–50

    CAS  Google Scholar 

  119. Signorello LB, Ye W, Fryzek JP, Lipworth L, Fraumeni JF, Blot WJ, McLaughlin JK, Nyrén O (2011) Nationwide study of cancer risk among hip replacement patients in Sweden. J Natl Cancer Inst 93:1405–1410

    Google Scholar 

  120. Steens W, von Foerster G, Katzer A (2006) Severe cobalt poisoning with loss of sight after ceramic-metal pairing in a hip—a case report. Acta Orthop 77:830–832

    Google Scholar 

  121. Svensson O, Mathiesen EB, Reinholt FP, Blomgren G (1988) Formation of a fulminant soft-tissue pseudotumor after uncemented hip arthroplasty: a case report. J Bone Joint Surg Am 70(8):1238–1242

    CAS  Google Scholar 

  122. Swanson SA, Freeman MA, Heath JC (1973) Laboratory tests on total joint replacement prostheses. J Bone Joint Surg Br 55(4):759–773

    CAS  Google Scholar 

  123. Tharani R, Dorey FJ, Schmalzried TP (2001) The risk of cancer following total hip or knee arthroplasty. J Bone Joint Surg Am 83-A(5):774–780

    Google Scholar 

  124. Tower SS (2010) Arthroprosthetic cobaltism: neurological and cardiac manifestations in two patients with metal-on-metal arthroplasty: a case report. J Bone Joint Surg Am 92(17):2847–2851

    Google Scholar 

  125. Vendittoli PA, Mottard S, Roy AG, Dupont C, Lavigne M (2007) Chromium and cobalt ion release following the Durom high carbon content, forged metal-on-metal surface replacement of the hip. J Bone Joint Surg Br 89(4):441–448

    Google Scholar 

  126. Vendittoli PA, Roy A, Mottard S, Girard J, Lusignan D, Lavigne M (2010) Metal ion release from bearing wear and corrosion with 28 mm and large-diameter metal-on-metal bearing articulations: a follow-up study. J Bone Joint Surg Br 92(1):12–19

    Google Scholar 

  127. Visuri T, Pukkala E, Paavolainen P, Pulkkinen P, Riska EB (1996) Cancer risk after metal on metal and polyethylene on metal total hip arthroplasty. Clin Orthop Relat Res 329 (Suppl):S280–S289

    Google Scholar 

  128. Visuri T, Borg H, Pulkkinen P, Paavolainen P, Pukkala E (2010) A retrospective comparative study of mortality and causes of death among patients with metal-on-metal and metal-on-polyethylene total hip prostheses in primary osteoarthritis after a long-term follow-up. BMC Musculoskelet Disord 11:78

    Google Scholar 

  129. Visuri T, Pulkkinen P, Paavolainen P, Pukkala E (2010) Cancer risk is not increased after conventional hip arthroplasty. Acta Orthop 81:77–81

    Google Scholar 

  130. Walsh A, Nikolaou V, Antoniou J (2012) Inflammatory pseudotumor complicating metal-on-highly cross-linked polyethylene total hip arthroplasty. J Arthroplasty 27(2):324.e5–e8

    Google Scholar 

  131. Wang JY, Wicklund BH, Gustilo RB, Tsukayama DT (1997) Prosthetic metals interfere with the functions of human osteoblast cells in vitro. Clin Orthop Relat Res 339:216–226

    Google Scholar 

  132. Werle J, Goodman S, Schurman D, Lannin J (2002) Polyethylene liner dissociation in Harris-Galante acetabular components: a report of 7 cases. J Arthroplasty 17:78–81

    Google Scholar 

  133. Willert HG, Buchhorn GH, Fayyazi A, Flury R, Windler M, Köster G, Lohmann CH (2005) Metal-on-metal bearings and hypersensitivity in patients with artificial hip joints: a clinical and histomorphological study. J Bone Joint Surg Am 87(1):28–36

    Google Scholar 

  134. Williams DH, Greidanus NV, Masri BA, Duncan CP, Garbuz DS (2011) Prevalence of pseudotumor in asymptomatic patients after metal-on-metal hip arthroplasty. J Bone Joint Surg Am 93A:2164–2171

    Google Scholar 

  135. Witzleb WC, Ziegler J, Krummenauer F, Neumeister V, Guenther KP (2006) Exposure to chromium, cobalt and molybdenum from metal-on-metal total hip replacement and hip resurfacing arthroplasty. Acta Orthop 77:697–705

    Google Scholar 

  136. Witzleb WC, Hanisch U, Kolar N, Krummenauer F, Guenther KP (2007) Neo-capsule tissue reactions in metal-on-metal hip arthroplasty. Acta Orthop 78:211–220

    Google Scholar 

  137. Ziaee H, Daniel J, Datta AK, Blunt S, McMinn DJ (2007) Transplacental transfer of cobalt and chromium in patients with metal-on-metal hip arthroplasty: a controlled study. J Bone Joint Surg Br 89(3):301–305

    CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, NY, USA

    H. John Cooper

  2. Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West Harrison St, Suite 300, 60612, Chicago, IL, USA

    Joshua J. Jacobs

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  1. H. John Cooper
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Correspondence to Joshua J. Jacobs .

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  1. Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, USA

    Lynne C. Jones

  2. Department of Biomedical Engineering, University of Memphis, Memphis, Tennessee, USA

    Warren O. Haggard

  3. Orthopaedic Research Laboratories Lutheran Hospital, Cleveland Clinic, Cleveland, Ohio, USA

    A. Seth Greenwald

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Cooper, H., Jacobs, J. (2014). Benign Responses to Orthopaedic Implants: Really?. In: Jones, L., Haggard, W., Greenwald, A. (eds) Metal-on-Metal Bearings. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8999-3_8

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