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Femoral Head Size Does Not Affect Ion Values in Metal-on-Metal Total Hips

  • Symposium: Update on Hard-on-Hard Bearings in Hip Arthroplasty
  • Published:
Clinical Orthopaedics and Related Research®

An Erratum to this article was published on 03 November 2011

Abstract

Background

Metal-on-metal articulations can release substantial amounts of particles containing cobalt and chromium into the surrounding milieu, causing concern for cellular toxicity and adverse local soft tissue reactions. The diameter of the femoral head has been one of the variables that inversely affects wear of metal-on-metal total hip arthroplasty (THA). The oxidative stress of increased metal ions can be measured with serum markers. It is still controversial if larger femoral head diameters decrease wear rates in patients with metal-on-metal THA and if the increased metal ions alter the body’s antioxidant status.

Questions/purposes

We therefore (1) determined whole blood metal ions in patients with small (28 mm and 36 mm) and large (40 mm and 44 mm) diameter femoral heads; (2) measured oxidative stress markers (total antioxidants, nitrotyrosine, and peroxides); and (3) determined whether acetabular version or inclination influenced ion levels.

Methods

One hundred four patients were retrospectively studied. We recorded Harris hip scores and UCLA activity scores. All patients were followed at 1 year.

Results

The activity scores were similar in the two groups. There was no difference in metal ion levels or oxidative stress markers between patients with small- or large-diameter femoral heads. Acetabular inclination and anteversion had no effect on the metal ion levels.

Conclusions

The data suggest there is no difference in ion values in patients with large or small metal-on-metal THA and the increased metal ions do not alter the oxidant status of the patient.

Level of Evidence

Level III, retrospective comparative study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Maricar Alminia and Laura Des Rosiers for their help in administration of the questionnaires and recording the clinical data.

Author information

Authors and Affiliations

  1. Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, QC, Canada

    Mitchell Bernstein MD, Alan Walsh MD, Alain Petit PhD, David J. Zukor MD & John Antoniou MD, PhD

  2. Lady Davis Institute for Medical Research, SMBD-Jewish General Hospital, Montreal, QC, Canada

    Alan Walsh MD, Alain Petit PhD, David J. Zukor MD & John Antoniou MD, PhD

  3. Department of Orthopaedics, Chemin de la Côte Ste-Catherine, Room E-003, SMBD-Jewish General Hospital, 3755, Montreal, QC, H3T 1E2, Canada

    John Antoniou MD, PhD

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  1. Mitchell Bernstein MD
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  2. Alan Walsh MD
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  4. David J. Zukor MD
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  5. John Antoniou MD, PhD
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Correspondence to John Antoniou MD, PhD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the Division of Orthopaedic Surgery, McGill University, SMBD-Jewish General Hospital, Montreal, QC, Canada.

An erratum to this article can be found at http://dx.doi.org/10.1007/s11999-011-2164-8

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Bernstein, M., Walsh, A., Petit, A. et al. Femoral Head Size Does Not Affect Ion Values in Metal-on-Metal Total Hips. Clin Orthop Relat Res 469, 1642–1650 (2011). https://doi.org/10.1007/s11999-010-1630-z

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