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Adverse reaction to metal debris following hip resurfacing: The influence of component type, orientation and volumetric wear

Lookup NU author(s): David Langton, Professor Tom Joyce, Dr Simon Jameson, Jane Lord


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We sought to establish the incidence of joint failure secondary to adverse reaction to metal debris (ARMD) following metal-on-metal hip resurfacing in a large, three surgeon, multicentre study involving 4226 hips with a follow-up of 10 to 142 months. Three implants were studied: the Articular Surface Replacement; the Birmingham Hip Resurfacing; and the Conserve Plus. Retrieved implants underwent analysis using a co-ordinate measuring machine to determine volumetric wear. There were 58 failures associated with ARMD. The median chromium and cobalt concentrations in the failed group were significantly higher than in the control group (p < 0.001). Survival analysis showed a failure rate in the patients with Articular Surface Replacement of 9.8% at five years, compared with < 1% at five years for the Conserve Plus and 1.5% at ten years for the Birmingham Hip Resurfacing. Two ARMD patients had relatively low wear of the retrieved components. Increased wear from the metal-on-metal bearing surface was associated with an increased rate of failure secondary to ARMD. However, the extent of tissue destruction at revision surgery did not appear to be dose-related to the volumetric wear.

Publication metadata

Author(s): Langton DJ, Joyce TJ, Jameson SS, Lord J, Van Orsouw M, Holland JP, Nargol AVF, De Smet KA

Publication type: Article

Publication status: Published

Journal: Journal of Bone and Joint Surgery: British Volume

Year: 2011

Volume: 93B

Issue: 2

Pages: 164-171

Print publication date: 01/02/2011

ISSN (print): 0301-620X

Publisher: British Editorial Society of Bone and Joint Surgery


DOI: 10.1302/0301-620X.93B2.25099


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