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Review
. 2017 Mar 13;1(10):345-353.
doi: 10.1302/2058-5241.1.160014. eCollection 2016 Oct.

Sequelae of large-head metal-on-metal hip arthroplasties: Current status and future prospects

Christiaan P van Lingen  1 , Luigi M Zagra  2 , Harmen B Ettema  1 , Cees C Verheyen  1
Affiliations
Review

Sequelae of large-head metal-on-metal hip arthroplasties: Current status and future prospects

Christiaan P van Lingen et al. EFORT Open Rev. .

Abstract

Large-head metal-on-metal (MoM) bearings were re-popularised in the late 1990s with the introduction of modern hip resurfacing (HR), followed closely by large metal head total hip arthroplasty (THA). A worldwide increase in the use of MoM hip arthroplasty subsequently saw a sharp decline, due to serious complications.MoM was rapidly adopted in the early 2000s until medical device alerts were issued by government regulatory agencies and national and international organisations, leading to post-marketing surveillance and discontinuation of these implants.Guidelines for MoM hip implant follow-up differ considerably between regulatory authorities worldwide; this can in part be attributed to missing or conflicting evidence.The authors consider that the use of large-head MoM THA should be discontinued. MoM HR should be approached with caution and, when considered, should be used only in patients who meet all of the recommended selection criteria, which limits its indications considerably.The phased introduction of new prostheses should be mandatory in future. Close monitoring of outcomes and long-term follow-up is also necessary for the introduction of new prostheses. Cite this article: van Lingen CP, Zagra LM, Ettema HB, Verheyen CC. Sequelae of large-head metal-on-metal hip arthroplasties: current status and future prospects. EFORT Open Rev 2016;1:345-353. DOI: 10.1302/2058-5241.1.160014.

Keywords: MoM; complications; hip arthroplasty; large-head; metal-on-metal.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Fig. 1
Fig. 1
Hip resurfacing: Birmingham hip resurfacing system (Smith & Nephew; Andover, Massachusetts).
Fig. 2
Fig. 2
Retrieval of total hip resurfacing, Bi-Metric TM stem with the M2a Magnum TM components (Biomet; Warsaw, Indiana).
Fig. 3
Fig. 3
CT scan of the axial section of an unilateral metal-on-metal total hip arthroplasty, showing a large pseudotumour anteromedial of the right hip.
See this image and copyright information in PMC

References

    1. No authors listed. Medicines and Healthcare products Regulatory Agency (MHRA). Medical device alert: all metal-on-metal (MoM) hip replacements. https://www.gov.uk/drug-device-alerts/medical-device-alert-metal-on-meta... (date last accessed 2 September 2016).
    1. No authors listed. U.S. Food and drug administration: Metal-on-metal hip implants. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/Implantsa... (date last accessed 02 September 2016).
    1. Verheyen CC, Verhaar JA. Failure rates of stemmed metal-on-metal hip replacements. Lancet 2012;380:105. - PubMed
    1. Haddad FS, Thakrar RR, Hart AJ, et al. Metal-on-metal bearings: the evidence so far. J Bone Joint Surg [Br] 2011;93-B:572-579. - PubMed
    1. Haddad FS, Konan S. Current controversies in hip surgery: a report on the proceedings of the London Hip Meeting 2011. J Bone Joint Surg [Br] 2012;94-B:297-301. - PubMed