The painful metal-on-metal hip resurfacing
We carried out metal artefact-reduction MRI, three-dimensional CT measurement of the position of the component and inductively-coupled plasma mass spectrometry analysis of cobalt and chromium levels in whole blood on 26 patients with unexplained pain following metal-on-metal resurfacing arthroplasty...
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Published in | Journal of bone and joint surgery. British volume Vol. 91; no. 6; pp. 738 - 744 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
London
British Editorial Society of Bone and Joint Surgery
01.06.2009
British Editorial Society of Bone & Joint Surgery |
Edition | British volume |
Subjects | |
Online Access | Get full text |
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Summary: | We carried out metal artefact-reduction MRI, three-dimensional CT measurement of the position of the component and inductively-coupled plasma mass spectrometry analysis of cobalt and chromium levels in whole blood on 26 patients with unexplained pain following metal-on-metal resurfacing arthroplasty. MRI showed periprosthetic lesions around 16 hips, with 14 collections of fluid and two soft-tissue masses. The lesions were seen in both men and women and in symptomatic and asymptomatic hips. Using three-dimensional CT, the median inclination of the acetabular component was found to be 55 degrees and its positioning was outside the Lewinnek safe zone in 13 of 16 cases. Using inductively-coupled plasma mass spectrometry, the levels of blood metal ions tended to be higher in painful compared with well-functioning metal-on-metal hips. These three clinically useful investigations can help to determine the cause of failure of the implant, predict the need for future revision and aid the choice of revision prostheses. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2 |
ISSN: | 0301-620X 2049-4394 2044-5377 2049-4408 |
DOI: | 10.1302/0301-620x.91b6.21682 |