Head Size and Metal-on-Metal Bearings

摘要

The reintroduction of metal-on-metal (M-M) bearing components in total hip arthroplasty (THA) occurred with small-diameter heads (28-32 mm) in the late 1980s and gave excellent results up to 15 years of follow-up (Dastane et al. 2011; Griibl et al. 2007; Migaud et al. 2011). Shortly thereafter, M-M hip resurfacing (SRA) resurged, and favorable outcomes are currently reported at follow-up exceeding 12 years (Amstutz et al. 2010; Coulter et al. 2012; Treacy et al. 2011). From this rapid overview of the literature on metallic articulations, one may erroneously conclude that bearing diameter has no influence on survival of M-M articulations. Currently, there is growing controversy regarding M-M bearings considering adverse reactions to metallic debris (ARMD) and concerns about blood ion elevation (Engh et al. 2010; Glyn-Jones et al. 2009; Hart et al. 2012; Heneghan et al. 2012).