Adverse Reactions In Metal-on-Metal Total Hip Arthroplasty: Two Cases Presenting as Pseudoseptic Acetabular Component

摘要

The need to improve the longevity of total hip arthroplasties (THAs) has led to a global increase in use of alternative bearing surfaces, particularly first-generation cobalt-chromium and second-generation cobalt-chromium-molybdenum alloys. Advantages of metal-on-metal (MOM) bearing surfaces include low volumetric wear rates, high fracture toughness, and the ability to use large femoral heads to increase hip stability. However, the number of degradation particles released from MOM articulations is higher than that found for conventional metal-on-polyethylene bearing surfaces. In addition, there is concern regarding the potential for significant crevice corrosion at the large-diameter femoral head-neck junction. Once considered an important, but uncommon, novel cause of failure, metal hypersensitivity reactions are now more prevalent than originally thought, and there is a diverse array of associated clinical and operative findings.