Current Concepts Review   |    
Metal-on-Metal Total Hip Arthroplasty
Ajay Malviya, FRCS(Orth)1; Jayasree Ramaskandhan, MSc1; James P. Holland, FRCS(Orth)1; Elizabeth A. Lingard, PhD1
1 Department of Orthopaedic Surgery, Freeman Hospital, Newcastle on Tyne NE7 7DN, United Kingdom
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from commercial entities (Stryker UK, Smith and Nephew, DePuy [Johnson and Johnson]).

Investigation performed at the Department of Orthopaedic Surgery, Freeman Hospital, Newcastle on Tyne, United Kingdom

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Jul 07;92(7):1675-1683. doi: 10.2106/JBJS.I.01426
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The effects of elevated levels of metal ions in patients who have undergone metal-on-metal total hip arthroplasty are not fully understood.

The effects of femoral head size on serum metal-ion levels have been the subject of conflicting reports, and further investigation is needed to evaluate the impact of acetabular and femoral component alignment.

The conduct of clinical trials of metal-on-metal total hip arthroplasties has been inadequate as few investigators have used a randomized controlled design to compare metal-on-metal bearings with other bearing surfaces.

Additional clinical research needs to include appropriate validated patient-reported outcome measures, activity monitoring, and health economics.

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