CORR Insights^®: What Are the Predictors and Prevalence of Pseudotumor and Elevated Metal Ions After Large-diameter Metal-on-metal THA?

Excerpt

The varied effects of metal-ion release from hip arthroplasty implants demand ongoing attention from the scientific community. Liberated metal ions, especially cobalt and chromium, can initiate a wide variety of pathologic local and systemic reactions in the host. The more dramatic systemic effects, such as cardiomyopathy and neuropathy, fortunately appear to be relatively uncommon. The practicing hip surgeon, however, is keenly aware of the periarticular damage noted at the time of revision when an adverse local tissue reaction (ALTR) to metal debris is encountered. Adverse local tissue reaction, including pseudotumors, were once thought to be a rare problem seen only in metal-on-metal (MoM) bearing hip arthroplasties. Today, dual-modular neck femoral implants, and even modular cobalt-chrome femoral heads have been implicated in the generation of elevated ion levels and ALTR. …