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Produce lower serum metal ion concentrations than metal-on-cross linked polyethylene bearings
1%
23/3432
Have a decreased volumetric wear rate compared to metal-on-ceramic bearings
12%
399/3432
Have smaller wear particles compared to metal-on-cross linked polyethylene bearings
74%
2550/3432
Have a higher incidence of early soft-tissue sarcoma compared to all other bearing surfaces.
7%
257/3432
The wear rate significantly increases after the first year of use.
5%
187/3432
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Metal-on-metal bearings used in total hip arthroplasty form smaller wear particles compared to metal-on-cross linked polyethylene bearings. Metal-on-metal bearings produce higher serum metal ion concentrations, have lower volumetric wear rates, and achieve a "steady state" of wear after the first year of use whereby the wear rate then decreases. The volumetric wear rate of metal-on-metal articulations is greater than metal-on-ceramic as reported by in vitro studies. Also, there is not evidence to suggest an increased risk of soft tissue sarcoma with use of the metal-on-metal bearings. Heisel et al, in an instructional lecture series, systematically discusses all types of bearing options with their advantages and disadvantages. Amstutz et al attempts to answer questions and concerns over the use of metal-on-metal bearings for total hip arthroplasty. Haddad et al review current literature on soft-tissue reactions resulting in implant failure and associated complications in the use of metal on metal hips. Implant position and immunologic reactions are thought to be key players in failure.
3.7
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