• Home
  • Search Results
  • Metal release and metal allergy after total hip replacement with resurfacing versus conventional hybrid prosthesis.

Metal release and metal allergy after total hip replacement with resurfacing versus conventional hybrid prosthesis.

Acta orthopaedica (2014-06-17)
Klas Gustafson, Stig S Jakobsen, Nina D Lorenzen, Jacob P Thyssen, Jeanne D Johansen, Charlotte M Bonefeld, Maiken Stilling, Thomas Baad-Hansen, Kjeld Søballe
ABSTRACT

Metal-on-metal (MOM) total hip arthroplasties were reintroduced because of the problems with osteolysis and aseptic loosening related to polyethylene wear of early metal-on-polyethylene (MOP) arthroplasties. The volumetric wear rate has been greatly reduced with MOM arthroplasties; however, because of nano-size wear particles, the absolute number has been greatly increased. Thus, a source of metal ion exposure with the potential to sensitize patients is present. We hypothesized that higher amounts of wear particles result in increased release of metal ions and ultimately lead to an increased incidence of metal allergy. 52 hips in 52 patients (median age 60 (51-64) years, 30 women) were randomized to either a MOM hip resurfacing system (ReCap) or a standard MOP total hip arthoplasty (Mallory Head/Exeter). Spot urine samples were collected preoperatively, postoperatively, after 3 months, and after 1, 2, and 5 years and tested with inductively coupled plasma-sector field mass spectrometry. After 5 years, hypersensitivity to metals was evaluated by patch testing and lymphocyte transformation assay. In addition, the patients answered a questionnaire about hypersensitivity. A statistically significant 10- to 20-fold increase in urinary levels of cobalt and chromium was observed throughout the entire follow-up in the MOM group. The prevalence of metal allergy was similar between groups. While we observed significantly increased levels of metal ions in the urine during the entire follow-up period, no difference in prevalence of metal allergy was observed in the MOM group. However, the effect of long-term metal exposure remains uncertain.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Thymidine, powder, BioReagent, suitable for cell culture
Sigma-Aldrich
Thymidine, ≥99%
Sigma-Aldrich
Polyethylene, low density, melt index 25 g/10 min (190°C/2.16kg)
Polyethylene (LDPE), ERM®, certified reference material
Sigma-Aldrich
Polyethylene, average Mw ~4,000 by GPC, average Mn ~1,700 by GPC
Sigma-Aldrich
Polyethylene, Ultra-high molecular weight, surface-modified, powder, 34-50 μm particle size
Sigma-Aldrich
Chromium, chips, 99.995% trace metals basis
Sigma-Aldrich
Polyethylene, Ultra-high molecular weight, average Mw 3,000,000-6,000,000
Sigma-Aldrich
Titanium, foil, thickness 0.127 mm, 99.7% trace metals basis
Sigma-Aldrich
Titanium, foil, thickness 0.25 mm, 99.7% trace metals basis
Sigma-Aldrich
Titanium, powder, <45 μm avg. part. size, 99.98% trace metals basis
Sigma-Aldrich
Chromium, powder, ≥99% trace metals basis, <45 μm
Sigma-Aldrich
Cobalt, powder, <150 μm, ≥99.9% trace metals basis
Sigma-Aldrich
Titanium, powder, −100 mesh, 99.7% trace metals basis
Sigma-Aldrich
Thymidine, ≥99.0% (HPLC)
Sigma-Aldrich
Cobalt, powder, 2 μm particle size, 99.8% trace metals basis
Sigma-Aldrich
Polyethylene, Ultra-high molecular weight, surface-modified, powder, 125 μm avg. part. size
Sigma-Aldrich
Polyethylene, High density, melt index 2.2 g/10 min (190 °C/2.16kg)
Sigma-Aldrich
Polyethylene, Medium density
Sigma-Aldrich
Polyethylene, Linear low density, melt index 1.0 g/10 min (190°C/2.16kg)
Sigma-Aldrich
Polyethylene, High density, melt index 12 g/10 min (190 °C/2.16kg)
Sigma-Aldrich
Titanium, foil, thickness 0.025 mm, 99.98% trace metals basis
Sigma-Aldrich
Chromium, powder, 99.5%, −100 mesh
Sigma-Aldrich
Titanium, wire, diam. 0.25 mm, 99.7% trace metals basis
Sigma-Aldrich
Titanium, sponge, 3-19 mm, 99.5% trace metals basis
Sigma-Aldrich
Cobalt, Carbon coated magnetic, nanopowder, <50 nm particle size (TEM), ≥99%
Sigma-Aldrich
Cobalt, granular, 99.99% trace metals basis
Sigma-Aldrich
Titanium, nanoparticles, dispersion, <100 nm particle size, in mineral oil, 98.5% trace metals basis
Sigma-Aldrich
Titanium, sputtering target, diam. × thickness 2.00 in. × 0.25 in., 99.995% trace metals basis
Sigma-Aldrich
Titanium, foil, thickness 0.5 mm, 99.99% trace metals basis