Metal-on-Metal Bearings: A Clinical Practicum PDF
Preview Metal-on-Metal Bearings: A Clinical Practicum
Metal-on-Metal Bearings Lynne C. Jones • A. Seth Greenwald Warren O. Haggard Editors Metal-on-Metal Bearings A Clinical Practicum 2123 Editors LynneC.Jones,Ph.D.,M.S. WarrenO.Haggard,Ph.D. AssociateProfessorof ProfessorandHerffChairofExcellence, OrthopaedicSurgery BiomedicalEngineeringDepartment DirectorofResidentResearch TheUniversityofMemphis JohnsHopkinsUniversity 330EngineeringTechnologyBuilding SchoolofMedicine Memphis,TN38152-3210,USA JHOC5255;Departmentof OrthopaedicSurgery 601N.CarolineStreet Baltimore,MD21287,USA A.SethGreenwald,D.Phil.(Oxon) Director OrthopaedicResearchLaboratories 2310SuperiorAvenueEast Cleveland,Ohio44114,USA ISBN978-1-4614-8998-6 ISBN978-1-4614-8999-3(eBook) DOI10.1007/978-1-4614-8999-3 SpringerNewYorkHeidelbergDordrechtLondon LibraryofCongressControlNumber:2013951511 © SpringerScience+BusinessMediaNewYork2014 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher, whetherthewholeorpart of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,broadcasting,reproductiononmicrofilmsorinanyotherphysicalway,andtransmissionor informationstorageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilar methodologynowknownorhereafterdeveloped.Exemptedfromthislegalreservationarebriefexcerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. 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Printedonacid-freepaper SpringerispartofSpringerScience+BusinessMedia(www.springer.com) Preface Overamillionmetal-on-metalhipprostheseshavebeenimplantedsince1996, ac- cording to the Hip Society [1]. Controversy arose with reports of adverse tissue reactionsandincreasedratesofrevisionassociatedwithsomeoftheimplantdesigns duringthe2000s.Today(2013),whilemanyorthopaedistshavediscontinuedusing metal-on-metal implants, others continue to implant prostheses with this hard-on- hard bearing. This book will review the current understanding of the history and rationale for the development of metal-on-metal hips, the clinical experience, the basicscience,andthefuture.Asanoutgrowthofseveralworkshopsonthetopic,this bookrepresentsacollaborativeeffortbetweenmembersoftheOrthopaedicResearch Society,theAmericanAcademyofOrthopaedicSurgeons(BiologicalImplantsCom- mittee, Biomedical Engineering Committee, and the Orthopaedic Device Forum), andtheSocietyForBiomaterials. The book is divided into five sections. Part one provides a historical review of metal-on-metalimplantsandposesthequestionsthathavebeenraisedconcerning theiruse.Thesecondpartfocusesontheclinicalexperiencewithmodernmetal-on- metalimplants.Itdiscussestheresultsofregistriesandoutcomestudiesaswellas thesignificanceoftestingpatientsformetalionlevelsandhypersensitivity.Partthree exploresthebiologicalresponsetometal-on-metalimplants.Beginningwithadis- cussionofthebasictenetsofwoundhealing,inflammation,andimmuneresponses, the implications of the adverse reactions seen around metal-on-metal implants are then analyzed by experts in the field. Part four discusses the possible contribution of the materials used in the manufacture of these implants, with special emphasis onwearmechanismsandtribocorrosion.Theclosingchapterofthebookexplores futuredirections. We hope that this book will become a reference source for orthopaedic resi- dents and fellows, orthopaedists, academics studying joint arthroplasty, and their colleaguesinindustry. References 1.LombardiAVJretal(2012)Thehipsociety:algorithmicapproachtodiagnosisandmanagement ofmetal-on-metalarthroplasty.JBoneJointSurgBr94(11SupplA):14–18 v Contents PartI Introduction 1 OverviewofMetal-on-MetalImplants............................ 3 LynneC.Jones,WarrenO.HaggardandA.SethGreenwald 2 Bearing Surfaces for Joint Replacement: New Materials or New Problems...................................................... 13 StuartGoodman PartII Clinical 3 OutcomeStudiesforMetal-on-MetalBearings:WhatEvidence-Based MedicineTellsUs .............................................. 23 MichaelA.MontandRobertPivec 4 MetalReactivity:ItsInfluenceonPrimaryandRevisionOutcomes .. 39 GeorgeGrammatopoulos,HemantPandit,AdrianLow andDavidMurray 5 AreMetalIonLevelsaTriggerforSurgicalIntervention? .......... 63 DavidLangton 6 MetalSensitivity:IsItPossibletoDetermineClinically?............ 83 NadimJ.HallabandPaulH.Wooley PartIII Biology 7 WoundHealing,ChronicInflammation,andImmuneResponses .... 109 PaulH.WooleyandNadimJ.Hallab 8 BenignResponsestoOrthopaedicImplants:Really? ............... 135 H.JohnCooperandJoshuaJ.Jacobs vii viii Contents 9 WhatDoestheHistologyTellUs? ................................ 153 ThomasW.Bauer PartIV Biomechanics 10 WhyMetal-on-Metal:WhatLaboratoryTestsHaveShownUs ...... 165 PeterThomas,BurkhardSummer,MarcThomsen,VeitKrenn andJanPhilippeKretzer 11 WhatDotheRetrievalsReallyTellUs? ........................... 173 RobinPourzal,RobertM.UrbanandMarkusA.Wimmer FutureDirections.................................................. 195 A.SethGreenwald,WarrenO.Haggard,andLynneC.Jones Index ............................................................ 199 Contributors ThomasW.Bauer DepartmentsofPathology,OrthopaedicSurgeryandTheSpine Center,TheClevelandClinic,Cleveland,OH,USA H. John Cooper Department of Orthopaedic Surgery, Lenox Hill Hospital, New York,NY,USA George Grammatopoulos Nuffield Department of Orthopaedics, Rheumatology andMusculoskeletalSciences,UniversityofOxford,Headington,Oxford,UK Stuart Goodman Departments of Orthopaedic Surgery and Bioengineering, StanfordUniversity,Stanford,USA A.SethGreenwald OrthopaedicResearchLaboratories,Cleveland,OH,USA Warren O. Haggard Biomedical Engineering Department, The University of Memphis,Memphis,TN,US Nadim J. Hallab OrthopedicAnalysis LLC, BioEngineering Solutions Inc, Oak Park,IL,USA DepartmentofOrthopedicSurgery,RushUniversity,Chicago,IL,USA OrthopedicAnalysisLLC,Chicago,IL,USA BioEngineerngSolutionsInc.,OakPark,IL,USA Joshua J. Jacobs Department of Orthopaedic Surgery, Rush University Medical Center,Chicago,IL,USA Lynne C. Jones Department of Orthopaedic Surgery, Johns Hopkins University SchoolofMedicine,Baltimore,MD,US ix x Contributors Veit Krenn MVZ for Cytology, Histology and Molecular Diagnostic, Trier, Germany JanPhilippeKretzer LaboratoryofBiomechanicsandImplantResearch, Clinic forOrthopedicsandTraumaSurgery,DepartmentofOrthopedics,TraumaSurgery andParaplegiology,HeidelbergUniversityHospital,Heidelberg,Germany David Langton North Tees Explant Centre (NTEC), Farndale House, University HospitalofNorthTees,Stockton-on-Tees,UK Adrian Low Nuffield Department of Orthopaedics, Rheumatology and MusculoskeletalSciences,UniversityofOxford,Headington,Oxford,UK Michael A. Mont Rubin Institute for Advanced Orthopedics, Center for Joint PreservationandReplacement,SinaiHospitalofBaltimore,Baltimore,MD,USA David Murray Nuffield Department of Orthopaedics, Rheumatology and MusculoskeletalSciences,UniversityofOxford,Headington,Oxford,UK Hemant Pandit Nuffield Department of Orthopaedics, Rheumatology and MusculoskeletalSciences,UniversityofOxford,Headington,Oxford,UK Robin Pourzal Department of Orthopedic Surgery, Rush University Medical Center,Chicago,IL,USA Robert Pivec Rubin Institute for Advanced Orthopedics, Center for Joint PreservationandReplacement,SinaiHospitalofBaltimore,Baltimore,MD,USA Burkhard Summer Clinic for Dermatology and Allergology, Ludwig- Maximilians-University,Munich,Germany Peter Thomas Clinic for Dermatology and Allergology, Ludwig-Maximilians- University,Munich,Germany MarcThomsen Clinics for Orthopedics andTrauma Surgery, DRK-Hospital and CityHospital,Baden-Baden,Germany Robert M. Urban Department of Orthopedic Surgery, Rush University Medical Center,Chicago,IL,USA Markus A. Wimmer Section of Tribology, Department of Orthopedic Surgery, RushUniversityMedicalCenter,Chicago,IL,USA PaulH.Wooley UniversityofKansasMedicalSchool,Wichita,KS,USA Part I Introduction
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