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 Lynne C. Jones, Ph.D., M.S. Warren O. Haggard, Ph.D. Associate Professor of Professor and Herff Chair of Excellence, Orthopaedic Surgery Biomedical Engineering Department Director of Resident Research The University of Memphis Johns Hopkins University 330 Engineering Technology Building School of Medicine Memphis, TN 38152-3210, USA JHOC 5255; Department of Orthopaedic Surgery 601 N. Caroline Street Baltimore, MD 21287, USA A. Seth Greenwald, D.Phil.(Oxon) Director Orthopaedic Research Laboratories 2310 Superior Avenue East Cleveland, Ohio 44114, USA ISBN 978-1-4614-8998-6 ISBN 978-1-4614-8999-3 (eBook) DOI 10.1007/978-1-4614-8999-3 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2013951511 © Springer Science+Business Media New York 2014 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts 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. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Preface Over a million metal-on-metal hip prostheses have been implanted since 1996, ac- cording to the Hip Society [1]. Controversy arose with reports of adverse tissue reactions and increased rates of revision associated with some of the implant designs during the 2000s. Today (2013), while many orthopaedists have discontinued using 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 basic science, and the future. As an outgrowth of several workshops on the topic, this book represents a collaborative effort between members of the Orthopaedic Research Society, theAmericanAcademy of Orthopaedic Surgeons (Biological Implants Com- mittee, Biomedical Engineering Committee, and the Orthopaedic Device Forum), and the Society For Biomaterials. The book is divided into five sections. Part one provides a historical review of metal-on-metal implants and poses the questions that have been raised concerning their use. The second part focuses on the clinical experience with modern metal-on- metal implants. It discusses the results of registries and outcome studies as well as the significance of testing patients for metal ion levels and hypersensitivity. Part three explores the biological response to metal-on-metal implants. Beginning with a dis- cussion of the basic tenets of wound healing, inflammation, and immune responses, 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 on wear mechanisms and tribocorrosion. The closing chapter of the book explores future directions. We hope that this book will become a reference source for orthopaedic resi- dents and fellows, orthopaedists, academics studying joint arthroplasty, and their colleagues in industry. References 1. Lombardi AV Jr et al (2012) The hip society: algorithmic approach to diagnosis and management of metal-on-metal arthroplasty. J Bone Joint Surg Br 94(11 Suppl A):14–18 v Contents Part I Introduction 1 Overview of Metal-on-Metal Implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Lynne C. Jones, Warren O. Haggard and A. Seth Greenwald 2 Bearing Surfaces for Joint Replacement: New Materials or New Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Stuart Goodman Part II Clinical 3 Outcome Studies for Metal-on-Metal Bearings: What Evidence-Based Medicine Tells Us . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Michael A. Mont and Robert Pivec 4 Metal Reactivity: Its Influence on Primary and Revision Outcomes . . 39 George Grammatopoulos, Hemant Pandit, Adrian Low and David Murray 5 Are Metal Ion Levels a Trigger for Surgical Intervention? . . . . . . . . . . 63 David Langton 6 Metal Sensitivity: Is It Possible to Determine Clinically? . . . . . . . . . . . . 83 Nadim J. Hallab and Paul H. Wooley Part III Biology 7 Wound Healing, Chronic Inflammation, and Immune Responses . . . . 109 Paul H. Wooley and Nadim J. Hallab 8 Benign Responses to Orthopaedic Implants: Really? . . . . . . . . . . . . . . . 135 H. John Cooper and Joshua J. Jacobs vii viii Contents 9 What Does the Histology Tell Us? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 Thomas W. Bauer Part IV Biomechanics 10 Why Metal-on-Metal: What Laboratory Tests Have Shown Us . . . . . . 165 Peter Thomas, Burkhard Summer, Marc Thomsen, Veit Krenn and Jan Philippe Kretzer 11 What Do the Retrievals Really Tell Us? . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Robin Pourzal, Robert M. Urban and Markus A. Wimmer Future Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 A. Seth Greenwald, Warren O. Haggard, and Lynne C. Jones Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199 Contributors Thomas W. Bauer Departments of Pathology, Orthopaedic Surgery and The Spine Center, The Cleveland Clinic, Cleveland, OH, USA H. John Cooper Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, NY, USA George Grammatopoulos Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Headington, Oxford, UK Stuart Goodman Departments of Orthopaedic Surgery and Bioengineering, Stanford University, Stanford, USA A. Seth Greenwald Orthopaedic Research Laboratories, Cleveland, OH, USA Warren O. Haggard Biomedical Engineering Department, The University of Memphis, Memphis, TN, US Nadim J. Hallab Orthopedic Analysis LLC, BioEngineering Solutions Inc, Oak Park, IL, USA Department of Orthopedic Surgery, Rush University, Chicago, IL, USA Orthopedic Analysis LLC, Chicago, IL, USA BioEngineerng Solutions Inc., Oak Park, 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 School of Medicine, Baltimore, MD, US ix x Contributors Veit Krenn MVZ for Cytology, Histology and Molecular Diagnostic, Trier, Germany Jan Philippe Kretzer Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Department of Orthopedics, Trauma Surgery and Paraplegiology, Heidelberg University Hospital, Heidelberg, Germany David Langton North Tees Explant Centre (NTEC), Farndale House, University Hospital of North Tees, Stockton-on-Tees, UK Adrian Low Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Headington, Oxford, UK Michael A. Mont Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, USA David Murray Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Headington, Oxford, UK Hemant Pandit Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, 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 Preservation and Replacement, Sinai Hospital of Baltimore, 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 Marc Thomsen Clinics for Orthopedics and Trauma Surgery, DRK-Hospital and City Hospital, 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, Rush University Medical Center, Chicago, IL, USA Paul H. Wooley University of Kansas Medical School, Wichita, KS, USA Part I Introduction
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