Metal levels in cemented total hip arthroplasty: A comparison of well- fixed and loose implants

W. W. Brien, E. A. Salvati, F. Betts, P. Bullough, T. Wright, C. Rimnac, R. Buly, K. Garvin

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

In a prospective study, synovial fluid metal levels from stainless steel, cobalt-chromium, and titanium-alloy cemented total hip implants were measured. There were 37 well-fixed and 44 loose hip arthroplasties. Tissue- metal levels were quantitated in the cases revised for loosening. Retrieval analysis for implant wear was performed. Synovial fluid analysis showed a fivefold increase in metal levels of loose compared with well-fixed stainless steel implants. There was a sevenfold increase in metal levels of loose compared with well-fixed cobalt-chromium implants. There was a 21-fold increase in metal levels of loose compared with well-fixed titanium-alloy (Ti-6Al-4V) implants. Tissue-metal levels from revised cobalt-chromium implants averaged 45 μg/g dry tissue weight compared to 4,470 μg/g dry tissue weight from revised titanium-alloy implants, a 100-fold increase. Implant retrieval analysis showed severe burnishing and scratching in all titanium-alloy femoral heads and extensive burnishing and scratching in the majority of the femoral stems. Well-fixed cemented implants have similar low synovial fluid metal levels. However, when loosening of implants occurs, titanium-alloy implants release disproportionate levels of metal into synovial fluid and local tissues compared to stainless steel or cobalt- chromium. These results raise serious concerns regarding the use of cemented titanium-alloy implants.

Original languageEnglish (US)
Pages (from-to)66-74
Number of pages9
JournalClinical Orthopaedics and Related Research
Issue number276
StatePublished - Jan 1 1992

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Arthroplasty
Hip
Titanium
Metals
Synovial Fluid
Stainless Steel
Chromium
Cobalt
Thigh
Chromium Alloys
Weights and Measures
Prospective Studies

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Brien, W. W., Salvati, E. A., Betts, F., Bullough, P., Wright, T., Rimnac, C., ... Garvin, K. (1992). Metal levels in cemented total hip arthroplasty: A comparison of well- fixed and loose implants. Clinical Orthopaedics and Related Research, (276), 66-74.

Metal levels in cemented total hip arthroplasty : A comparison of well- fixed and loose implants. / Brien, W. W.; Salvati, E. A.; Betts, F.; Bullough, P.; Wright, T.; Rimnac, C.; Buly, R.; Garvin, K.

In: Clinical Orthopaedics and Related Research, No. 276, 01.01.1992, p. 66-74.

Research output: Contribution to journalArticle

Brien, WW, Salvati, EA, Betts, F, Bullough, P, Wright, T, Rimnac, C, Buly, R & Garvin, K 1992, 'Metal levels in cemented total hip arthroplasty: A comparison of well- fixed and loose implants', Clinical Orthopaedics and Related Research, no. 276, pp. 66-74.
Brien WW, Salvati EA, Betts F, Bullough P, Wright T, Rimnac C et al. Metal levels in cemented total hip arthroplasty: A comparison of well- fixed and loose implants. Clinical Orthopaedics and Related Research. 1992 Jan 1;(276):66-74.
Brien, W. W. ; Salvati, E. A. ; Betts, F. ; Bullough, P. ; Wright, T. ; Rimnac, C. ; Buly, R. ; Garvin, K. / Metal levels in cemented total hip arthroplasty : A comparison of well- fixed and loose implants. In: Clinical Orthopaedics and Related Research. 1992 ; No. 276. pp. 66-74.
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