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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 4, 472-476.
doi: 10.1302/0301-620X.88B4.17333  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Differences in ion release after ceramic-on-ceramic and metal-on-metal total hip replacement

MEDIUM-TERM FOLLOW-UP

L. Savarino, MSc, Senior Investigator1; M. Greco, Technician1; E. Cenni, MD, Senior Investigator1; L. Cavasinni, MD, Orthopaedic Surgeon2; R. Rotini, MD, Orthopaedic Surgeon3; N. Baldini, MD, Orthopaedic Surgeon4; and A. Giunti, MD, Professor of Orthopaedic Surgery4

1 Laboratory for Pathophysiology of Orthopaedic Implants
2 Sulmona Hospital, Orthopaedic Division, Sulmona, L’Aquila, Italy.
3 Shoulder and Elbow Pathology Service
4 7th Division of Orthopaedic Surgery, Istituti Ortopedici Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy.

Correspondence should be sent to Dr L. Savarino; e-mail: lucia.savarino{at}ior.it

Modern metal-on-metal bearings produce less wear debris and osteolysis, but have the potential adverse effect of release of ions. Improved ceramic-on-ceramic bearings have the lowest wear of all, but the corrosion process has not been analysed.

Our aim was to measure the serum ion release (ng/ml) in 23 patients having stable hip prostheses with a ceramic-on-ceramic coupling (group A) and to compare it with the release in 42 patients with a metal-on-metal bearing (group B) in the medium term. Reference values were obtained from a population of 47 healthy subjects (group C). The concentrations of chromium, cobalt, aluminium and titanium were measured.

There was a significant increase of cobalt, chromium and aluminium levels (p < 0.05) in group B compared with groups A and C. Group A did not differ significantly from the control group. Despite the apparent advantage of a metal-on-metal coupling, especially in younger patients with a long life expectancy, a major concern arises regarding the extent and duration of ion exposure. For this reason, the low corrosion level in a ceramic-on-ceramic coupling could be advantageous.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General