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Why Is There a Continuing Role for Metal-on-Metal in Hip Replacement?

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Tribology in Total Hip and Knee Arthroplasty

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Abstract

In 2013, recent reports and authors advocated reducing the use of metal on metal as a bearing component in total hip arthroplasty (THA). This was based on the side effects observed after the use of the large head diameter metal-on-metal THA. These arguments were supported by recent literature which mainly focused on one device: the large femoral head diameter ASR (DePuy). In fact, the literature reports favourable long-term results especially for small head diameter (28- or 32-mm metal-on-metal head diameter) since its reintroduction in 1988 in Europe.

The authors reported their experience with the use of metal on metal as a bearing component in THA. They considered and explained why the metal-on-metal bearing use could be considered as an alternative bearing component in a comprehensive approach. They reported several publications which focused on the use of metal-on-metal bearing especially in young and active patients.

Adequate selection of MoM articulation allows a safe use of these bearing components (forged metal alloy, high carbide rate, etc.). This hard-on-hard bearing is very sensitive to orientation (especially for inclination), and careful attention should be paid during implantation for small MoM articulation as well as larger head like with hip resurfacing in order to avoid cam effect and/or edge loading. Our 15-year experience with this bearing in 28 and 32 mm, using forged alloy and high carbide content, without adverse effect, is the main reason to keep on using this articulation in primary (THA or hip resurfacing) as revision THA.

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Conflict of Interest

Julien Girard is a consultant for Zimmer, Wright Medical Technology and Smith and Nephew. Henri Migaud is a consultant for Zimmer and Tornier.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Roger Salengro Hospital, University of Lille, Lille, France

    Julien Girard PhD, MD & Henri Migaud MD

  2. Department of Sport and Medicine, University of Lille 2, Lille, France

    Julien Girard PhD, MD

  3. Orthopaedic Department, Lille University Hospital, 2 avenue Oscar Lambret, Lille Cedex, 59037, France

    Julien Girard PhD, MD

Authors
  1. Julien Girard PhD, MD
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  2. Henri Migaud MD
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Corresponding author

Correspondence to Julien Girard PhD, MD .

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Editors and Affiliations

  1. Orthopaedic Department, Orthopaedic Hospital Vienna-Speising, Vienna, Austria

    Karl Knahr

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Girard, J., Migaud, H. (2014). Why Is There a Continuing Role for Metal-on-Metal in Hip Replacement?. In: Knahr, K. (eds) Tribology in Total Hip and Knee Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45266-6_12

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  • DOI: https://doi.org/10.1007/978-3-642-45266-6_12

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-45265-9

  • Online ISBN: 978-3-642-45266-6

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