Total Hip Arthroplasty Clinical Trial
Official title:
Investigation of Systemic Metal Ion Concentration Following a Ceramic-on-metal Total Hip Arthroplasty
This is a pilot study to compare systemic concentrations of cobalt and chromium in patients that have previously undergone total hip arthroplasties with ceramic on metal and metal on metal bearing surfaces.
This is a pilot study to compare systemic concentrations of cobalt and chromium in patients
that have previously undergone total hip arthroplasties with ceramic on metal and metal on
metal bearing surfaces. Secondary goals include an assessment of osteolysis on radiographs,
potential long term analysis of implant survivability, and cancer rates in the two patient
populations.
Increased metal ion production has been documented in metal-on-metal arthroplasty
articulations. There are several concerns over metal ion production. First, even though
there is a decreased histiocytic response to metallic debris, a dose dependent cytotoxic
response with Interleukin 6, Prostaglandin E2, and Tumor Necrosis Factor alpha persists and
may cause osteolysis in the long term. Second, increased levels of cobalt, chromium and
nickel has been shown to correlate with increased cancer rates in several animal models, and
the carcinogenic risk in humans has not been fully elucidated as yet. Third,
hypersensitivity reactions to metal ion develop in up to 25% of these patients, and 60% of
patients with poorly functioning hip.
Ceramic on metal avoids many of these problems due to the improved wear characteristics. If
the level of metal ion production is significantly reduced and the implant survivability is
proven in long term studies, this articulation may become the preferred method.
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Observational Model: Cohort, Time Perspective: Prospective
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