ReviewWorld journal of orthopedics2016
Management of metal-on-metal hip implant patients: Who, when and how to revise?
Review in World journal of orthopedics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- Retrospective Analysis of Pseudotumor of the Hip: Clinical Management and Outcomes.Orthopaedic surgery · 2026Article
- Ethical Considerations in Disclosing Orthopedic Implant Failures to Patients.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2026Article
- Cobalt and titanium levels in the brain are associated with Alzheimer's disease pathology but not cognition: A study of older adults with and without total joint replacement.Acta biomaterialia · 2026Article
- Frequency of safety signals from scientific reports, manufactures, registers, and other sources for a random selection of hip and knee prostheses.Acta orthopaedica · 2025Article
- Hyaluronic acid-British anti-Lewisite as a safer chelation therapy for the treatment of arthroplasty-related metallosis.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- Prosthetic hip-associated cobalt toxicity: a systematic review of case series and case reports.EFORT open reviews · 2022Review
- Molecular pathology of adverse local tissue reaction caused by metal-on-metal implants defined by RNA-seq.Genomics · 2019Article
- Follow-up of Metal-on-Metal Hip Replacements at a Large District Hospital and the Implementation of Medicines and Healthcare Products Regulatory Agency Guidelines: A Review of 297 Patients.Clinics in orthopedic surgery · 2019Article
- Pleomorphic clinical spectrum of metallosis in total hip arthroplasty.International orthopaedics · 2019Article
- Systemic cobaltism manifesting as oral mucosal discoloration and metallic gustation after metal-on-metal hip resurfacing.Arthroplasty today · 2018Article
- Metal-on-Metal Hip Joint Prostheses: a Retrospective Case Series Investigating the Association of Systemic Toxicity with Serum Cobalt and Chromium Concentrations.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2017Article
- Surgical management of hip prosthetic failure in metallosis: A case series and literature review.Journal of orthopaedicsReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The debate on how best to manage patients with metal-on-metal (MOM) hip implants continues. With over 1 million patients affected worldwide, the impact is far reaching. The majority of the aggressive failures of MOM hip implants have been dealt with by revision hip surgery, leaving patients with a much more indolent pattern of failure of devices that have been in situ for more than 10 years. The longer-term outcome for such patients remains unknown, and much debate exists on how best to manage these patients. Regulatory guidance is available but remains open to interpretation due to the lack of current evidence and long-term studies. Metal ion thresholds for concern have been suggested at 7 ppb for hip resurfacing arthroplasty and below this level for large diameter total hip arthroplasties. Soft tissue changes including pseudotumours and muscle atrophy have been shown to progress, but this is not consistent. New advanced imaging techniques are helping to diagnose complications with metal hips and the reasons for failure, however these are not widely available. This has led to some centres to tackle difficult cases through multidisciplinary collaboration, for both surgical management decisions and also follow-up decisions. We summarise current evidence and consider who is at risk, when revision should be undertaken and how patients should be managed.
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Registered trials
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