Observational studyBMC musculoskeletal disorders2016
Adverse reactions to metal debris occur with all types of hip replacement not just metal-on-metal hips: a retrospective observational study of 3340 revisions for adverse reactions to metal debris from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man.
Observational study in BMC musculoskeletal disorders, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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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
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Hip resurfacing versus total hip arthroplasty: a systematic review and meta-analysis of randomized clinical trials.International orthopaedics · 2024Pooled it
- Trunnion corrosion: what surgeons need to know in 2018.The bone & joint journal · 2018Pooled it
- Prosthesis-Related Risk Factors for Trunnionosis: A Comprehensive Literature Review.Clinics in orthopedic surgery · 2026Review
- Findings From 333 Retrieved MoM Total Hip Arthroplasty Components of a Single Design Reveal Modular Interface Corrosion as Most Common Feature.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- Symptomatic Periarticular Fluid Collection After Total Hip Arthroplasty: Septic or Aseptic Complication? A Case Report and Literature Review.Reports (MDPI) · 2025Article
- Diagnostic Dilemma: Unusual Post-replacement Hip Pain Following Trauma Leading to Metallosis - A Case Report.Journal of orthopaedic case reports · 2024Article
- The influence of surgical technique guidance and surgeon's experience on the femoral head assembly in total hip arthroplasty.Archives of orthopaedic and trauma surgery · 2024Article
- Article
- Targeting of Periprosthetic Muscles for the Ultrasonographic Screening of Hip Abnormalities in Hip Resurfacing Arthroplasty Patients.Journal of clinical medicine · 2023Article
- Case report and review: Angiosarcoma with thrombocytopenia after total hip arthroplasty.Frontiers in surgery · 2023Article
- A Rare Case of Adverse Reaction to Metal Debris in a Ceramic-on-Ceramic Total Hip Replacement.Journal of functional biomaterials · 2022Article
- Current status and future potential of wear-resistant coatings and articulating surfaces for hip and knee implants.Materials today. Bio · 2022Review
- Adverse reaction to metal debris due to fretting corrosion between the acetabular components of modular dual-mobility constructs in total hip replacement: a systematic review and meta-analysis.EFORT open reviews · 2021Review
- Uncemented versus cemented arthroplasty after metal-on-metal total hip replacement in patients with femoral neck fractures: a retrospective study.The Journal of international medical research · 2021Article
- Taper corrosion: a complication of total hip arthroplasty.EFORT open reviews · 2020Review
- Activation of synovial fibroblasts from patients at revision of their metal-on-metal total hip arthroplasty.Particle and fibre toxicology · 2020Article
- Risk of mature B-cell neoplasms and precursor conditions after joint replacement: A report from the Haematological Malignancy Research Network.International journal of cancer · 2020Article
- F-18 FDG PET brain imaging in symptomatic arthroprosthetic cobaltism.European journal of nuclear medicine and molecular imaging · 2020Article
- Taper fretting corrosion with Stryker Anato stem after hip replacement.Arthroplasty today · 2020Article
- What Is the Risk of THA Revision for ARMD in Patients with Non-metal-on-metal Bearings? A Study from the Australian National Joint Replacement Registry.Clinical orthopaedics and related research · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundAdverse reactions to metal debris (ARMD) have resulted in the high short-term failure rates observed with metal-on-metal hip replacements. ARMD has recently been reported in non-metal-on-metal total hip replacements (non-MoM THRs) in a number of small cohort studies. However the true magnitude of this complication in non-MoM THRs remains unknown. We used a nationwide database to determine the risk of ARMD revision in all non-MoM THRs, and compared patient and surgical factors associated with ARMD revision between non-MoM and MoM hips.
methodsWe performed a retrospective observational study using data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. All primary hip replacements undergoing revision surgery for ARMD were included (n = 3,340). ARMD revision risk in non-MoM THRs was compared between different commonly implanted bearing surfaces and femoral head sizes (Chi-squared test). Differences in patient and surgical factors between non-MoM hips and MoM hips revised for ARMD were also analysed (Chi-squared test and unpaired t-test).
resultsOf all ARMD revisions, 7.5% (n = 249) had non-MoM bearing surfaces. The relative risk of ARMD revision was 2.35 times (95% CI 1.76-3.11) higher in ceramic-on-ceramic bearings compared with hard-on-soft bearings (0.055 vs. 0.024%; p < 0.001), and 2.80 times (95% CI 1.74-4.36) higher in 36 mm metal-on-polyethylene bearings compared to 28 mm and 32 mm metal-on-polyethylene bearings (0.058 vs. 0.021%; p < 0.001). ARMD revisions were performed earlier in non-MoM hips compared to MoM hips (mean 3.6-years vs. 5.6-years; p < 0.0001). Non-MoM hips had more abnormal findings at revision (63.1 vs. 35.7%; p < 0.001), and more intra-operative adverse events (6.4 vs. 1.6%; p < 0.001) compared to MoM hips.
conclusionsAlthough the overall risk of ARMD revision surgery in non-MoM THRs appears low, this risk is increasing, and is significantly higher in ceramic-on-ceramic THRs and 36 mm metal-on-polyethylene THRs. ARMD may therefore represent a significant clinical problem in non-MoM THRs.
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