ArticleActa orthopaedica2017
High blood metal ion levels in 19 of 22 patients with metal-on-metal hinge knee replacements.
Article in Acta orthopaedica, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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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.
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Who cites it
14 citing papers in PubMed, 25 citations in OpenAlex.
- Metal ion exposure after oncologic megaprosthesis salvage surgery: a systematic review.Journal of bone oncology · 2026Article
- Knee arthroplasty failure is associated with significant systemic multimetal exposure.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Systemic Cobalt Toxicity Secondary to Tibial Component Malpositioning in Bilateral Primary Total Knee Arthroplasties.Arthroplasty today · 2026Article
- Highly Elevated Metal Ion Levels After Tumor Resections and Reconstruction With Megaprostheses Around the Knee.Clinical orthopaedics and related research · 2025Article
- Secondary Infection of Adverse Local Tissue Reaction Leading to Amputation in a Patient With a Modular Knee Endoprosthesis.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Taper Junction Subsidence Occurs in Modular Tumor Endoprostheses: How Concerned Should We Be?Clinical orthopaedics and related research · 2025Article
- CORR Insights®: Taper Junction Subsidence Occurs in Modular Tumor Endoprostheses: How Concerned Should We Be?Clinical orthopaedics and related research · 2025Article
- Elevated cobalt levels in metal-on-polyethylene knee megaprostheses: a prospective 1-year cohort study of 56 patients with hip and knee megaprostheses.Acta orthopaedica · 2024Article
- Concentrations of Cobalt, Chromium and Titanium and Immunological Changes after Primary Total Knee Arthroplasty-A Cohort Study with an 18-Year Follow-Up.Journal of clinical medicine · 2024Article
- Systemic Metal Ion Concentrations in Patients With Hip and Knee Megaprostheses: A Prospective Cohort Study.Arthroplasty today · 2022Article
- Retrieval Analysis of Modern Knee Tumor Megaendoprosthesis Shows Considerable Volumetric Metal Wear Generated at the Rotating Hinge.Materials (Basel, Switzerland) · 2020Article
- [ARMD reaction patterns in knee arthroplasty : A novel hypothetical mechanism: hingiosis].Der Orthopade · 2020Article
- Are Serum Metal Ion Levels a Concern at Mid-term Followup of Revision Knee Arthroplasty With a Metal-on-metal Hinge Design?Clinical orthopaedics and related research · 2019Article
- CORR Insights®: Are Serum Metal Ion Levels a Concern at Mid-term Followup of Revision Knee Arthroplasty With a Metal-on-metal Hinge Design?Clinical orthopaedics and related research · 2019Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - There has been increasing alarm regarding metal-on-metal (MoM) joint replacements leading to elevated levels of metal ions and adverse reactions to metal debris (ARMDs). There is little information available concerning the prevalence of and risk factors for these adverse reactions, except with MoM hip joint replacements. We determined the levels of metal ions in blood and the rate of revision due to ARMDs in patients treated with MoM hinge total knee arthroplasty (TKA). Patients and methods - 22 patients with TKAs and MoM hinge connecting mechanisms were studied for whole-blood chromium and cobalt levels at 6 months, 1 year, and/or ≥2 years after surgery. Possible ARMDs were investigated by MRI. 12 patients with TKAs and metal-on-polyethylene (MoP) connecting mechanisms served as controls. Results - The cobalt levels were over 5 ppb in 19 of the 22 patients in the MoM group and in 1 of the 12 patients in the MoP group. The chromium levels were over 5 ppb in 11 of the 22 patients in the MoM group and in none of the 12 patients in the MoP group. Pseudotumors were operated in 4 of the 22 patients in the MoM group and in none of the patients in the MoP group. Interpretation - Our results clearly show that the MoM hinge TKA carries a high risk of increased levels of systemic metal ions and also local ARMD, leading to complicated knee revisions. We therefore discourage the use of MoM hinge TKA.
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