Trial reportActa orthopaedica2017
Comparison of metal ion concentrations and implant survival after total hip arthroplasty with metal-on-metal versus metal-on-polyethylene articulations.
Trial report in Acta orthopaedica, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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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
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Pooled it
- Similarly low blood metal ion levels at 10-years follow-up of total hip arthroplasties with Oxinium, CoCrMo, and stainless steel femoral heads. Data from a randomized clinical trial.Journal of biomedical materials research. Part B, Applied biomaterials · 2023Trial
- 25-year follow-up of 102 unrevised cementless total hip arthroplasties with a second-generation metal-on-metal bearing in a young patient cohort.Arthroplasty (London, England) · 2026Article
- Kinetics and Fluid-Specific Behavior of Metal Ions After Hip Replacement.Bioengineering (Basel, Switzerland) · 2025Article
- Target Organs of Metals Released from Metal-on-Polyethylene Knee and Hip Arthroplasty Implants: Implications for Tissue Metal Profiles.Biological trace element research · 2025Article
- Article
- 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
- Prosthetic Metals: Release, Metabolism and Toxicity.International journal of nanomedicine · 2024Review
- Head, acetabular liner composition, and rate of revision and wear in total hip arthroplasty: a Bayesian network meta-analysis.Scientific reports · 2023Article
- Serum cobalt and chromium concentration following total hip arthroplasty: a Bayesian network meta-analysis.Scientific reports · 2023Article
- Similar risk of cancer in patients younger than 55 years with or without a total hip arthroplasty (THA): a population- based cohort study on 18,771 exposed to THA and 87,683 controls.Acta orthopaedica · 2022Article
- The etiology of revision total hip arthroplasty: current trends in a retrospective survey of 3450 cases.Archives of orthopaedic and trauma surgery · 2020Article
- What Surgeons Need to Know About Adverse Local Tissue Reaction in Total Hip Arthroplasty.The Journal of arthroplasty · 2020Review
- Molecular pathology of adverse local tissue reaction caused by metal-on-metal implants defined by RNA-seq.Genomics · 2019Article
- Paeoniflorin Inhibits Receptor Activator for Nuclear Factor κB (RANK) Ligand-Induced Osteoclast Differentiation In Vitro and Particle-Induced Osteolysis In Vivo.Medical science monitor : international medical journal of experimental and clinical research · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - Large metal-on-metal (MoM) articulations are associated with metal wear and corrosion, leading to increased metal ion concentrations and unacceptable revision rates. There are few comparative studies of 28-mm MoM articulations with conventional metal-on-polyethylene (MoP) couplings. We present a long-term follow-up of a randomized controlled trial comparing MoM versus MoP 28-mm articulations, focused on metal ions and implant survival. Patients and methods - 85 patients with a mean age of 65 years at surgery were randomized to a MoM (Metasul) or a MoP (Protasul) bearing. After 16 years, 38 patients had died and 4 had undergone revision surgery. 13 patients were unavailable for clinical follow-up, leaving 30 patients (n = 14 MoM and n = 16 MoP) for analysis of metal ion concentrations and clinical outcome. Results - 15-year implant survival was similar in both groups (MoM 96% [95% CI 88-100] versus MoP 97% [95% CI 91-100]). The mean serum cobalt concentration was 4-fold higher in the MoM (1.5 μg/L) compared with the MoP cohort (0.4 μg/L, p < 0.001) and the mean chromium concentration was double in the MoM (2.2 μg/L) compared with the MoP cohort (1.0 μg/L, p = 0.05). Mean creatinine levels were similar in both groups (MoM 93 μmol/L versus MoP 92 μmol/L). Harris hip scores differed only marginally between the MoM and MoP cohorts. Interpretation - This is the longest follow-up of a randomized trial on 28-mm MoM articulations, and although implant survival in the 2 groups was similar, metal ion concentrations remained elevated in the MoM cohort even in the long term.
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