ReviewJournal of orthopaedics
Metal ion levels with use of modular dual mobility constructs: Can the evidence guide us on clinical use?
Review in Journal of orthopaedics. 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
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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.
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Who cites it
12 citing papers in PubMed, 13 citations in OpenAlex.
- Mid-Term Analysis of Serum Metal Ion Levels Comparison Between Monoblock and Modular Dual Mobility Components: A Source for Concern?Arthroplasty today · 2026Article
- Is It the Trunnion or Is It the Liner? Investigating Bilateral Dual-Mobility Constructs With Different Inner Femoral Head Compositions.Arthroplasty today · 2026Article
- Unexpected Metal Ion Elevation and Adverse Tissue Reactions in Trident II Dual Mobility Constructs With Ceramic Heads.Arthroplasty today · 2026Article
- Comparison of Outcomes Between Modular Dual Mobility and Conventional Hip Implants in Primary, Elective Total Hip Arthroplasty.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Bibliometric Analysis of Dual Mobility Total Hip Arthroplasty.Hip & pelvis · 2025Article
- Comparison of hypoallergenic knee arthroplasties in patients with metal hypersensitivity versus standard arthroplasties in non-hypersensitivity patients: A scoping review.Journal of orthopaedics · 2025Review
- Intraprosthetic Dislocation Following Dual Mobility Total Hip Arthroplasty: A Retrieval Analysis Study.Arthroplasty today · 2025Article
- Corrosion of Modular Dual-Mobility Acetabular Components Leading to Acetabular Bone Loss and Protrusio.Arthroplasty today · 2024Article
- Malseated Liner in Modular Dual Mobility Total Hip Replacement: A Report of Three Cases.Cureus · 2024Article
- No Change in Serum Metal Ions Levels After Primary Total Hip Replacement With an Additively Manufactured Dual Mobility Acetabular Construct.Arthroplasty today · 2022Article
- Dual Mobility in Total Hip Arthroplasty: Biomechanics, Indications and Complications-Current Concepts.Indian journal of orthopaedics · 2021Review
- Ten to 15-Year Outcomes of Monoblock Uncemented Dual Mobility Cups: Excellent Survival Rate and Outcome in Primary Total Hip Arthroplasty.JB & JS open accessArticle
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDual mobility (DM) use in total hip arthroplasty (THA) has increased, particularly for prevention and management of instability. However, a modular interface raises concern for metal ion generation. The purpose of this study was to determine the 1) serum cobalt and chromium levels; 2) prevalence of ion levels >1 mcg/L; and 3) effect of femoral head material on ion levels following THA using modular DM bearings.
methodsWe performed a systematic review (MEDLINE, Embase, Cochrane databases) for articles relating to metal ion levels and modular DM (MDM) THA. Eight studies (290 patients) met the inclusion criteria. We recorded post-operative ion levels at a minimum of 12 months, and compared levels with ceramic (n = 125) and metal femoral heads (n = 165). A meta-analysis could not be performed due to poor study quality and heterogeneity.
resultsAt average follow-up of 30.4 months, mean cobalt level was 0.71 mcg/L, and mean chromium level was 0.66 mcg/L [22 patients (8%) had elevated ion levels above 1 mcg/L]. When compared to MDM with a ceramic head, metal head use had higher cobalt (1.26 vs. 0.42 mcg/L) and chromium levels (1.23 vs. 0.46 mcg/L). MDM with a metal head was 1.30 times more likely to have elevated ion levels >1 mcg/L. There was no effect of ion levels on outcome scores.
conclusionsMeasurable elevations of serum cobalt and chromium levels are present in patients with well-functioning MDM THAs. The impact and contributions of the additional metal liner interface are still unclear. The use of a ceramic head appears to mitigate ion release, while reducing other mechanisms of metallosis like taper corrosion. Higher quality studies are necessary to understand whether MDM bearings pose long term issues. Until then, the judicious use of MDM articulations is recommended.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.