Metal-on-polyethylene versus metal-on-metal bearing surfaces in total hip arthroplasty: a prospective randomised study investigating metal ion levels and chromosomal aberrations in peripheral lymphocytes

T. W. R. Briggs, S. A. Hanna, B. Kayani, S. Tai, R. C. Pollock, S. R. Cannon, G. W. Blunn, R. W. J. Carrington

Research output: Contribution to journalArticlepeer-review

Abstract

The long term biological effects of wear products following total hip arthroplasty (THA) are unclear. However, the indications for THA are expanding, with increasingly younger patients undergoing the procedure. This prospective, randomised study compared two groups of patients undergoing THA after being randomised to receive one of two different bearing surfaces: metal-on-polyethylene (MoP) n = 22 and metal-on-metal (MoM) n = 23. We investigated the relationship between three variables: bearing surface (MoP vs MoM), whole blood levels of chromium (Cr) and cobalt (Co) and chromosomal aberrations in peripheral lymphocyte pre-operatively and at one, two and five years post-surgery. Our results demonstrated significantly higher mean cobalt and chromium (Co and Cr) blood levels in the MoM group at all follow-up points following surgery (p < 0.01), but there were no significant differences in the chromosomal aberration indices between MoM and MoP at two or five years (two years: p = 0.56, p = 0.08, p = 0.91, p = 0.51 and five years: p = 0.086, p = 0.73, p = 0.06, p = 0.34) for translocations, breaks, loss and gain of chromosomes respectively. Regression analysis showed a strong linear relationship between Cr levels and the total chromosomal aberration indices in the MoM group (R(2) = 0.90016), but this was not as strong for Co (R(2) = 0.68991). In the MoP group, the analysis revealed a poor relationship between Cr levels and the total chromosomal aberration indices (R(2) = 0.23908) but a slightly stronger relationship for Co (R(2) = 0.64292). Across both groups, Spearman's correlation detected no overall association between Co and Cr levels and each of the studied chromosomal aberrations. There remains no clear indication which THA bearing couple is the most biocompatible, especially in young active patients. While THA continues to be very successful at alleviating pain and restoring function, the long-term biological implications of the procedure still require further scrutiny.

Original languageEnglish
Pages (from-to)1183-1191
Number of pages9
JournalBone & Joint Research
Volume97-B
Issue number9
DOIs
Publication statusPublished - Sept 2015

Keywords

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip
  • Chromium
  • Chromosome Aberrations
  • Cobalt
  • Female
  • Hip Prosthesis
  • Humans
  • Lymphocytes
  • Male
  • Metal-on-Metal Joint Prostheses
  • Middle Aged
  • Polyethylene
  • Postoperative Period
  • Prosthesis Design
  • Comparative Study
  • Randomized Controlled Trial

Fingerprint

Dive into the research topics of 'Metal-on-polyethylene versus metal-on-metal bearing surfaces in total hip arthroplasty: a prospective randomised study investigating metal ion levels and chromosomal aberrations in peripheral lymphocytes'. Together they form a unique fingerprint.

Cite this