June 23, 2016 — A new study has found that metal-on-metal hip implants release tiny particles of metal that can penetrate into bone-marrow and contribute to bone loss.
The study was published by the medical journal Biomaterials, based on data from patients in Germany, where 220,000 total hip replacements are performed each year.
Metal-on-metal hip implants release cobalt and chromium when the moving parts grind together.
When dissolved metal ions get into the bone marrow, researchers found that they interfere with the transformation of Mesenchymal Stromal cells (MSCs) into osteoblasts, which are cells that mineralize bone.
Patients with higher levels of metal ions in their bone marrow had less of an ability to make osteoblasts, which could contribute to bone loss and increase the risk of premature revision surgery.
Metal-on-metal hip implants have been under intense scrutiny since 2010, when DePuy recalled the ASR. In recent years, studies have linked the ASR with a 40% five-year risk of revision surgery. Hip implants are supposed to last at least 15 years.
The authors of the study said the ongoing use of metal-on-metal hip implants “needs critical reconsideration,” warning that the risks clearly outweigh the benefits. Many studies have found lower rates of revision surgery associated with plastic and ceramic designs.
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