الفهرس Only 14 pages are availabe for public view
 |  | from | 164 |  |  |
| | | from | 164 | | |
Abstract
The nature of the articulating surfaces in total hip arthroplasty has been the subject of current major debate. It has become clear through mid‐term and
long‐term evaluations that wear of the bearing coupling is a notable issue.
The conventional bearing consisted of cobalt‐chromium femoral head articulating against an ultra high
molecular weight polyethylene acetabular component, has predictable wear of polyethylene insert, generating
debris that can lead to biologic reaction,osteolysis, pain, and possible prosthetic failure.
As patient demand for the procedure of THR increases, and the average age at which such replacement decreases, the problems with prosthetic failure will be
magnified. In response to these issues, a number of other bearing couples have been introduced including cross‐linked polyethylene inserts, ceramic on ceramic
articulation, and re‐introduction of metal on metal bearings.
As with any other bearing articulation, there are disadvantages to the use of metal on metal articulation.
Some of these are well documented, while others are more theoretical. Concerns continue to exist regarding
the production of metal ions, biologic concerns resulting from prolonged exposure to elevated serum metal ions, issues of hypersensitivity, implant specific issues, and challenge of appropriate patient selection.
There’s also a concern about the potential for malignant development secondary to prolonged exposure to elevated serum elements.