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Open Access Research article

Metal debris concentrations in soft tissues adjacent to loosened femoral stems is higher in uncemented than cemented implants

Krzysztof Kmieć, Marek Synder, Piotr Kozłowski, Marek Drobniewski and Marcin Sibiński*

Author Affiliations

Clinic of Orthopaedics and Paediatric Orthopaedics, Medical University of Łódź Poland, Drewnowska 75, 91-002 Lodz, Poland

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BMC Musculoskeletal Disorders 2014, 15:267  doi:10.1186/1471-2474-15-267

Published: 7 August 2014

Abstract

Background

There are still many questions related to aseptic femoral stem loosening. Systemic and local immune responses to the implanted “foreign body” is one of the reasons for loosening. The purpose of the study was to measure metal ion concentration (Ti, Co, Cr, Mo, Ni, Al) around loosened femoral stems and compare their levels around uncemented and cemented implants.

Methods

This paper reports 50 hips operated for isolated stem loosening, in 50 patients at the mean age of 57 years (from 21 to 87). There were 25 cemented (Co,Cr29,Mo,Ni) and 25 uncemented (Ti, Al) stems. The mean follow-up from primary hip replacement to revision was 10.1 years (from 0.5 to 17). During the procedure, scar tissue around the stem was taken for analysis of metal ions.

Results

The concentrations of titanium and aluminium in soft tissues around uncemented loosened stems were higher than cemented ones (p < 0.001, p < 0.001 respectively). However, no statistically significant differences were observed between both types of stems in terms of ions of the metal of which cemented implants had been made of (Co, Cr, Mo, Ni).

Conclusions

In soft tissue around a loosened stem, the concentrations of metal ions from implants are much higher in case of uncemented stems than of cemented ones. Metal ions from vitalium femoral heads were found around uncemented stems in similar values to cemented streams.

Keywords:
Metal debris; Stem loosening; Hip revision; Cemented implants; Uncemented implants