![]() ![]() ![]() ![]() The abnormal soft-tissue reaction to MoM bearing surfaces results from the deposition of cobalt-chrome particulate debris in the surrounding tissues. The deposition of metal ions into the periprosthetic space can lead to a wide spectrum of soft-tissue reactions including massive sterile effusions, necrosis, corrosive osteolysis, and both cystic and solid periprosthetic masses. Despite the theoretical advantages associated with lower wear rates and the greater relative stability of large diameter components, factors that have made this bearing combination favorable option in younger and more active patients have not yet been shown to have long-term superiority over other bearing choices. Since 1996, more than 1 million total hip arthroplasties with a metal-on-metal bearing couple have been implanted in the United States and worldwide. Current alternatives are represented by metal-on-metal (MoM) couplings, ceramic-on-ceramic, and a combination of ceramic-coated heads with polyethylene. For this reason, a number of alternative bearings have been developed, based on both new and traditional concepts. The production of wear debris, which is primarily generated by the contact surface of the prosthetic components, represents the major causal factor of periprosthetic osteolysis and therefore of implant survival. Total hip replacement is a universally recognized treatment for the final stage of arthrosis. ![]()
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