Published online Oct 18, 2021. doi: 10.5312/wjo.v12.i10.768
Peer-review started: April 30, 2021
First decision: June 16, 2021
Revised: June 30, 2021
Accepted: August 23, 2021
Article in press: August 23, 2021
Published online: October 18, 2021
Osteolysis is one of the most common and important adverse reactions to total hip arthroplasty (THA). Therefore it’s important to define if there are conditions that facilitate its occurrence.
There is a lack of works studying the correlation between metal ions levels and osteolysis and its different prevalence between modular THA and monolithic prostheses.
Studies analyzing these topics would help the surgeons in the choice of the implants and in the in a correct patients’ follow-up. So that we designed this work aiming to have a comprehensive vision of a complication, such as the osteolysis, in THA.
We enrolled 76 patients who underwent an operation of first implant of THA, with no other prosthesis and no Cobalt and Chrome (CoCr) work exposure. We divided them in three groups: Patients with monoblock prosthesis with metal head (Group A,), patients with modular prosthesis with ceramic head (Group B), patients with modular prosthesis with metal head (Group C). We analyzed the presence, if any, of osteolysis, its localization and the serum and urinary metal ions levels (Cr and Co).
We found out a direct correlation between the release of periprosthetic metal ions and osteolysis, also this study highlights that modularity is related to a higher metal ion release and osteolysis events.
Our study reveals that there is a correlation between metal ions levels and presence and severity of osteolysis and that this is more evident in modular THA, due to higher corrosion.
Obviously there is a need for more studies to obtain a good level of evidence and confirm these findings.