Table 2.
Comparison of the literature reveals different responses to small- and large-diameter metal-on-metal and hip resurfacings suggesting adverse tissue reactions
| Author | Metal-on-metal design | Osteolysis | Tissue response | Head size | Metal content | Corrosion | Particle liberation |
|---|---|---|---|---|---|---|---|
| Lavigne et al. [27] | Biomet, DePuy (Ultamet), Smith & Nephew (Sikomet), Zimmer (Metasul) | NA | + | > 50 mm | Blood | + | − |
| Jacobs et al. [18] | Metasul, DePuy (Ultamet) Modular cemented and uncemented | + | Foreign body reaction | − | NA | + | − |
| Langton et al. [25] | Resurfacing (ASR [DePuy], BHR [Smith & Nephew], Conserve [Wright]) | − | + | NA | NA | + | + |
| Langton et al. [26] | Resurfacing (ASR BHR Conserve) | NA | ARMD | NA | NA | NA | + |
| Willert et al. [42] | Metasul | + | ALVAL | 28 mm | NA | NA | + |
| Lohmann et al. [29] | Sikomet | + | ALVAL | 28 mm | Tissue | − | + |
| Savarino et al. [36] | NA | NA | NA | NA | Blood | + | NA |
| Long et al. [30] | Metasul | 37,4% (1-year followup) | Inflammation | 44–50 mm | NA | NA | NA |
| Mahendra et al. [31] | BHR, Conserve Plus [Wright], Cormet [Corin] | NA | Macrophages 86% ALVAL 14% | NA | NA | NA | + |
| Current study | LDH [Zimmer] Metasul | 52% | Foreign body reaction and necrosis (91%), ALVAL (9%) | ≥ 40 mm | Tissue | + | + |
NA = not available; ARMD = adverse reaction to metal debris; ALVAL = aseptic lymphocyte-dominated vasculitis associated lesion.