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There has been recent evidence in the literature on the possibility of the trunnion as a potential source of metal ions; however, much of this evidence is received from retrieval analysis of large head MoM THRs [13, 14].
This study is one of the only available studies looking at a group of young patients having had THA with a majority of modern large head MOM bearings (70%).
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Six Heads' mom wanted to know if he was training properly, listening to his manager and trainer.
Hart et al. (2009) have shown that in a series of 16 failed large-head MoM prostheses, 13 were positioned outside the Lewinnek "safe zone".
There have been three obvious changes to the most recent designs of large-head MoM hips that we believe to be of paramount importance.
Metal wear debris does not appear to influence the fixation of hip components in large-head MoM articulations at medium-term follow-up.
More importantly, the mounting concerns regarding metal ion release as well as early high failure rates of large-head MoM made continued recruitment unjustifiable.
Our overall clinical experience with the use of large-head MoM was poor with a 10% failure rate at just under three years, with the majority of failures secondary to aseptic loosening of the acetabular component.
In 2012, we completed a 5- to 7-year follow-up examination of all 41 patients with large-head MoM THA (31 men), mean age 52 (28 68) years.
The primary goal of this preliminary report was to quantify BMD on the acetabular side with a large-head MoM bearing and compare it with that of a standard MoP bearing in primary THR.
In a randomized trial of 49 patients who received either large-head MoM articulations or standard (28- to 32-mm) MoP THRs, no statistically significant benefits were found in function, dislocation, or implant failure (Hanna et al. 2012), although the numbers are small and this could be a consequence of type-II statistical error.
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