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Updated: Aug 14, 2026
Potentiodynamic Corrosion Testing
Published on: September 4, 2016
Revision total hip arthroplasty in hip joints with metallosis: a single-center experience with 31 cases
Jun-Dong Chang1, Sang-Soo Lee, Mina Hur
1Department of Orthopaedic Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Youngdungpo-gu, Seoul, Republic of Korea.
Insights
Metallosis, a complication of hip replacement, often causes bone loss (osteolysis). However, successful revision hip surgery is achievable even if metallosis is not fully removed.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Arthroplasty Research
Background:
- Metallosis is a known complication following total hip arthroplasty.
- It can arise from polyethylene liner dissociation, catastrophic wear, or fixation screw issues.
- The clinical significance and impact on revision surgery outcomes require further elucidation.
Purpose of the Study:
- To analyze clinical and radiographic findings of metallosis.
- To evaluate the relationship between metallosis and clinical outcomes in revision total hip arthroplasty.
- To determine if complete metallosis eradication is necessary for successful revision surgery.
Main Methods:
- Retrospective analysis of 31 hips undergoing revision total hip arthroplasty.
- Assessment of metallosis grading (I-III) and associated causes.
- Radiographic evaluation for osteolysis, cup migration, and inclination changes.
Main Results:
- Metallosis was linked to polyethylene dissociation (24 hips), wear (6 hips), and fixation screws (1 hip).
- Osteolysis was prevalent, observed in 77.4% of hips.
- Despite metallosis presence, final follow-up showed no osteolysis, migration, or inclination changes, with favorable clinical outcomes.
Conclusions:
- Metallosis frequently coexists with osteolysis around the acetabular cup in revision total hip arthroplasty.
- Complete elimination of metallosis is not essential for achieving successful clinical outcomes in revision surgery.
- Favorable results can be obtained even in severe metallosis cases.
Abstract:
Clinical and radiographic findings of metallosis in relation to the clinical outcome of revision total hip arthroplasty were analyzed for 31 hips. Causes of metallosis were dissociation of polyethylene liner in 24 hips, catastrophic wear in 6, and the screw used for stem fixation in 1. Metallosis was grade I in 12 hips, grade II in 7, and grade III in 12. Osteolysis around the acetabular cup was observed in 24 (77.4%) of 31 hips. At the time of final follow-up evaluation, none of the hips showed osteolysis, acetabular cup migration, or any change in inclination. Although metallosis could not be completely eradicated in severe cases, the clinical outcome for these hips was favorable. This study demonstrates that metallosis frequently causes osteolysis and that complete elimination of it is not a prerequisite for the success of revision total hip arthroplasty.