Atlanta Bone and Joint Specialists
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    • Maurice Jové, M.D.
    • Nathan Jové, M.D.
    • Jeff Traub, M.D.
    • Brian Vanderhoof, D.O.
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      • Omid Midanaky, PA-C
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        • Metal on Metal Hip Problems
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        • Ankle Sprains and Instability
        • Achilles Tendon Tears
      • Concussions
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      • Stem Cell Therapy
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      • PRP (Platelet-Rich Plasma) Injections
      • Hyaluronic Gel Injections
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    • Hand Surgery >
      • Carpal Tunnel Sydnrome
      • Cubittal Tunnel Syndrome
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      • Distal Radius Fracture
      • Ankle Fractures
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    • Orthopedic Survey Center >
      • Outpatient Total Joint Replacement Survey
      • Painful Knee Replacement Survey
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      • Rotator Cuff Surgery Survey
      • Meniscus Tear Survey
      • Partial Knee Replacement Survey
    • FAQ
    • How to Prepare and What to Expect Knee Surgery
    • Blog
  • Español
  • Online Scheduling
  • Home
  • Our Doctors
    • Maurice Jové, M.D.
    • Nathan Jové, M.D.
    • Jeff Traub, M.D.
    • Brian Vanderhoof, D.O.
    • Physician Assistants >
      • Omid Midanaky, PA-C
      • Aidan O'Connor, MPH, PA-C
      • Elissa Ricker, PA-C
  • Locations
  • Appointments
    • Online Scheduling
    • Forms
    • Referrals
    • Independent Medical Examination
    • Telemedince and E-Visits >
      • E-Visit Scheduler
    • Saturday Clinic
    • What To Expect
    • Medical Tourism
  • Our Office
    • About Us
    • Social Media >
      • Facebook
      • Instagram
      • LinkedIN
      • Twitter
      • YouTube
    • Orthopedic Expert Witness
    • Conditions Treated
    • Payments
    • Bracing
    • Office Staff >
      • Office Manager >
        • Brian Pallone
      • Front Desk & Checkout >
        • Decatur
        • Loganville >
          • Meagan
        • Snellville >
          • Cheryl
      • Billing & Collections >
        • Maurice Jové, M.D. >
          • Buffie
        • Nathan Jové, M.D. >
          • Mayra
          • Makenzie
        • Jeff Traub, M.D. >
          • Jennifer
          • Liz
      • Scheduling >
        • Jeff Traub, M.D. >
          • Andrea
        • Maurice Jové, M.D. >
          • Rachael
        • Nathan Jové, M.D. >
          • Lindsay
        • Brian Vanderhoof, D.O. >
          • Megan
      • Radiology >
        • David
        • Rebecca
        • Carla
        • Oscar
      • Medical Records >
        • Team
    • Insurance
    • MRI
    • Medical Records >
      • Decatur
      • Loganville
      • Snellville
    • Prescription Refill Request >
      • Decatur
      • Loganville
    • Reviews
    • Affiliate Hospital Resources >
      • Emory Decatur Hospital
    • Marketing Internship
    • Job Opportunities
  • Patient Education
    • Coronavirus Update Page
    • What is an Orthopedic Doctor
    • Joint Replacement Center >
      • Arthritis Center >
        • Arthritis 101
      • Hip >
        • Anterior Hip Replacement
        • Total Hip Replacement
      • Knee >
        • Total Knee Replacement
        • Anterior Reference Knee Replacement
        • Knee Replacement Surgery Recovery
        • Partial Knee Replacement
        • Patellofemoral Replacement
        • Tourniquet-less Knee Replacement
      • Shoulder >
        • Total Shoulder Replacement
        • Reverse Total Shoulder Replacement
      • Outpatient Joint Replacement Center
      • Metal Sensitivity and Nickel Allergy
      • Revision Surgery >
        • Revision Knee Replacement
        • Revision Hip Replacement Surgery
        • Metal on Metal Hip Problems
      • Infections >
        • Hip and Knee Replacement Infections
    • Sports Medicine Program >
      • Arthroscopic Surgery
      • Shoulder >
        • Rotator Cuff Tears
        • SLAP Tears
        • Labral Tears
      • Knee >
        • Meniscus Tears
        • ACL Tears
        • Patella (Kneecap) Instability
        • Patella (Kneecap) Dislocation
      • Foot and Ankle >
        • Ankle Sprains and Instability
        • Achilles Tendon Tears
      • Concussions
    • Regenerative Medicine >
      • Stem Cell Therapy
      • Cartilage Restoration
      • PRP (Platelet-Rich Plasma) Injections
      • Hyaluronic Gel Injections
    • EMG
    • Hip Fracture Center
    • Hand Surgery >
      • Carpal Tunnel Sydnrome
      • Cubittal Tunnel Syndrome
      • Trigger Finger
    • Fracture (Broken Bone) Center >
      • Distal Radius Fracture
      • Ankle Fractures
    • Blood Clots After Orthopedic Surgery
    • Learning Center
    • Home Therapy
    • Video
    • Orthopedic Survey Center >
      • Outpatient Total Joint Replacement Survey
      • Painful Knee Replacement Survey
      • Painful Hip Replacement Survey
      • Rotator Cuff Surgery Survey
      • Meniscus Tear Survey
      • Partial Knee Replacement Survey
    • FAQ
    • How to Prepare and What to Expect Knee Surgery
    • Blog
  • Español
  • Online Scheduling

Metal on Metal Hip Replacement Failures

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Our guide for the failed metal on metal hip replacement

Metal on Metal Hip Replacement.  History and Design Rationale

Around 2005-2006, a new idea was brought to Orthopedics.  Instead of having a metal on plastic construct for hip replacements, lets make a metal articulate with metal.  The thought process was that two metals would not wear as much as metal on plastic.  As plastic wear creates small debris that then gets removed by our immune system and can lead to bone resorption (weakening), the orthopedic industry tried to make a product that would have less wear and therefore less particulate debris.  It all sounded great, a huge metal head that was very similar to the size of our current hip itself, the ultimate stability and no ability to cause plastic debris.  In theory, everything was lining up for metal on metal hip replacements to be the wave of the future.
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Metal on metal hip replacement. Metal head articulates with metal liner.

2009-2012

As we started to gather data about these metal on metal hip replacements, we began to see early failures and metal ion levels increasing in the blood.  We didn't know the consequence and we didn't know what was happening.  Many surgeons began to stop using metal on metal hip replacements and in 2012 the FDA increasingly became concerned, took some products off the market and put a serious dent in the metal on metal hip replacement use.
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Comparison of two hips with the right showing bone loss on the medial (inner) part of the upper stem due to ALVAL

Where did it go wrong?

While traditional hip replacement with metal on plastic had osteolysis (bone breakdown) due to the larger phagocytes (cells that eat large, foreign debris from the body), we now found that white blood cells (lymphocytes) were creating a new problem: ALVAL- aseptic, lymphocyte-dominated vasculitis-associated lesion.  ALVAL was causing pseudotumors- not cancerous but these tumors ate away at tisuse and turned it black, ruined muscle integrity and dissolved bony structure.  
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A gigantic pseudtumor visible on X-Ray

I had a metal on metal hip replacement.  What do I do?

Our practice recomends immediate attention and monitoring.  We follow the guidelines made by the American Academy of Orthopedic Surgeons, which essentially involves monitoring patient blood levels of metal while also seeing patients routinely for screening for pseudotumors.  We sometimes recommend MARS MRI, which helps reduce metal aritfact while identyfing pseudotumors.
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Call us to schedule your appointment today.
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Click here to make an online appointment today with any of our Orthopedic Surgeons. All of our surgeons specialize in revision surgery for metal on metal hip replacements.
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Risk stratification after a hip replacement with a metal on metal hip. These guidelines are the best standard to ensure metal on metal hip failures are identified early and therefore unable to cause damage.
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  • Prior blood clot or pulmonary embolus
    • the #1 predictor of having another clot
  • Factor 5 Leiden
  • Von Willdebrands disease
  • Venous Statsis
  • Extensive immobilization after surgery
  • Lower Extremity surgery
  • Oral Contraceptive Birth Control

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​Call to Schedule Your Appointment Today
SE HABLA ESPAÑOL!


Office Hours

Mon-Fri: 9AM-5PM  


Telephone

Decatur                             404.296.5005
Loganville                         770.564.3393
Snellville                           770.985.9330

High School Football Season Added Coverage Hours

Saturdays During High School Football Season
Injury Clinic is for INJURED PLAYERS ONLY.
Snellville
ONLY.
9AM-10AM

MEDIA ROOM