(20) Why did metal-on-metal prostheses demonstrate poor clinical performance?

Increasing data are available describing risk factors for the development of local and systemic adverse events based on the use of metal-on-metal hip implants. Especially the use of large head metal-on-metal implants with diameters greater than 36 mm show unsatisfactory results. The major drawback is the local and systemic risk of the explosion of the metal. The revision rate of metal-on-metal hip implants with a diameter of the head above 32 mm is 4 times higher than of comparable ceramic-ceramic hip implants. This has been reported after 10 years follow up.

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