Adverse reaction to metal debris in a consecutive series of DUROM™ hip resurfacing: pseudotumour incidence and metal ion concentration



The aim of this study was to evaluate the incidence of adverse reactions to metal debris (ARMD) in a consecutive series of DUROM™ Hip Resurfacing Arthroplasty (HRA) at mid-term follow-up.


Between October 2003 and March 2007 a total of 134 consecutive DUROM™ HRA in 121 patients were performed at our institution. Follow-up could be obtained in 101 unrevised patients (83%) at a mean time of 8.51 ± 0.97 years postoperatively and included patient-related outcome measurement, plain radiographs, MARS-MRI as well as whole blood metal ion assessment.


17 (16.5%) out of 103 hips revealed pseudotumour occurrence in MRI investigation, 1 (10.6%) with a diameter of ≥2 cm. Higher incidence of pseudotumours was found patients with femoral component size <50 mm. 38 patients had elevated cobalt levels, 36 of them (35%) in the range of 2-7 μg/l and 2 patients (1.9%) at a rate of >7 μg/l. In contrast to cobalt determination, only elevated chromium values showed a positive association with pseudotumour occurrence and size.


A significant proportion of patients developed pseudotumours and metal ion elevation in a consecutive cohort of DUROM™ HRA after mid-term follow-up. The incidence, however, seems not to differ from results of other well performing resurfacing brands; clinical relevance of our findings is unclear. Regarding potential local as well as systemic effects of metal particle release, close follow-up of patients is essential, even with clinically well-performing implants.

Hip Int 2017; 27(4): 343 - 348




Albrecht Hartmann, Jan-Dirk Kieback, Jörg Lützner, Klaus-Peter Günther, Jens Goronzy

Article History


Financial support: This project was funded by Zimmer Inc.
Conflict of interest: AH: paid lectures for Infectopharm, Aesculap, Link, Zimmer. JL: research support from Aesculap, Mathys, Smith & Nephew, Stryker, Zimmer; paid lectures for Aesculap, Bayer, Linvatec, Link, Mathys. KPG: research support and personal fees from Aesculap, Link, Zimmer. JDK: None. JG: None.

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  • University Centre of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus, Technical University Dresden, Dresden - Germany
  • Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn - Germany

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