Does bearing size influence metal ion levels in large-head metal-on-metal total hip arthroplasty? A comparison of three total hip systems

Table 3 Effect of femoral head size on metal ion concentrations

Authors	Year	Study design	Follow-up	Metal ion levels (μg/l)	p value	Conclusion
Antoniou et al. [32]	2008	Comparison of 36 mm head MOM THA with 28 mm head MOM THA	12 months	Large head, Cr 0.4, Co 2.3	>0.2 for Cr	No difference in metal ion levels in small or large-head MOM THA
Antoniou et al. [32]	2008	Comparison of 36 mm head MOM THA with 28 mm head MOM THA	12 months	Small head, Cr 0.6, Co 2.6	>0.15 for Co
Daniel et al. [31]	2008	Comparison of large-head MOM THA (42 to 54) with 28 mm head MOM THA	12 months	Large head, Cr 1.4, Co 2.3	Not significant	No difference in metal ion levels in small or large-head MOM THA
Daniel et al. [31]	2008		12 months	Small head, Cr 1.7, Co 1.7	Not significant
Bernstein et al. [34]	2011	Comparison of large-head MOM THA (40 to 44) with small-head MOM (28 and 36 mm) THA	12 months	Large head, Cr 0.51, Co 2.22	0.29 for Cr	No difference in metal ion levels in small or large-head MOM THA
Bernstein et al. [34]	2011		12 months	Small head, Cr 0.78, Co 2.34	0.42 for Co
Hallows et al. [35]	2011	Comparison of large-head MOM THA (38 and larger) with small-head MOM (28 and 32 mm) THA	12 months	Large head, Cr 0.8, Co 0.7	0.0158 for Cr	Chromium ion levels in blood higher for small-head MOM THA as compared to large-head MOM THA. No difference in blood Cobalt ion levels
Hallows et al. [35]	2011		12 months	Small head, Cr 2.1, Co 0.7	0.869 for Co

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