Approach, Rationale, and Examples of Metal-on-Metal Device Retrieval and Analysis for Evidence-Based Education

    Published: May 2013

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    A program operated since 1970 is now transitioning to an evidenced-based education (EBE) format and is utilizing examples of medical device retrieval and analysis (DRA) to introduce basic and applied concepts on the compatibility and longevity of device and host interactions. This paper provides an approach to EBE utilizing principles from the physical and biological sciences, which could be useful to other programs. The requirements of DRA include compliance with all regulations for confidentiality and safety. Explanations of identifying, processing, analyzing, and reporting on revision explants and en bloc postmortem donor specimens have provided the details of how initial observations and hypotheses can lead to establishing mechanism-based cause–effect relationships. Examples of surface interactions along total hip arthroplasty articulations and porous regions for biological fixation have been provided. DRA studies on human applications of surgical implant devices have provided quantitative data to accept hypotheses about reduced magnitudes of wear over time (0–20 yr) along metal on metal articulations of one device design and biomaterial. Also, the magnitude of ongrowth and ingrowth of bone into a specific rough/porous metallic surface (bone to implant contact) and the biomechanical properties of the bone within and away from the fixation have led to detailed discussions of osseous integration of joint prosthesis, and conditions of a stable fixation. Experience has shown the value of device retrieval and analysis study results as a component of evidence-based education within a sub-discipline area associated with medical treatments including surgical implant devices.


    DRA, en bloc, explants, specimens

    Author Information:

    Lemons, J.
    Dept. of Clinical and Community Sciences, School of Dentistry, Univ. of Alabama at Birmingham, Birmingham, AL

    Sarver, D.
    Medical Student, Univ. of Alabama at Birmingham, Birmingham, AL

    Beck, P.
    Dept. of Clinical and Community Sciences, School of Dentistry, Univ. of Alabama at Birmingham, Birmingham, AL

    Petersen, D.
    Frontier Medical Products, Birmingham, AL

    Eberhardt, A.
    Univ. of Alabama at Birmingham, Birmingham, AL

    Committee/Subcommittee: F04.22

    DOI: 10.1520/STP156020120034

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