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High revision rates attributable to adverse reactions to metal debris have been reported for total hip arthroplasties (THAs) with metal-on-metal implants and hip resurfacings. The effect of revision on blood metal ion levels is described only in small series, the clinical results of revisions have been contradictory, and concerns regarding component loosening have been presented.

Revision of Metal-on-metal Hip Prostheses Results in Marked Reduction of Blood Cobalt and Chromium Ion Concentrations