London Implant Retrieval Centre resources

Below are documents designed for surgeons referring patients / hip implants but also radiologists wishing to use our CT and MRI protocols and patients wanting to contribute their implants to our research program.

See LIRC papers Feb 2012 (PDF, 109kb) on patients with painful metal-on-metal hip replacements.

Referrals must include a letter from a referring surgeon or GP. These can be faxed to 020 3311 7332 or emailed to

Our most recent references

1. Cobalt from metal-on-metal hip replacements maybe the clinically relevant active agent responsible for periprosthetic tissue reactions. Alister J Hart *a, Paul D Quinnb, Ferdinand Lalia, Barry Sampsonc, John A Skinner, Jonathan J Powelle, John Nolanf, Keith Tuckerf, Simon Donellf, Adrienne Flanaganh, J Fred W Mosselmans. Acta Biomater. 2012 Jun 8. [Epub ahead of print]

2. Chemical speciation of nanoparticles surrounding metal- on-metal hips. Angela E. Goode, James M. Perkins, Ann Sandison, Chithra Karunakaran, Huikai Cheng, David Wall, John Skinner, Alister J. Hart, Alexandra E. Porter,* David W. McComb* and Mary P. Ryan. In press for Chemical Communications 2012

3. Simple isolation method for the bulk isolation of wear particles from metal on metal bearing surfaces generated in a hip simulator test. Fang Lu, Matt Royle, Ferdinand V. Lali Alister J. Hart Simon Collins, Jonathan Housden, Julia C. Shelton. J Mater Sci Mater Med. 2012 Apr;23(4):891-901. Epub 2012 Mar 6.

4. Which factors determine the wear rate of large diameter metal-on-metal hip arthroplasties?: multivariate analysis of 276 components. AJ Hart, AK Matthies, K Ilo, S Muirhead-Allwood, R Underwood, P Cann, P Maggiore, J Cobb, M Porter, JA Skinner. In Press for JBJSA

5. Pseudotumors in Association with Well-Functioning Metal-on-Metal Hip Prostheses: A Case-Control Study Using Three-Dimensional Computed Tomography and Magnetic Resonance Imaging.
 Hart AJ, Satchithananda K, Liddle AD, Sabah SA, McRobbie D, Henckel J, Cobb JP, Skinner JA, Mitchell AWJ Bone Joint Surg Am 94(4):317-325 15 Feb 2012

6. Introducing new joint replacements to clinical practice. John A Skinner, Peter R Kay, Alister J Hart. BMJ. 2011 Dec 20;343:d8188. doi: 10.1136/bmj.d8188

7. Metal-on-Metal Bearings, Inflammatory Pseudotumours and their Neurological Manifestations. A Review and Diagnostic Triad. BS Mann, PM Whittingham-Jones, DA Shaerf, ZS Nawaz, Harvie P , AJ Hart and JA Skinner. Hip Int. 2012 Mar-Apr;22(2):129-36. doi: 10.5301/HIP.2012.9185

8. Numerical simulation of SAR induced around Co-Cr-Mo hip prostheses in situ exposed to RF fields associated with 1.5- and 3-T MRI body coils. Powell J, Papadaki A, Hand J, Hart A, McRobbie D. Magn Reson Med. 2011 Dec 9. doi: 10.1002/mrm.23304. [Epub ahead of print]

9. Understanding why metal-on-metal hip arthroplasties fail: A Comparison Between Patients With Well Functioning and Revised Birmingham Hip Resurfacing Arthroplasties. Hart AJ1, Matthies A1, Henckel J1, Ilo K1, Skinner J2, Noble PC3. J Bone Joint Surg Am. 2012 Feb 15;94(4):e22.

10. Fracture of a ceramic component in total hip replacement. Whittingham-Jones P, Mann B, Coward P, Hart AJ, Skinner JA. J Bone Joint Surg Br. 2012 Apr;94(4):570-3

11. Pseudotumors are Common in Well-positioned, Low Wearing Metal-on-Metal Hips. Ashley Matthies, John Skinner, Humza Osmani, Johann Henckel, Alister Hart, Clin Orthop Relat Res. 2012 Jul;470(7):1895-906

12. Matthies AK, Henckel J, Skinner JA, Hart AJ. A retrieval analysis of explanted Durom metal-on-metal hip arthroplasties. Hip Int. 2011 Nov-Dec;21(6):724-31. doi: 10.5301/HIP.2011.8885.

13. Risk Factors for Edge Loading in Metal-on-Metal Hip Arthroplasty. Underwood RJ, Zografos A, Sayles R, Cann P, Hart AJ. Mechanical Engineers, Part H: Journal of Engineering in Medicine March 2012 vol. 226 no. 3 217-226

14. Volumetric wear assessment of retrieved metal-on-metal hip prostheses and the impact of measurement uncertainty. Bills P, Racasan R, Jiang X, Blunt L, Underwood R, Cann P, Skinner J, Hart A J. In press for Wear, doi:10.1016/j.wear.2011.08.030.

15. Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal orthopaedic implants. Sampson B, Hart AJ. Ann Clin Biochem. 2012 Mar;49(Pt 2):118-31. Epub 2011 Dec 7.

16. Sensitivity and specificity of blood cobalt and chromium metal ions for predicting failure of metal-on-metal hip arthroplasty. Hart AJ, Bandi A, Sabah S, P. Maggiore, P. Tarassoli B. Sampson, J. Skinner. J Bone Joint Surg [Br] 2011;93-B:1308–13.

17. Inlet protein aggregation: a new mechanism for lubricating film formation with model synovial fluids. Fan J; Myant CW; Underwood R; Cann PM; Hart A. (Jul 2011). Proc Inst Mech Eng H. 225:696-709.

18. A comparison of explanted Articular Surface Replacement and Birmingham Hip Resurfacing components. Underwood R; Matthies A; Cann P; Skinner JA; Hart AJ. (Sep 2011). J Bone Joint Surg Br. 93:1169-1177. DOI.

19. Insufficient Acetabular Version Increases Blood Metal Ion Levels after Metal-on-metal Hip Resurfacing. Hart AJ; Skinner JA; Henckel J; Sampson B; Gordon F. (Sep 2011). CLIN ORTHOP RELAT R. 469:2590-2597. DOI.

20. Metal-on-metal bearings: the evidence so far. Haddad FS; Thakrar RR; Hart AJ; Skinner JA; Nargol AV; Nolan JF; Gill HS; Murray DW; et al. (May 2011). J Bone Joint Surg Br. 93:572-579. DOI.

21. Hypoxia target gene expression in tissue response to cobalt containing nanoparticles. Lali FV et al. Paper in Metal ions in Biology and Medicine (John Libbey, Paris) (June, 2011) Vol 11 pages 196-202

22. Magnetic resonance imaging findings in painful metal-on-metal hips: a prospective study. Sabah SA; Mitchell AW; Henckel J; Sandison A; Skinner JA; Hart AJ. (Jan 2011). J Arthroplasty. 26:71-76.e2. DOI.

23. Retrieval analysis of 240 metal-on-metal hip components, comparing modular total hip replacement with hip resurfacing. Matthies A; Underwood R; Cann P; Ilo K; Nawaz Z; Skinner J; Hart AJ. (Mar 2011). J BONE JOINT SURG BR. 93B:307-314. DOI.

24. The relationship between the angle of version and rate of wear of retrieved metal-on-metal resurfacings A PROSPECTIVE, CT-BASED STUDY. Hart AJ; Ilo K; Underwood R; Cann P; Henckel J; Lewis A; Cobb J; Skinner J. (Mar 2011). J BONE JOINT SURG BR. 93B:315-320. DOI.

25. An analysis of metal ion levels in the joint fluid of symptomatic patients with metal-on-metal hip replacements. Davda K; Lali FV; Sampson B; Skinner JA; Hart AJ. (Jun 2011). J Bone Joint Surg Br. 93:738-745. DOI.

26. Why large-head metal-on-metal hip replacements are painful: the anatomical basis of psoas impingement on the femoral head-neck junction. Cobb JP; Davda K; Ahmad A; Harris SJ; Masjedi M; Hart AJ. (Jul 2011). J Bone Joint Surg Br. 93:881-885. DOI.

27. Quantification of the difference between 3d ct and plain radiograph for measurement of the position of medial unicompartmental knee replacements. Holme T; Henckel J; Cobb J; Hart A. Knee. 2011 Oct;18(5):300-5.

28. The chemical form of metallic debris in tissues surrounding metal-on-metal hips with unexplained failure. Hart AJ; Quinn PD; Sampson B; Sandison A; Atkinson KD; Skinner JA; Powell JJ; Mosselmans JF. (Nov 2010). Acta Biomater. 6:4439-4446. DOI.

29. Large ball metal on metal hips obscure cup angle measurement on plain radiographs. Hart AJ; Dandachli W; Schlueter-Brust K; Henckel J; Cobb J. (Oct 2009). Hip Int. 19:323-329.

30. The painful metal-on-metal hip resurfacing. Hart AJ; Sabah S; Henckel J; Lewis A; Cobb J; Sampson B; Mitchell A; Skinner JA. (Jun 2009). J Bone Joint Surg Br. 91:738-744. DOI.

31. Circulating levels of cobalt and chromium from metal-on-metal hip replacement are associated with CD8+ T-cell lymphopenia. Hart AJ; Skinner JA; Winship P; Faria N; Kulinskaya E; Webster D; Muirhead-Allwood S; Aldam CH; et al. (Jun 2009). J Bone Joint Surg Br. 91:835-842. DOI.

32. Microfocus study of metal distribution and speciation in tissue extracted from revised metal on metal hip implants. Hart AJ; Sandison A; Quinn P; Sampson B; Atkinson K; Skinner JA; Goode A; Powell JP; et al. (2009). J. Phys.: Conf. Ser. 190. DOI.

33. The Determination of Cobalt and Chromium in Whole Blood Sampled from Metal-Metal and Metal-Polyethylene Hip Articulation Patients by DRC-ICP-MS. Winship P; Faria N; Skinner J; Hart AJ; Powell JJ. (May 2008). Metal Ions in Biology and Medicine. Vol X. Publisher weblink.

34. Cup Inclination Angle Of Greater Than 50 Degrees Increases Whole Blood Concentrations Of Cobalt And Chromium Ions After Metal-On-Metal Hip Resurfacing. Hart AJ; Buddhev P; Winship P; Faria N; Powell J; Skinner J. (Sep 2008). Hip Int. 18(3):212-219. Author weblink.

35. Learning how to resurface cam-type femoral heads with acceptable accuracy and precision: the role of computed tomography-based navigation. Cobb JP; Kannan V; Dandachli W; Iranpour F; Brust KU; Hart AJ. (Aug 2008). J Bone Joint Surg Am. 90 Suppl 3:57-64. DOI.

36. The effect of metal ions in solution on bacterial growth compared with wear particles from hip replacements. Anwar HA; Aldam CH; Visuvanathan S; Hart AJ. (Dec 2007). J Bone Joint Surg Br. 89:1655-1659. DOI.

37. The association between metal ions from hip resurfacing and reduced T-cell counts. Hart AJ; Hester T; Sinclair K; Powell JJ; Goodship AE; Pele L; Fersht NL; Skinner J. (Apr 2006). J Bone Joint Surg Br. 88:449-454. DOI.

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