Metal on metal joint replacements are considered as an alternative to metal on polyethylene implants, especially in case of young patients who require a safe and long term performance of the device. The reduction of wear particles is a key factor in order to improve the life time of the implant in the human body. Metals have excellent properties that may increase the long term success of the artificial joint replacement. However, corrosion of the metallic implant leads to an increase of the ion levels in the body of the patient. Metallic ions may produce a host response that can induce a catastrophic failure of the implant. This review initially focuses on the consequences that the degradation of the metals used in orthopaedic implants have for the health of the patient, and the different biological reactions that lead to the failure of the implant. Parameters that affect the release of particles and ions into the body are discussed as well. Special attention is given to the tribology, corrosion and tribocorrosion behaviour of metal on metal implants. Finally, an overview of mathematical models that have been used to model the behaviour of the implants is also presented.
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