Hip arthroplasty with the articular surface replacement (ASR) system: survivorship analysis and functional outcomes

2013 ◽  
Vol 24 (6) ◽  
pp. 925-930 ◽  
Author(s):  
S. Shemesh ◽  
Y. Kosashvili ◽  
S. Heller ◽  
E. Sidon ◽  
L. Yaari ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Articular Surface ◽  
Surface Replacement ◽  
Survivorship Analysis ◽  
Articular Surface Replacement ◽  
Asr System

Establishing thresholds for metal ion levels in patients with bilateral Articular Surface Replacement hip arthroplasty

2018 ◽  
Vol 29 (5) ◽  
pp. 475-480 ◽  
Author(s):  
Gabrielle S Donahue ◽  
Vincent P Galea ◽  
Inari Laaksonen ◽  
James W. Connelly ◽  
Orhun Muratoglu ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Metal Ion ◽  
Articular Surface ◽  
High Specificity ◽  
Hip Resurfacing ◽  
Surface Replacement ◽  
Post Surgery ◽  
Articular Surface Replacement ◽  
Clinical Problems

Introduction: The primary aim of the current study was to determine whether metal ion levels could identify well- from poorly-functioning implants in patients after undergoing bilateral Articular Surface Replacement (ASR) Hip System. The secondary aim was to establish threshold values for Co and Cr that could be used to predict clinical problems in these patients. Materials and methods: The study included 125 patients treated with bilateral ASR hip resurfacing (HRA) and 93 patients treated with bilateral ASR XL total hip arthroplasty (THA) at a mean follow-up of 7.1 years post-surgery. Patients were labelled as well- or poorly-functioning based on strict criteria. We calculated the Co and Cr safe upper ion limits (SUL) for ASR HRA and ASR XL THA separately and assessed these cutoffs ability to predict clinical problems. Results: In patients with bilateral ASR HRA, the well-functioning group had lower ions than the poorly-functioning. In ASR THA patients, there was no difference in blood Co or Cr levels between well- and poorly-functioning implant groups ( p = 0.118 and p = 0.379, respectively). Both Co and Cr could effectively discriminate between well-functioning and poorly-functioning ASR HRA implants ( p < 0.001 and p < 0.001, respectively), but not for ASR THA implants ( p = 0.118 and p = 0.564, respectively). SULs of 4.0 ppb for Co and 4.0 ppb for Cr could differentiate between well- and poorly-functioning implants with high specificity. Conclusions: Metal ion levels are a more reliable tool in MoM HRA than THA when discriminating well- from poorly-functioning implants in bilateral patients. For patients treated with bilateral ASR HRA, ion levels above 4.0 ppb are highly specific for the detection of clinical problems.

scholarly journals Indications for MARS-MRI in Patients Treated With Articular Surface Replacement XL Total Hip Arthroplasty

2018 ◽  
Vol 33 (9) ◽  
pp. 2906-2911 ◽  
Author(s):  
James W. Connelly ◽  
Vincent P. Galea ◽  
Inari Laaksonen ◽  
Sean J. Matuszak ◽  
Rami Madanat ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Articular Surface ◽  
Surface Replacement ◽  
Total Hip ◽  
Articular Surface Replacement

Implication of Femoral Stem on Performance of Articular Surface Replacement (ASR) XL Total Hip Arthroplasty

2014 ◽  
Vol 29 (11) ◽  
pp. 2127-2135 ◽  
Author(s):  
Johannes Cip ◽  
Archibald von Strempel ◽  
Christian Bach ◽  
Matthias Luegmair ◽  
Thomas Benesch ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Articular Surface ◽  
Femoral Stem ◽  
Surface Replacement ◽  
Total Hip ◽  
Articular Surface Replacement

Risk factors for mid-term revision surgery in patients with articular surface replacement total hip arthroplasty

2017 ◽  
Vol 28 (1) ◽  
pp. 44-49
Author(s):  
Gabrielle S. Donahue ◽  
Viktor Lindgren ◽  
Vincent P. Galea ◽  
Rami Madanat ◽  
Orhun K. Muratoglu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Metal Ion ◽  
Articular Surface ◽  
Cobalt Metal ◽  
Surface Replacement ◽  
Total Hip ◽  
Articular Surface Replacement ◽  
Patient Reported

Introduction: This study assessed the associations between gender and implant survival, as well as adverse local tissue reaction (ALTR), in patients with articular surface replacement (ASR) XL total hip arthroplasty (THA). Secondly, we sought to report the differences between genders in metal ion levels and patient reported outcome measures (PROMs) in these patients. Methods: 563 unilateral ASR XL THA patients were enrolled in a multicentre follow-up study at a mean of 6.4 years after index surgery. All patients had blood metal ion levels and PROMs obtained annually, and a valid anteroposterior pelvis radiograph. A sub-set of patients from a single centre had annual MRI performed and were analysed for the presence of moderate-to-severe ALTR. Results: 60 hips (11%) were revised during the study period. The only variables found to be associated with revision surgery in patients with unilateral THA were VAS pain (hazard ratio [HR], 1.35; p<0.001) and elevated cobalt metal ion levels (HR, 1.05; p<0.001). No variables assessed were found to be associated with prevalence of ALTR. Chromium concentrations were greater in female patients than males, while cobalt levels were similar between genders. Males reported higher HHS, EQ-5D and UCLA scores than females. Conclusions: Both males and females with metal-on-metal THA implants should be followed with equal vigilance as gender does not appear to be associated with poor outcomes, such as revision surgery and presence of ALTR.

Obesity is not associated with hip failure in patients with articular surface replacement of the hip

2019 ◽  
Vol 30 (1) ◽  
pp. 78-86
Author(s):  
Gabrielle S Ray ◽  
Inari Laaksonen ◽  
Vincent P Galea ◽  
Rami Madanat ◽  
Orhun Muratoglu ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Metal Ion ◽  
Articular Surface ◽  
Female Gender ◽  
Tissue Reaction ◽  
Normal Weight ◽  
Surface Replacement ◽  
Increased Risk ◽  
Articular Surface Replacement ◽  
Patient Reported

Background: Our main aim was to investigate whether obese patients were at increased risk of elevated metal ion levels and/or adverse local tissue reaction (ALTR) after being treated with articular surface replacement (ASR) hip arthroplasty. Methods: This study included 360 patients who underwent metal-on-metal (MoM) hip resurfacing (HRA) or total hip arthroplasty (THA). 95 patients (26%) were underweight/normal weight (BMI < 25 kg/m2), 139 (39%) were overweight (BMI 25–30 kg/m2), and 126 (36%) were obese (BMI ⩾ 30 kg/m2). Blood metal ion levels and patient-reported outcome measures (PROMs) were obtained, and a sub-cohort of 85 patients had MARS MRI performed. Logistic regression analyses were used to assess the associations between obesity and metal ions, as well as ALTR. Results: BMI was not associated with either elevated metal ion levels or ALTR. In HRA patients, female gender (OR 3.0; p = 0.019) and pain (OR 2.3; p = 0.046) were associated with elevated Co levels. Female patients had increased risk of elevated Cr levels (OR 3.0; p = 0.02). In THA patients, female gender (OR 2.2; p = 0.004) and VAS satisfaction (OR 2.1; p = 0.01) were associated with elevated Co levels. Female gender (OR 3.6; p = 0.001) and time from surgery (OR 1.4; p = 0.005) were associated with Cr levels. In the sub-cohort, ALTR was associated with Co levels (OR 16.1; p = 0.002) in HRA patients. Conclusion: Patients with BMI ⩾ 30 kg/m2 present no increased risk for elevated metal ion levels or development of ALTR.

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