Incidence of Adverse Reactions to Metal Debris From 28-mm Metal-on-Metal Total Hip Arthroplasties With Minimum 10 Years of Follow-Up: Clinical, Laboratory, and Ultrasound Assessment of 44 Cases

2017 ◽  
Vol 32 (4) ◽  
pp. 1206-1210 ◽  
Author(s):  
Béchir Ayoub ◽  
Sophie Putman ◽  
Pierre Cholewinski ◽  
Amandine Paris ◽  
Henri Migaud ◽  
...  
Keyword(s):  
Adverse Reactions ◽  
Clinical Laboratory ◽  
Metal Debris ◽  
Total Hip ◽  
Metal On Metal ◽  
Ultrasound Assessment ◽  
Hip Arthroplasties

scholarly journals Small-head metal on metal total hip arthroplasty is associated with a high rate of complication and reoperation at mid-term follow-up

2021 ◽  
Vol 9 ◽  
pp. 205031212110147
Author(s):  
Nobuhiko Sumiyoshi ◽  
Kazuhiro Oinuma ◽  
Yoko Miura
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Adverse Reactions ◽  
Small Diameter ◽  
High Rate ◽  
Metal Debris ◽  
Total Hip ◽  
Metal On Metal ◽  
Small Head

Background: Adverse reactions to metal debris are significant complications after metal-on-metal total hip arthroplasty. Recently, late appearances of adverse reactions to metal debris and subsequent need for reoperations have been reported with small-diameter head metal-on-metal devices. We retrospectively investigated mid-term clinical outcomes of small-head metal-on-metal total hip arthroplasty. Methods: We reviewed 159 hips in 139 patients who had a small-head metal-on-metal total hip arthroplasty (M2a Taper; Biomet, Warsaw, IN) with a minimum 5-year follow-up and documented postoperative complications. Results: Focal osteolysis in either the femur or acetabulum was observed in 12 hips (7.5%, 44 months after surgery on average), with pseudotumor observed in 8 hips (5%, 120 months after surgery on average). Four hips (2.5%) had dislocations (84 months after surgery on average) and six hips (3.8%, 122 months after surgery on average) underwent reoperation. Conclusion: Small-head metal-on-metal total hip arthroplasty is associated with a high degree of complications at mid-term follow-up period. Considering this, we discourage the use of metal-on-metal total hip arthroplasty regardless of head size.

scholarly journals Does modularity of metal-on-metal hip implants increase cobalt: chromium ratio?

2019 ◽  
pp. 112070001987363
Author(s):  
Kevin C Ilo ◽  
Karim Aboelmagd ◽  
Harry S Hothi ◽  
Asaad Asaad ◽  
John A Skinner ◽  
...  
Keyword(s):  
Metal Ion ◽  
Hip Implants ◽  
Cobalt Chromium ◽  
Metal Debris ◽  
Material Loss ◽  
Total Hip ◽  
Modular Stem ◽  
Metal On Metal ◽  
Hip Replacements ◽  
Hip Arthroplasties

Background: Blood metal ion levels are used in the surveillance of metal-on-metal (MoM) hip implants. Modular implants contain an extra source of metal debris that may affect the ratio of metal ions in the blood. Methods: This was a retrospective study of 503 patients with hip replacements made by a single manufacturer (Smith & Nephew, Warwick, UK) with the same bearing surface. There were 54 total hip arthroplasties, 35 Birmingham Mid-Head Resections and 414 hip resurfacings. Whole blood metal ion levels and their ratios were analysed to investigate the effect of a modular junction. Results: The cobalt:chromium ratios were greater in the total hip arthroplasty group (mean 2.3:1) when compared to the resurfacings group (mean 1.3:1, p = <0.05) and Birmingham Mid-Head Resection group (mean 1.1:1, p = 0.11). Conclusions: This study demonstrated a trend for a higher cobalt:chromium ratio in patients with MoM total hip replacement that may be due to metal debris from the modular stem-head junction. Further work is required to correlate clinical data with retrieval analysis to confirm the effect of taper material loss on the cobalt:chromium ratio.

scholarly journals Revision surgery of metal-on-metal hip arthroplasties for adverse reactions to metal debris

2018 ◽  
Vol 89 (3) ◽  
pp. 278-288 ◽  
Author(s):  
Gulraj S Matharu ◽  
Antti Eskelinen ◽  
Andrew Judge ◽  
Hemant G Pandit ◽  
David W Murray
Keyword(s):  
Revision Surgery ◽  
Adverse Reactions ◽  
Metal Debris ◽  
Metal On Metal ◽  
Hip Arthroplasties

scholarly journals Survival at 11 to 21 years for 779 Metasul® metal-on-metal total hip arthroplasties

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902092626
Author(s):  
Roger Erivan ◽  
Guillaume Villatte ◽  
Stéphane Millerioux ◽  
Aurélien Mulliez ◽  
Stéphane Descamps ◽  
...  
Keyword(s):  
Survival Rate ◽  
Aseptic Loosening ◽  
Surface Coating ◽  
P Value ◽  
Level Of Evidence ◽  
Total Hip ◽  
Metal On Metal ◽  
Hip Arthroplasties ◽  
Oxford Score

Background: Total hip arthroplasties (THAs) bearing is one of the most important factors for hip replacement because THA survival depends on it. Metal-on-metal (MoM) bearing has lower wear than metal-on-polyethylene but lot of aseptic loosening decrease utilization. We analyze the survival rate of 28 mm Metasul® bearings after a mean follow-up of 12.9 years. Methods: The main objective of this study was to evaluate the survival of the MoM. We evaluate 779 consecutive THAs performed between January 1995 and December 2005 for primary osteoarthritis, congenital dysplasia classified Crowe I, or rheumatoid arthritis. Survival rate was calculated by the Kaplan–Meir method. The association between survival and age, gender, body mass index (BMI), and surface coating was investigated with a proportional odds model. The clinical assessment included Oxford score. Results: Six hundred fifty-two THAs were reviewed. Sixty-two revisions (9.5%) were performed including 34 aseptic loosening and 11 deep infections. The survival for prosthesis with any reason at 20 years was 87% (confidence interval (CI) 83–90.2) for aseptic loosening at 20 years was 90.1% (CI 87–93.8). There was no association with age, BMI, and surface coating. Gender was significant with lower aseptic loosening for men, hazard ratio = 0.45, p value = 0.035. Oxford score was 57 ± 6.7 (19–60). Conclusion: The survival rate of Metasul was well and seems to be like our clinical finding. However, radiographic aseptic loosening without surgery is not included in the survival rate. The Oxford score was very good with a lot of patients with asymptomatic hip. Level of Evidence: Level IV/Retrospective study

scholarly journals MoM total hip replacements in Europe: a NORE report

2019 ◽  
Vol 4 (6) ◽  
pp. 423-429 ◽  
Author(s):  
Bart G. Pijls ◽  
Jennifer M. T. A. Meessen ◽  
Keith Tucker ◽  
Susanna Stea ◽  
Liza Steenbergen ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hip Replacement ◽  
National Registry ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Large Head ◽  
Metal On Metal ◽  
Hip Replacements ◽  
Hip Arthroplasties

The purpose of this paper is to determine the prevalence of metal-on-metal (MoM) total hip replacement (THR) in European registries, to assess the incidence of revision surgery and to describe the national follow-up guidelines for patients with MoM THR including resurfacings. Eleven registries of the Network of Orthopaedic Registries of Europe (NORE) participated totalling 54 434 resurfacings and 58 498 large stemmed MoM THRs. The resurfacings and stemmed large head MoM had higher pooled revision rates at five years than the standard total hip arthroplasties (THA): 6.0%, 95% confidence interval (CI) 5.3 to 6.8 for resurfacings; 6.9%, 95% CI 4.4 to 9.4 for stemmed large head MoM; and 3.0%, 95% CI 2.5 to 3.6 for conventional THA. The resurfacings and stemmed large head MoM had higher pooled revision rates at ten years than the standard THAs: 12.1%, 95% CI 11.0 to 13.3 for resurfacings; 15.5%, 95% CI 9.0 to 22 for stemmed large head MoM; and 5.1%, 95% CI 3.8 to 6.4 for conventional THA. Although every national registry reports slightly different protocols for follow-up, these mostly consist of annual assessments of cobalt and chromium levels in blood and MRI (MARS) imaging. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180078

MRI findings, metal ion levels and clinical outcome of a complete series of large metal on metal THA: what’s really going on?

2018 ◽  
Vol 28 (2_suppl) ◽  
pp. 48-53 ◽  
Author(s):  
Daniele Marchica ◽  
Enrico Gallazzi ◽  
Giovanni Materazzi ◽  
Giulio A Battaglia ◽  
Luigi Zagra
Keyword(s):  
Clinical Outcome ◽  
Metal Ion ◽  
Harris Hip Score ◽  
Mri Findings ◽  
Metal Debris ◽  
Large Head ◽  
Metal On Metal ◽  
Complete Series ◽  
Hip Arthroplasties

Introduction: Metal-on-metal (MoM) large head total hip arthroplasties (THAs) were discontinued early after their introduction because of the high number of failures due to adverse reaction to metal debris (ARMD). Aim of this study is to report the clinical outcome at a mid-term follow-up (FU) of a series of large-head MoM THA. Methods: In this prospective study, 25 hips (24 patients, 3 males, 21 females, mean age 62.44 years) who have undergone primary THA with large head (diameter ⩾36 mm) MoM prosthesis were evaluated. Each patient underwent a standard follow-up after surgery, that included blood tests with metal ion levels (Co and Cr), x-ray of the pelvis, metal artifact reduction sequence magnetic resonance imaging (MARS-MRI) and clinical evaluation. Results: At an average follow-up of 7.3 years, 4 hips have been surgically reviewed: 2 for causes not related to ARMD (1 heterotopic ossification and 1 periprosthetic fracture); the other 2 on the same patient (bilateral) with ARMD, who was eventually found to be allergic to nickel. Increased metal ions, osteolysis and severe MRI alterations were found in patients with ARMD. Asymptomatic alterations at MRI were found in 8 patients. Harris Hip Score improved after surgery from a mean of 51 points to a mean of 90 points ( p < 0.01). Conclusions: The findings of this study show that not all the patients with MoM THA will develop clear symptoms of ARMD at mid-term follow-up. Patients should be closely monitored following protocols such as that proposed in the European Consensus Statement.

scholarly journals Few Adverse Reactions to Metal on Metal Articulation in Total Hip Arthroplasty in a Review Study on 358 Consecutive Cases with 1 to 5 Years Follow-Up

2012 ◽  
Vol 6 (1) ◽  
pp. 366-370 ◽  
Author(s):  
Jens Stürup ◽  
Line B Dahl ◽  
Karl-Erik Jensen ◽  
Anne-Birgitte Larsen ◽  
Peter Gebuhr
Keyword(s):  
Adverse Reaction ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Adverse Reactions ◽  
Groin Pain ◽  
Total Hip ◽  
Metal On Metal ◽  
Patient Reported ◽  
Pain Patients

The aim of the present study was to determine the frequency of adverse reaction to metal on metal total hip arthroplasty using a M2a-38 articulation and a Magnum articulation, (Biomet Warsaw, Indiana). All patients who had received a Metal on Metal bearing prosthesis, in two centres in Copenhagen, were asked to complete a questionnaire about groin pain. Patients with self-reported groin pain, 68/314, underwent a physical examination and had Co and Cr ion levels measured in full blood samples. Fifty patients also had a CT scan performed. The present study found one patient with bilateral arthroplasty, who had an adverse reaction on one side. In addition the study showed that females had higher values of Co and Cr, and that younger patient reported groin pain more often. The conclusion of this study is that the number of adverse reactions is low, despite the time of observation being relatively short, no high frequency of adverse reactions to this prosthesis is expected.

Sign in / Sign up

Export Citation Format

Share Document