scholarly journals Pseudotumors in small-head metal-on-metal total hip arthroplasties at a minimum follow-up of 20 years.

2021 ◽  
Author(s):  
P. Kolbitsch ◽  
I. Noebauer-Huhmann ◽  
A. Giurea ◽  
B. Kubista ◽  
R. Windhager ◽  
...  
Keyword(s):  
Total Hip ◽  
Metal On Metal ◽  
Small Head ◽  
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 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

Long term outcome of small head metal-on-metal total hip arthroplasty: a 15-to-22 year follow-up

2021 ◽  
Author(s):  
Anton Maliarov ◽  
Olga L. Huk ◽  
Laura M. Epure ◽  
Stephane G. Bergeron ◽  
John Antoniou ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Total Hip ◽  
Metal On Metal ◽  
Small Head

Prevalence and natural course of pseudotumours after small-head metal-on-metal total hip arthroplasty

2019 ◽  
Vol 101-B (3) ◽  
pp. 317-324 ◽  
Author(s):  
J-K. Moon ◽  
Y. Kim ◽  
K-T. Hwang ◽  
J-H. Yang ◽  
J-A. Ryu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Metal Ion ◽  
Harris Hip Score ◽  
Total Hip ◽  
Metal On Metal ◽  
Significant Difference ◽  
Small Head ◽  
New Onset

Aims The present study investigated the five-year interval changes in pseudotumours and measured serum metal ions at long-term follow-up of a previous report of 28 mm diameter metal-on-metal (MoM) total hip arthroplasty (THA). Patients and Methods A total of 72 patients (mean age 46.6 years (37 to 55); 43 men, 29 women; 91 hips) who underwent cementless primary MoM THA with a 28 mm modular head were included. The mean follow-up duration was 20.3 years (18 to 24). All patients had CT scans at a mean 15.1 years (13 to 19) after the index operation and subsequent follow-up at a mean of 20.2 years (18 to 24). Pseudotumour volume, type of mass, and new-onset pseudotumours were evaluated using CT scanning. Clinical outcomes were assessed by Harris Hip Score (HHS) and the presence of groin pain. Serum metal ion (cobalt (Co) and chromium (Cr)) levels were measured at the latest follow-up. Results At final follow-up, pseudotumours were observed in 26/91 hips (28.6%). There was an increase in volume of the pseudotumour in four hips (15.4%), no change in volume in 21 hips (80.8%), and a decrease in volume in one hip (3.8%). There were no new-onset pseudotumours. There was no significant difference in HHS between patients with and without pseudotumours. At final follow-up, mean serum Co ion levels and median Co:Cr ratios were significantly greater in patients with pseudotumours, but the serum Cr ion levels were not significantly different. Conclusion At a mean 20 years of follow-up, pseudotumours were observed in 26/91 hips (28.6%) with no new-onset pseudotumours during subsequent follow-up. Most pseudotumours in small-head MoM THA were static in volume and asymptomatic with normal serum metal ion levels. Cite this article: Bone Joint J 2019;101-B:317–324.

MRI Findings in Patients After Small-Head Metal-on-Metal Total Hip Arthroplasty with a Minimum Follow-up of 10 Years

2017 ◽  
Vol 99A (18) ◽  
pp. 1540-1546 ◽  
Author(s):  
Tobias Reiner ◽  
Thuy D. Do ◽  
Matthias C. Klot ◽  
Fabian Hertzsch ◽  
Kirsten Seelmann ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Mri Findings ◽  
Total Hip ◽  
Metal On Metal ◽  
Small Head

scholarly journals Uncemented versus cemented arthroplasty after metal-on-metal total hip replacement in patients with femoral neck fractures: a retrospective study

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110122
Author(s):  
Wenlu Liu ◽  
Huanyi Lin ◽  
Xianshang Zeng ◽  
Meiji Chen ◽  
Weiwei Tang ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Clinical Outcomes ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Complication Rates ◽  
Total Hip ◽  
Metal On Metal

Objective To compare the clinical outcomes of primary metal-on-metal total hip replacement (MoM-TR) converted to uncemented total hip replacement (UTR) or cemented total hip replacement (CTR) in patients with femoral neck fractures (AO/OTA: 31B/C). Methods Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter. Results The mean follow-up was 84.12 (67–100) months for UTR and 84.23 (66–101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR). Conclusion In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.

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