A Comparison of Clinical Results of Hip Resurfacing Arthroplasty and                     28 mm Metal on Metal Total Hip Arthroplasty: A Randomised Trial with 3–6 Years                     Follow-Up

Introduction: Hip resurfacing arthroplasty (HRA) is an alternative to conventional total hip arthroplasty (THA) with potential advantages of preserving femoral bone stock and the ability to participate in higher impact activities. This study compares outcomes, satisfaction and preference in patients who underwent HRA in 1 hip and THA on the contralateral side. Methods: 62 Patients with an HRA in 1 hip and a contralateral THA were retrospectively identified at 3 centres, consisting of 38 males and 24 females with 53 patients (85.5%) undergoing HRA first. A survey regarding satisfaction and preference for each procedure and outcome scores were obtained. Results: Patients were younger (51.5 vs. 56.6 years, p = 0.002) and had longer follow-up on the HRA hip (11.0 vs. 6.0 years, p < 0.001). HRA was associated with larger increase in Harris Hip Score from preoperative to final follow-up (35.8 vs. 30.6, p = 0.035). 18 Patients (29.0%) preferred HRA, 19 (30.6%) preferred THA and 25 (40.3%) had no preference ( p = 0.844). When asked what they would choose if they could only have 1 surgery again, 41 (66.1%, p < 0.001) picked HRA. Overall satisfaction ( p = 0.504), willingness to live with their HRA versus THA for the rest of their life ( p = 0.295) and recommendation to others ( p = 0.097) were similar. Conclusions: Although HRA is associated with risks related to metal-on-metal bearings, it showed greater increase in patient-reported outcomes and a small subjective preference amongst patients who have undergone both conventional and resurfacing arthroplasty.

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Outcomes after the conversion of metal-on-metal hip resurfacing arthroplasty to ceramic-on-ceramic total hip arthroplasty: A retrospective observational study with a mean 10-year follow-up

10.21203/rs.2.21421/v1 ◽

2020 ◽

Author(s):

Weiguang Yu ◽

Mao Shuai ◽

Jinluan Lin ◽

Baomin Chen ◽

Mingdong Zhao ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Metal Ion ◽

Hip Resurfacing ◽

Hip Resurfacing Arthroplasty ◽

Resurfacing Arthroplasty ◽

Metal On Metal ◽

The Mean ◽

Ceramic On Ceramic

Abstract Background The purpose of this retrospective study was to assess clinical outcomes following failed metal-on-metal hip resurfacing arthroplasty (MoM-HRA) revised using ceramic-on-ceramic total hip arthroplasty (CoC-THA) via the direct anterior approach (DAA).Methods Data involving 112 patients (112 hips) with failed primary MoM-HRA that was revised using CoC-THA via the DAA during 2006 - 2018 were retrospectively analysed. The mean age was 54.6 years (45–63 years). Frequent surgical indications for conversion were aseptic loosening and femoral neck fracture. The primary endpoint was the Postel-Merle d’Aubigne functional score (PMA). Secondary endpoints were the major orthopaedic complication rate and serum metal ion levels (chromium and cobalt).Results The mean follow-up time was 10 years (range, 4 - 13 years). The mean PMA improved from 9 (4-14) to 16 (13-18) (p = 0.001). Six patients had undergone a re-revision intervention. Fourteen incidents of aseptic loosening and four periprosthetic fractures were observed. A consistent decline in mean serum metal ion levels was detected [chromium decreased from 36.6 μg/L (12.5-76.5 μg/L) prior to conversion to 2.6 μg/L (0.1-13.5 μg/L) at final follow-up (p = 0.001), cobalt decreased from 37.5 μg/L (6.7-93.2 μg/L) to 2.2 μg/L (1.2-18.4 μg/L) (p =0.003)].Conclusion Failed primary MoM-HRA converted to CoC-THA using the DAA yielded acceptable clinical outcomes.

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Hip resurfacing arthroplasty versus large-diameter head metal-on-metal total hip arthroplasty: comparison of three Designs from the Finnish Arthroplasty Register

Scandinavian Journal of Surgery ◽

10.1177/1457496913495345 ◽

2013 ◽

Vol 103 (1) ◽

pp. 54-59 ◽

Cited By ~ 10

Author(s):

M. Junnila ◽

I. Kostensalo ◽

P. Virolainen ◽

V. Remes ◽

M. Matilainen ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Large Diameter ◽

Hip Resurfacing ◽

Arthroplasty Register ◽

Hip Resurfacing Arthroplasty ◽

Total Hip ◽

Resurfacing Arthroplasty ◽

Metal On Metal

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Large Diameter Metal on Metal Articulations. Comparison of Total Hip Arthroplasty and Hip Resurfacing Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2012.07.032 ◽

2013 ◽

Vol 28 (4) ◽

pp. 650-653 ◽

Cited By ~ 21

Author(s):

Christopher M. Jack ◽

William L. Walter ◽

Andrew J. Shimmin ◽

Kara Cashman ◽

Richard N. de Steiger

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Large Diameter ◽

Hip Resurfacing ◽

Hip Resurfacing Arthroplasty ◽

Total Hip ◽

Resurfacing Arthroplasty ◽

Metal On Metal

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Intraoperative Complications and Mid-Term Follow-Up of Large-Diameter Head Metal-on-Metal Total Hip Arthroplasty and Hip Resurfacing Arthroplasty

Scandinavian Journal of Surgery ◽

10.1177/1457496917748220 ◽

2018 ◽

Vol 107 (2) ◽

pp. 180-186

Author(s):

S. S. A. Miettinen ◽

T. J. Mäkinen ◽

K. Mäkelä ◽

H. Huhtala ◽

J. S. Kettunen ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Intraoperative Complications ◽

Large Diameter ◽

Hip Resurfacing ◽

Hip Resurfacing Arthroplasty ◽

Total Hip ◽

Resurfacing Arthroplasty ◽

Hip Arthroplasties

Background and Aims: Large-diameter head total hip arthroplasty and hip resurfacing arthroplasty were popular in Finland from 2000 to 2012 for the treatment of hip osteoarthritis. The aim of this retrospective study was to investigate the mid-term survival of large-diameter head total hip arthroplasty patients operated on in three university hospitals and to compare these results to the survival of hip resurfacing arthroplasty patients. Material and Methods: A total of 3860 hip arthroplasties (3029 large-diameter head total hip arthroplasties in 2734 patients and 831 hip resurfacing arthroplasties in 757 patients) were operated on between January 2004 and December 2009. The mean follow-up was 4.3 years (range: 0.3–8.0 years) in the total hip arthroplasty group and 5.1 years (range: 1.7–7.9 years) in the hip resurfacing arthroplasty group. Cox multiple regression model and Kaplan–Meier survival analysis were used to study the survival of the total hip arthroplasties and the hip resurfacing arthroplasties. Intraoperative complications and reasons for revisions were also evaluated. Results: In Cox regression analysis, the hazard ratio for revision of hip resurfacing arthroplasty was 1.5 compared with large-diameter head total hip arthroplasty (95% confidence interval: 1.0–2.2) ( p = 0.029). The cumulative Kaplan–Meier survival rate was 90.7% at 7.7 years for the large-diameter head total hip arthroplasty (95% confidence interval: 86.8–94.6) and 92.2% at 7.6 years for hip resurfacing arthroplasty (95% confidence interval: 89.9–94.6). There were a total of 166/3029 (5.5%) intraoperative complications in the large-diameter head total hip arthroplasty group and 20/831 (2.4%) in the hip resurfacing arthroplasty group ( p = 0.001). Revision for any reason was performed on 137/3029 (4.5%) of the arthroplasties in the large-diameter head total hip arthroplasty group and 52/831 (6.3%) in the hip resurfacing arthroplasty group ( p = 0.04). Conclusion: The mid-term survival of both of these devices was poor, and revisions due to adverse reactions to metal debris will most likely rise at longer follow-up. There were more intraoperative complications in the large-diameter head total hip arthroplasty group than in the hip resurfacing arthroplasty group.

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