Minimum 15-year results of metasul 28-mm metal-on-metal total hip arthroplasty in patients younger than 50 years of age

Abstract Background Some propitious mid- and long-term studies had been reported for MoM bearings; however, most studies have addressed specific patient groups rather than younger, active patients, who probably represent the most suitable population for investigations on wear and osteolysis. The purpose of this study to evaluate the long-term results of second-generation metal-on-metal cementless total hip arthroplasty (THA) in patients aged <50 years. Methods From December 1997 to January 2004, primary THA using a metal-on-metal bearing cementless implant was performed in 63 patients (72 hips) aged <50 years. The mean follow-up duration was 18.6 (range, 15.9–22.1) years, and the mean age at initial operation was 39 (range, 22–49) years. Clinical results, complications, survivorship, osteolysis, and aseptic loosening were evaluated. Results The mean Harris hip score and Western Ontario and McMaster Universities Arthritis Index scores were improved from 57.8 (range, 28–69) points and 73.4 (range, 63–94) points preoperatively to 91.7 (range, 80–100) points and 25.5 points (range, 17–38) points, respectively, at the last follow-up. Osteolysis lesions were found in 12 hips (acetabulum, 6 and femur, 6). The notching occurred on the femoral stem neck occurred in 12 hips. The mean serum cobalt and chromium concentrations were 2.3 (range, 0.2–10.6) μg/L and 1.7 (range, 0.4–8.1) μg/L, respectively, at a mean follow-up of 12.7 years in 32 patients (50.1%). The Kaplan-Meier survivorship curve analysis with revision for any reason as the endpoint revealed that 93.1% survived at 18.6 years’ follow-up. Conclusions Second-generation metal-on-metal cementless THA was found to produce satisfactory clinical and radiographic results with a low revision rate for osteolysis and aseptic loosening in patients aged less than 50 years.

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Long-Term Results of Total Hip Arthroplasty with RM Classic Cups

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2019-25-3-25-33 ◽

2019 ◽

Vol 25 (3) ◽

pp. 25-33

Author(s):

V. V. Danilyak ◽

V. V. Klyuchevsky ◽

M. A. Molodov ◽

E. V. Goryunov ◽

K. V. Marchenkova

Keyword(s):

Total Hip Arthroplasty ◽

Aseptic Loosening ◽

Hip Arthroplasty ◽

Polyethylene Wear ◽

Long Term Results ◽

Harris Hip Score ◽

Pelvic Bone ◽

Total Hip

Relevance. The RM Classic monoblock titanium-coated polyethylene cup is widely used in the total hip arthroplasty. However, so far in Russia there has been no analysis of follow-up over 10 years for a limited number of patients in a single hospital. The aim of the study was to evaluate the long-term outcomes of total hip replacement with RM Classic acetabular component. Materials and Methods. The outcomes of 328 total hip arthroplasties (289 patients operated in the period from 1997 to 2007) with RM Classic cups were evaluated in a monocentral retrospective clinical study. The average follow-up period was 14.4 years. Revision procedure due to aseptic loosening, polyethylene wear or osteolysis was considered as the end point of the study. Results. 9 revisions during the short and medium follow-up periods (up to 10 years) were associated with malpositioning of RM Classic components and errors in surgical technique. The indications for later revision THA (19 cases) were polyethylene wear and aseptic loosening. Only in one case they were combined with pelvic bone osteolysis with the formation of III a defect according to W.G. Paprosky classification. Within 15 years the Kaplan-Meier survivorship of RM Classic cup was 92.5%. There was a statistically significant difference of the survival curves in the ceramic-on-poly against metal-on-poly bearings: 94.9% and 79.4%, respectively. The average Harris Hip Score was 88.6. Conclusion. RM Classic uncemented monoblock cup has proven its high efficiency and survival in 15 years follow-up period and over.

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LONG-TERM RESULTS OF ENHANCED TAPERED STEM VerSys ET USE IN PRIMARY TOTAL HIP ARTHROPLASTY

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2010-0-3-7-15 ◽

2010 ◽

Vol 16 (3) ◽

pp. 7-15

Author(s):

R. M. Tikhilov ◽

V. M. Shapovalov ◽

I. I. Artyukh ◽

V. A. Shubnyakov

Keyword(s):

Total Hip Arthroplasty ◽

Aseptic Loosening ◽

Hip Arthroplasty ◽

High Efficiency ◽

Long Term Results ◽

Harris Hip Score ◽

Total Hip ◽

The Mean ◽

Primary Total Hip Arthroplasty

The authors reported the outcome at a minimum of five years of 130 consecutive arthroplasties of VerSys ET (Zimmer) in 111 patients. The procedures were performed between 2001 and 2004. In 129 cases (99.2%) Trilogy cup (Zimmer) was used in one case - Muller's acetabular cage (Mathys). The mean age of patients was 49.5 (SD 11.5) (23 to 73), male 76 (58.5%), female - 54 (41.5%), overweight patients 109 (83.8%). Majority of patients had activity in Charnley class A. The most frequent was femur Dorr type A (27,0%) and Dorr type В (66,1%). The mean follow-up was 76 months (60 to 96). The outcomes assessed in 103 patients (120 hips) (92.3%). Outcomes of ten cases were not determined. The mean Harris Hip score improves from 35.1 (SD 8.3) preoperatively to 94.3 (SD 8.5) post-operatively. Kaplan-Meier analysis with revision of the stem as the end-point demonstrated 97,7% survival in term 60 to 96 months, for aseptic loosening - 99,2%. Subsidence of the implants in 61 (50.8%) patients was fixed at a mean follow-up 18.3 (SD3.7) months after surgery and did not progress further. After surgery stem position was neutral 91(75.8%) patients, varus - 14 (12.1%) and valgus - 14 (12.1%). Complications were observed in 8 (6.7%) cases: among them - periprosthetic fractures 6 (5.0%), stem aseptic loosening - 1 (0.8%), recurrent dislocation - 1 (0.8%). Four patients undergone revision surgery We consider the high efficiency of VerSys ET stem use for primary total hip arthroplasty.

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3rd generation ceramic-on-ceramic cementless total hip arthroplasty: a minimum 10-year follow-up study

Hip International ◽

10.1177/1120700018768617 ◽

2018 ◽

Vol 28 (2) ◽

pp. 133-138 ◽

Cited By ~ 3

Author(s):

Yeong J. Lau ◽

Shashank Sarmah ◽

Johan D. Witt

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Senior Author ◽

Long Term Results ◽

Abduction Angle ◽

Wear Properties ◽

Total Hip ◽

Ceramic On Ceramic

Introduction: 3rd generation ceramic bearings were introduced in total hip arthroplasty (THA) with the potential to have better mechanical strength and wear properties than their predecessors. At present, there are few studies looking at the long-term results of this latest generation of ceramic bearings. The purpose of our study was to investigate the long-term clinical and radiographic results of 3rd generation ceramic-on-ceramic THA and the incidence of ceramic specific complications such as squeaking and bearing surface fracture. Methods: The database of the senior author (J.D.W.) was reviewed. A total of 126 hip replacements performed in 108 patients (average age 39.6 years) with an average follow-up of 12.1 years (10-16 years) was identified. Clinical notes and plain radiographs were reviewed. To measure function, patients were contacted and an Oxford Hip Questionnaire was completed. Patients were also directly questioned about the presence of squeaking or any other sounds from the hip. Radiographs were evaluated for signs of wear, osteolysis, loosening and heterotopic ossification. The abduction angle of the acetabular component was measured. Results: The average Oxford Hip Score was 39.8 out of 48. Survivorship at 10 years was 94.6% (95% CI) with revision for any cause as the endpoint. There was 1 femoral head fracture, no osteolysis, no squeaking and no detectable wear. Conclusions: The good clinical and radiographic results for this series of patients are similar to other recent long-term studies looking at 3rd generation ceramic-on-ceramic THA. The results compare favourably with other bearing surfaces. The lack of osteolysis associated with this articulation is encouraging and may also make it a good choice for younger patients requiring total hip replacement.

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Mid- to long-term outcomes of cementless modular, fluted, tapered stem for massive femoral bone loss in revision total hip arthroplasty

10.21203/rs.3.rs-37004/v1 ◽

2020 ◽

Author(s):

Kai Zheng ◽

Ning Li ◽

Weicheng Zhang ◽

Jun Zhou ◽

Yaozeng Xu ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Bone Loss ◽

Hip Arthroplasty ◽

Long Term Results ◽

Revision Total Hip Arthroplasty ◽

Femoral Bone ◽

Total Hip ◽

Tapered Stem

Abstract Background: Revision total hip arthroplasty is frequently accompanied by bone loss. The purpose of this study is to evaluate mid- to long-term results of revision total hip arthroplasty for massive femoral bone loss using cementless modular, fluted, tapered stems.Methods: During the period of 2007 to 2015 at a single hospital, 34 hips (33 patients) underwent primary revision surgery with cementless modular, fluted, tapered stems due to massive bone loss, and patients with prosthetic joint infection (PJI) or tumours were excluded. The hips were revised with the LINK MP (Waldemar Link, Hamburg, Germany) prosthesis. Bone loss was categorized by the Paprosky classification for prosthesis loosening and Vancouver classification for peri-prosthetic fracture. All revision bearing surfaces were ceramic-on-ceramic (CoC). Clinical outcomes, radiographic outcomes and survivorship were evaluated.Results: The mean follow-up was 9.1±2.5 years (range, 5-13 years). The Harris hip score was 43.6±11.5 preoperatively and maintained at 86.5±6.6 at the time of latest follow-up (p<0. 05). The X-ray showed bone ingrowth fixation in 30 hips (88%), fibrous stable fixation in 3 hips (9%) and instability in 1 hip (3%). The average stem subsidence was 3.9±2.2 mm (range, 1 to 10 mm). The survivorship of prostheses with re-revision for any reason was 95% (95% CI, 12.0 to 13.0) at the 10-year follow-up. Three (9%) re-revisions were needed, including 1 for aseptic loosening, 1 for dislocation and 1 for infection.Conclusions: The mid- to long-term results of revision total hip arthroplasty with the cementless modular, fluted, tapered stem (LINK MP stem) are encouraging for massive femoral bone loss.

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A Mid- to Long-Term Follow-Up Experience with a Specific Metal-on-Metal Total Hip Arthroplasty Design

Joints ◽

10.1055/s-0040-1710388 ◽

2020 ◽

Author(s):

Christian Carulli ◽

Giacomo Sani ◽

Fabrizio Matassi ◽

Roberto Civinini ◽

Massimo Innocenti

Keyword(s):

Total Hip Arthroplasty ◽

Acetabular Component ◽

Hip Arthroplasty ◽

Harris Hip Score ◽

Systemic Complications ◽

Total Hip ◽

Metal On Metal ◽

Long Term Follow Up

Abstract Purrpose Metal-on-metal (MoM) total hip arthroplasty (THA) has been a subject of recent discussion and concern due to the early failures caused by local and systemic adverse reactions related to specific designs. The aim of this study is to analyze the outcomes and survival rates of a single brand of MoM implants implanted in a consecutive series of patients at a single institution. Methods Between 2007 and 2012, 116 (118 hips) patients were evaluated at a mean follow-up of 6.6 years after primary THA. The diagnosis leading to surgery was osteoarthritis (80 patients) and proximal femoral fracture (36 patients). A single design of THA was implanted. All patients were evaluated before surgery and postoperatively at 1, 3, 6, and 12 months by clinical scores and radiographic studies. The data analysis was made using Student's t-test. Results The minimum follow-up was of 4 years, with a mean follow-up of 6.6 years. Two aseptic loosenings of the acetabular component were recorded (one per group), which were not associated with local or systemic complications related to metal ion release. Both were revised by an isolated acetabular cup substitution with metal-on-polyethylene couplings. Nonprogressive radiolucency lines < 2 mm in zone 2 were observed in other six patients around the acetabular component without clinical manifestation (four in the arthritis group and two in the fracture group). Postoperative Harris Hip Score and SF-36 (36-Item Short Form Survey) score improved in both groups. Conclusion Despite several MoM implants showing early complications and failures, a specific MoM design may be associated with good clinical results at a mid- to long-term follow-up. Level of Evidence This is a therapeutic case series, Level 4 study.

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Eleven-Year follow-up of Second-Generation Metal-on-Metal Total Hip Arthroplasty

Journal of Orthopaedic Surgery ◽

10.1177/230949901001800104 ◽

2010 ◽

Vol 18 (1) ◽

pp. 15-21 ◽

Cited By ~ 3

Author(s):

Myung-Sik Park ◽

Woo-Chul Chung ◽

Sun-Jung Yoon ◽

Hong-Man Cho ◽

Suk-Hyun Kwon

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Second Generation ◽

Total Hip ◽

Metal On Metal

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Mid-To-Long Term follow-up of Transcend Metal-On-Metal versus Interseal Metal-On-Polyethylene Bearings in Total Hip Arthroplasty

Hip International ◽

10.5301/hip.2011.8705 ◽

2011 ◽

Vol 21 (5) ◽

pp. 571-576 ◽

Cited By ~ 3

Author(s):

James P. Yoon ◽

Michel J. Le Duff ◽

Karren M. Takamura ◽

Stephen Hodge ◽

Harlan C. Amstutz

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Total Hip ◽

Metal On Metal ◽

Long Term Follow Up

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Long-term outcomes of patients undergoing uncemented or cemented arthroplasty revision following metal-on-metal total hip arthroplasty failure: A retrospective observational study with a mean follow-up of 7 years

10.21203/rs.2.20209/v1 ◽

2020 ◽

Author(s):

Wenli Chen ◽

Mao Shuai ◽

Jinluan Lin ◽

Baomin Chen ◽

Mingdong Zhao ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Functional Outcomes ◽

High Rate ◽

Harris Hip Score ◽

Long Term Outcomes ◽

Total Hip ◽

Metal On Metal

Abstract Background A high rate of complications due to metal-on-metal (MoM) revisions has been relatively commonly documented. The purpose of this retrospective study was to compare the long-term outcomes of patients who had undergone uncemented or cemented total hip arthroplasty (THA) revision for prior primary MoM THA failure.Methods Data from 234 patients (234 hips) who underwent uncemented or cemented THA (UTHA or CTHA) for prior primary MoM THA failure during 2007 - 2018 were retrospectively analysed. Follow-up occurred 3 months, 6 months, 1 year, 2 years, and then every 1 year after conversion. The mean follow-up time was 84.15 months (range, 67 - 101 months). The primary endpoint was the modified Harris Hip Score (HHS). The secondary endpoint was the major orthopaedic complication rate.Results The HHS demonstrated statistically greater differences in the CTHA group than in the UTHA group 12 months after conversion. From the 12th month after conversion to the final follow-up, CTHA yielded better functional outcomes than UTHA. There were significant differences in the rates of re-revision, aseptic loosening, and periprosthetic fracture between the groups (10.3% for UTHA vs 2.5% for CTHA, p = 0.015; 16.3% for UTHA vs 5.9% for CTHA, p = 0.011; and 12.0% for UTHA vs 4.2% for CTHA, p = 0.045, respectively).Conclusion In the setting of revision for primary MoM THA failure, we found definite evidence of the superiority of CTHA over UTHA in terms of improving functional outcomes and decreasing the major orthopaedic complication rate.

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Mid- to Long-Term Survivorship Analysis of a Second-Generation Highly Cross-Linked Polyethylene in Total Hip Arthroplasty

The Journal of Hip Surgery ◽

10.1055/s-0040-1714292 ◽

2020 ◽

Vol 4 (03) ◽

pp. 124-128

Author(s):

David Yeroushalmi ◽

Katherine A. Lygrisse ◽

Mohamad Sharan ◽

Nolan A. Maher ◽

Joseph D. Zuckerman ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Wear Rate ◽

Hip Arthroplasty ◽

Second Generation ◽

Abduction Angle ◽

Linear Wear ◽

Wear Rates ◽

Total Hip

AbstractThe emergence of highly cross-linked polyethylene (HCLPE) has drastically improved survivorship of implants used in total hip arthroplasty (THA), as demonstrated by midterm outcomes. However, there is limited data evaluating long-term outcomes and wear rates of these liners. Therefore, the aim of this study is to evaluate the longest-to-date follow-up of a specific second-generation HCLPE liner, the progression of wear rate, and its relation to acetabular cup positioning. A retrospective study was conducted on patients who underwent THA between January 2001 and December 2005 using a specific second-generation HCLPE liner. Annual liner wear rate (mm/year) was calculated in this group as well as acetabular positioning through abduction angle (degrees). Failures and reason for failures such as periprosthetic fracture, dislocation, and osteolysis were noted when applicable. Forty hips of 35 patients were included in this study with a clinical and radiographic follow-up of 13.4 ± 2.2 years (range: 10.0–16.7 years). Linear and volumetric wear rates were calculated to be 0.037 ± 0.020 mm/year and 22.94 ± 12.07 mm3/year, respectively. No radiographic femoral or acetabular osteolysis was observed in any of the cases. One patient required revision due to complications unrelated to the liner. No significant relationship could be established for acetabular component abduction angle and linear wear rate (p = 0.690, Spearman's rho = 0.03). Our study demonstrates comparable liner wear rates to that of other second-generation HCLPE liners in long-term follow-up. The XLPE liner continues to exhibit minimal progression of linear wear when compared with previous midterm studies and maintains a low rate of postoperative complications requiring revision THA surgery. Further studies are warranted to assess long-term wear and survivorship between this specific liner and comparable HCLPE models.

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