Minimum 5-Year Follow-up of Articular Surface Replacement Acetabular Components Used in Total Hip Arthroplasty

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.

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Excellent Short-term Results of Articular Surface Replacement XL Total Hip Arthroplasty

Journal of Orthopedics & Bone Disorders ◽

10.23880/jobd-16000101 ◽

2017 ◽

Vol 1 (1) ◽

Author(s):

Jun-Ying Sun

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Articular Surface ◽

Surface Replacement ◽

Short Term ◽

Total Hip ◽

Articular Surface Replacement

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Revision of Articular Surface Replacement (ASR) Total Hip Arthroplasty: Correlation of Perioperative Data and Early Post-Revision Outcome Results

The Journal of Arthroplasty ◽

10.1016/j.arth.2015.04.010 ◽

2015 ◽

Vol 30 (9) ◽

pp. 1607-1617 ◽

Cited By ~ 6

Author(s):

Johannes Cip ◽

Christian Bach ◽

Mark Widemschek ◽

Matthias Luegmair ◽

Arno Martin

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Articular Surface ◽

Surface Replacement ◽

Total Hip ◽

Articular Surface Replacement

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Early Failure of Articular Surface Replacement XL Total Hip Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2011.03.027 ◽

2011 ◽

Vol 26 (6) ◽

pp. 14-18 ◽

Cited By ~ 33

Author(s):

Garen D. Steele ◽

Thomas K. Fehring ◽

Susan M. Odum ◽

Anne C. Dennos ◽

Matthew C. Nadaud

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Articular Surface ◽

Surface Replacement ◽

Early Failure ◽

Total Hip ◽

Articular Surface Replacement

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Radiolucent lines do not affect the longevity of highly cross-linked polyethylene cemented components in total hip arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.103b10.bjj-2020-2298.r2 ◽

2021 ◽

Vol 103-B (10) ◽

pp. 1604-1610

Author(s):

Yusuke Takaoka ◽

Koji Goto ◽

Jiro Tamura ◽

Yaichiro Okuzu ◽

Toshiyuki Kawai ◽

...

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Acetabular Component ◽

Hip Arthroplasty ◽

Long Term Outcome ◽

Total Hip ◽

Radiolucent Lines ◽

Kaplan Meier ◽

Acetabular Components

Aims We aimed to evaluate the long-term outcome of highly cross-linked polyethylene (HXLPE) cemented acetabular components and assess whether any radiolucent lines (RLLs) which arose were progressive. Methods We retrospectively reviewed 170 patients who underwent 187 total hip arthroplasties at two hospitals with a minimum follow-up of ten years. All interventions were performed using the same combination of HXLPE cemented acetabular components with femoral stems made of titanium alloy. Kaplan-Meier survival analysis was performed for the primary endpoint of acetabular component revision surgery for any reason and secondary endpoint of the appearance of RLLs. RLLs that had appeared once were observed over time. We statistically assessed potential relationships between RLLs and a number of factors, including the technique of femoral head autografting and the Japanese Orthopaedic Association score. Results The mean follow-up period was 13.0 years (10.0 to 16.3). Femoral head autografting was performed on 135 hips (72.2%). One acetabular component was retrieved because of deep infection. No revision was performed for the aseptic acetabular loosening. The Kaplan-Meier survival curve for the primary and secondary endpoints were 98.2% (95% confidence interval (CI) 88.6% to 99.8%) and 79.3% (95% CI 72.8% to 84.6%), respectively. RLLs were detected in 38 hips (21.2%), at a mean of 1.7 years (1 month to 6 years) postoperatively. None of the RLLs were progressive, and the presence of RLLs did not show a significant association with the survival and clinical score. RLLs were more frequently observed in hips without femoral head autografts than in those with autografts. Conclusion The use of HXLPE cemented acetabular components in total hip arthroplasty demonstrated excellent clinical outcomes after ten years, and no RLLs were progressive, and their presence did not affect the outcome. Femoral head autografting did not negatively impact the acetabular component survival or the appearance of RLLs. Cite this article: Bone Joint J 2021;103-B(10):1604–1610.

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Intrapelvic component retrieval via anterior inferior iliac spine osteotomy in revision total hip arthroplasty

Hip International ◽

10.1177/1120700018812128 ◽

2018 ◽

Vol 29 (2) ◽

pp. 222-225

Author(s):

William Stickney ◽

Richard S Yoon ◽

Jay N Patel ◽

David S Klein ◽

George J Haiduekwych ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Anterior Inferior Iliac Spine ◽

Single Exposure ◽

Component Retrieval ◽

Case Presentation ◽

Total Hip ◽

Revision Reconstruction ◽

Acetabular Components

Introduction: In the revision setting, intrapelvic acetabular components provide a unique set of challenges for the treating surgeon. Retrieval is complicated by complex anatomical relationships within the pelvis and historically, surgeons have used multiple approaches to safely retrieve the cup. Case presentation: We present the case of a 53-year-old female with intrapelvic migration of the acetabular components of her total hip arthroplasty. Patient was treated through a novel, single incision approach with utilisation of an anterior inferior iliac spine (AIIS) osteotomy. Results: An AIIS osteotomy allows for improved visualisation within the pelvis and safe retrieval through a single exposure without compromising the ability to perform definitive, revision reconstruction. At 1-year follow-up, the patient has had no complications related to infection or failure of the implants. Ambulation is performed with the aid of a cane in the community with mild, occasional pain.

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