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BMC Musculoskeletal Disorders

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Open Access 01-12-2020 | Hip-TEP | Research article

Favourable clinical outcomes following cemented arthroplasty after metal-on-metal total hip replacement: a retrospective study with a mean follow-up of 10 years

Authors: Weiguang Yu, Meiji Chen, Xianshang Zeng, Mingdong Zhao, Xinchao Zhang, Junxing Ye, Jintao Zhuang, Guowei Han

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

Abstract

Background

Given the unexpected high rate of failure following metal-on-metal total hip replacement (MoM-THR), it is expected that more MoM-THR patients will experience revision. The long-term outcomes regarding the primary MoM-THR revised to cemented THR (CTHR) remain controversial. The purpose of this retrospective review was to evaluate the long-term outcomes of patients who underwent conversion from MoM-THR to CTHR.

Methods

A total of 220 patients (220 hips) who underwent a conversion of primary MoM-THR to CTHR from March 2006 to October 2016 were retrospectively reviewed. The primary outcomes were the functional outcomes assessed using the Harris hip scores (HHS) and major radiographic outcomes. Follow-ups occurred at 3 months, 6 months, 1 year, 2 years, and then every two years after revision.

Results

Mean follow-up was 10.1 years (5–13 years). Distinct improvements were detected in the mean HHS between the preoperative and last follow-up analysis (62.35[±8.49] vs. 84.70[±14.68], respectively, p < 0.001). The key orthopaedic complication rate was 18.2% (27/148). Seven (4.7%) cases experienced a CTHR failure at a mean of 3.4 (±1.2) years after revision MoM-THR, mostly attributed to recurrent dislocation.

Conclusion

CTHR might yield an acceptable functional score and a low rate of the key orthopaedic complications.

Matharu GS, Pandit HG, Murray DW. Poor survivorship and frequent complications at a median of 10 years after metal-on-metal hip resurfacing revision. Clin Orthop Relat Res. 2017;475(2):304–14. https://doi.org/10.1007/s11999-016-4882-4.CrossRefPubMed

Mohaddes M, Naucler E, Karrholm J, Malchau H, Odin D, Rolfson O. Implant survival and patient-reported outcome following total hip arthroplasty in patients 30 years or younger: a matched cohort study of 1,008 patients in the Swedish hip Arthroplasty register. Acta Orthop. 2019;90(3):249–52. https://doi.org/10.1080/17453674.2019.1599776.CrossRefPubMedPubMedCentral

Jennings JM, White S, Martin JR, Yang CC, Miner TM, Dennis DA. Revisions of modular metal-on-metal THA have a high risk of early complications. Clin Orthop Relat Res. 2019;477(2):344–50. https://doi.org/10.1097/corr.0000000000000363.CrossRefPubMed

Matharu GS, Berryman F, Dunlop DJ, Revell MP, Judge A, Murray DW, Pandit HG. No threshold exists for recommending revision surgery in metal-on-metal hip Arthroplasty patients with adverse reactions to metal debris: a retrospective cohort study of 346 revisions. J Arthroplast. 2019;34(7):1483–91. https://doi.org/10.1016/j.arth.2019.03.022.CrossRef

Lehtovirta L, Reito A, Lainiala O, Parkkinen J, Hothi H, Henckel J, Hart A, Eskelinen A. Host-specific factors affect the pathogenesis of adverse reaction to metal debris. BMC Musculoskelet Disord. 2019;20. https://doi.org/10.1186/s12891-019-2578-0.

Wegrzyn J, Pibarot V, Jacquel A, Carret JP, Bejui-Hugues J, Guyen O. Acetabular reconstruction using a Kerboull cross-plate, structural allograft and cemented dual-mobility cup in revision THA at a minimum 5-year follow-up. J Arthroplast. 2014;29(2):432–7. https://doi.org/10.1016/j.arth.2013.05.030.CrossRef

Bonner B, Arauz P, Klemt C, Kwon YM. Outcome of re-revision surgery for adverse local tissue reaction in metal-on-polyethylene and metal-on-metal Total hip Arthroplasty. J Arthroplast. 2020;35(6):S284–S8. https://doi.org/10.1016/j.arth.2020.02.006.CrossRef

Meyer H, Mueller T, Goldau G, Chamaon K, Ruetschi M, Lohmann CH. Corrosion at the cone/taper Interface leads to failure of large-diameter metal-on-metal Total hip Arthroplasties. Clin Orthop Relat Res. 2012;470(11):3101–8. https://doi.org/10.1007/s11999-012-2502-5.CrossRefPubMedPubMedCentral

Borton ZM, Mumith AS, Nicholls AJ, Pearce AR, Briant-Evans TW, Griffiths JT. The outcome of revision surgery for failed metal-on-metal Total hip Arthroplasty. J Arthroplast. 2019;34(8):1749–54. https://doi.org/10.1016/j.arth.2019.03.067.CrossRef

10.

Crawford DA, Adams JB, Morris MJ, Berend KR, Lombardi AV. Revision of failed metal-on-metal Total hip Arthroplasty: midterm outcomes of 203 consecutive cases. J Arthroplast. 2019;34(8):1755–60. https://doi.org/10.1016/j.arth.2019.04.019.CrossRef

11.

Liu TJ, Hua XX, Yu WG, Lin JL, Zhao MD, Liu J, Zeng XS. Long-term follow-up outcomes for patients undergoing primary total hip arthroplasty with uncemented versus cemented femoral components: a retrospective observational study with a 5-year minimum follow-up. J Orthop Surg Res. 2019;14(1). https://doi.org/10.1186/s13018-019-1415-3.

12.

Amstutz HC, Le Duff MJ, Campbell PA, Dorey FJ. The effects of technique changes on aseptic loosening of the femoral component in hip resurfacing. Results of 600 conserve plus with a 3 to 9 year follow-up. J Arthroplast. 2007;22(4):481–9. https://doi.org/10.1016/j.arth.2006.08.001.CrossRef

13.

Rokkum M, Brandt M, Bye K, Hetland KR, Waage S, Reigstad A. Polyethylene wear, osteolysis and acetabular loosening with an HA-coated hip prosthesis - a follow-up of 94 consecutive arthroplasties. J Bone Joint Surg Br. 1999;81B(4):582–9. https://doi.org/10.1302/0301-620x.81b4.8715.CrossRef

14.

Smith AJ, Dieppe P, Vernon K, Porter M, Blom AW. Natl joint registry England W. failure rates of stemmed metal-on-metal hip replacements: analysis of data from the National Joint Registry of England and Wales. Lancet. 2012;379(9822):1199–204. https://doi.org/10.1016/s0140-6736(12)60353-5.CrossRefPubMed

15.

Burd TA, Lowry KJ, Anglen JO. Indomethacin compared with localized irradiation for the prevention of heterotopic ossification following surgical treatment of acetabular fractures. J Bone Joint Surg Am. 2001;83A(12):1783–8. https://doi.org/10.2106/00004623-200112000-00003.CrossRef

16.

Unger AS, Lewis RJ, Gruen T. Evaluation of a porous tantalum uncemented acetabular cup in revision total hip arthroplasty - clinical and radiological results of 60 hips. J Arthroplast. 2005;20(8):1002–9. https://doi.org/10.1016/j.arth.2005.01.023.CrossRef

17.

Korovessis P, Petsinis G, Repanti M, Repantis T. Metallosis after contemporary metal-on-metal total hip arthroplasty - five to nine-year follow-up. J Bone Joint Surg Am. 2006;88A(6):1183–91. https://doi.org/10.2106/jbjs.D.02916.CrossRef

18.

Waldstein W, Koller U, Springer B, Kolbitsch P, Brodner W, Windhager R, Lass R. Serum cobalt concentrations remain at low levels at a minimum of 20 years following metal-on-metal total hip arthroplasty. Bone Joint Res. 2020;9(3):146–51. https://doi.org/10.1302/2046-3758.93.Bjr-2019-0218.R1.CrossRefPubMedPubMedCentral

19.

Smith AJ, Dieppe P, Howard PW, Blom AW. Natl joint registry England W. failure rates of metal-on-metal hip resurfacings: analysis of data from the National Joint Registry for England and Wales. Lancet. 2012;380(9855):1759–66. https://doi.org/10.1016/s0140-6736(12)60989-1.CrossRefPubMed

20.

Levine BR, Hsu AR, Skipor AK, Hallab NJ, Paprosky WG, Galante JO, Jacobs JJ. Ten-year outcome of serum metal ion levels after primary Total hip Arthroplasty a concise follow-up of a previous report. J Bone Joint Surg Am. 2013;95A(6):512–8. https://doi.org/10.2106/jbjs.L.00471.CrossRef

21.

Ko LJM, Pollag KE, Yoo JY, Sharkey PF. Serum metal ion levels following Total hip Arthroplasty with modular dual mobility components. J Arthroplast. 2016;31(1):186–9. https://doi.org/10.1016/j.arth.2015.07.035.CrossRef

22.

Bouveau V, Haen TX, Poupon J, Nich C. Outcomes after revision of metal on metal hip resurfacing to total arthroplasty using the direct anterior approach. Int Orthop. 2018;42(11):2543–8. https://doi.org/10.1007/s00264-018-3858-2.CrossRefPubMed

23.

Law JI, Crawford DA, Adams JB, Lombardi AV. Metal-on-metal Total hip revisions: pearls and pitfalls. J Arthroplast. 2020;35(6):S68–72. https://doi.org/10.1016/j.arth.2020.01.011.CrossRef

24.

Lainiala O, Reito A, Nieminen J, Eskelinen A. Complications and re-revisions after revisions of 528 metal-on-metal hips because of adverse reaction to metal debris. Acta Orthop. 2020;91(4):365–71. https://doi.org/10.1080/17453674.2020.1748351.CrossRefPubMed

25.

Higgs GB, Hanzlik JA, MacDonald DW, Gilbert JL, Rimnac CM, Kurtz SM. Implant res Ctr writing C. is increased modularity associated with increased fretting and corrosion damage in metal-on-metal Total hip Arthroplasty devices? A retrieval study. J Arthroplast. 2013;28(8):2–6. https://doi.org/10.1016/j.arth.2013.05.040.CrossRef

26.

Chougle A, Hemmady MV, Hodgkinson JP. Severity of hip dysplasia and loosening of the socket in cemented total hip replacement - a long-term follow-up. J Bone Joint Surg Br. 2005;87B(1):16–20.CrossRef

27.

Carlson BC, Bryan AJ, Carrillo-Villamizar NT, Sierra RJ. The utility of metal ion trends in predicting revision in metal-on-metal Total hip Arthroplasty. J Arthroplast. 2017;32(9):S214–S9. https://doi.org/10.1016/j.arth.2017.02.031.CrossRef

28.

Civinini R, Lepri AC, Carulli C, Matassi F, Villano M, Innocenti M. Patients following revision Total hip Arthroplasty with modular dual mobility components and cobalt-chromium inner metal head are at risk of increased serum metal ion levels. J Arthroplast. 2020;35(6):S294–S8. https://doi.org/10.1016/j.arth.2020.02.050.CrossRef

29.

Lainiala OS, Reito AP, Nieminen JJ, Eskelinen AP. Declining Revision Burden of Metal-on-Metal Hip Arthroplasties. J Arthroplasty. 2019;34(9):2058. https://doi.org/10.1016/j.arth.2019.04.058.CrossRefPubMed

30.

Wu A, Weaver MJ, Heng MM, Urman RD. Predictive model of surgical time for revision Total hip Arthroplasty. J Arthroplast. 2017;32(7):2214–8. https://doi.org/10.1016/j.arth.2017.01.056.CrossRef

31.

Hothi HS, Berber R, Panagiotopoulos AC, Whittaker RK, Rhead C, Skinner JA, Hart AJ. Clinical significance of corrosion of cemented femoral stems in metal-on-metal hips: a retrieval study. Int Orthop. 2016;40(11):2247–54. https://doi.org/10.1007/s00264-016-3116-4.CrossRefPubMed

32.

Chen Z, Chen WL, Yu WG, Zhao MD, Lin JL, Zhou CM, Chen H, Ye JX, Zeng XS, Zhuang JT. Mid-term outcomes of uncemented or cemented arthroplasty revision following metal-on-metal total hip arthroplasty failure: a retrospective observational study. J Int Med Res. 2020;48(6). https://doi.org/10.1177/0300060520932051.

33.

Hasegawa M, Naito Y, Yamaguchi T, Miyazaki S, Wakabayashi H, Sudo A. Factors associated with symptomatic pseudotumors following metal-on-metal total hip arthroplasty. BMC Musculoskelet Disord. 2016;17:1–5. https://doi.org/10.1186/s12891-016-1317-z.CrossRef

34.

Hjorth MH, Stilling M, Soballe K, Bolvig LH, Thyssen JP, Mechlenburg I, Jakobsen SS. No association between pseudotumors, high serum metal-ion levels and metal hypersensitivity in large-head metal-on-metal total hip arthroplasty at 5-7-year follow-up. Skelet Radiol. 2016;45(1):115–25. https://doi.org/10.1007/s00256-015-2264-8.CrossRef

35.

Liow MHL, Dimitriou D, Tsai TY, Kwon YM. Preoperative risk factors associated with poor outcomes of revision surgery for “Pseudotumor” in patients with metal-on-metal hip Arthroplasty. J Arthroplast. 2016;31(12):2835–42. https://doi.org/10.1016/j.arth.2016.05.034.CrossRef

36.

Martin AJ, Jenkins DR, van Citters DW. Role of corrosion in taper failure and head disassociation in total hip arthroplasty of a single design. J Orthop Res. 2018;36(11):2996–3003. https://doi.org/10.1002/jor.24107.CrossRefPubMed

37.

Steinberg J, Shah KM, Gartland A, Zeggini E, Wilkinson JM. Effects of chronic cobalt and chromium exposure after metal-on-metal hip resurfacing: an Epigenome-wide association pilot study. J Orthop Res. 2017;35(10):2323–8. https://doi.org/10.1002/jor.23525.CrossRefPubMedPubMedCentral

Title: Favourable clinical outcomes following cemented arthroplasty after metal-on-metal total hip replacement: a retrospective study with a mean follow-up of 10 years
Authors: Weiguang Yu
Meiji Chen
Xianshang Zeng
Mingdong Zhao
Xinchao Zhang
Junxing Ye
Jintao Zhuang
Guowei Han
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Hip-TEP
Hip-TEP
Published in: BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-020-03797-y

At a glance: The STEP trials

Springer Medicine

Favourable clinical outcomes following cemented arthroplasty after metal-on-metal total hip replacement: a retrospective study with a mean follow-up of 10 years

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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