Cemented metal-on-metal total hip replacement with 28-mm head: prospective, long-term, clinical, radiological and metal ions data

Malek, Ibrahim A.; Rao, Sheethal Prasad Patange Subba; Rath, N.K.; Mallya, U.N.

doi:10.1007/s00590-014-1578-x

Eur J Orthop Surg Traumatol

2014

DOI: 10.1007/s00590-014-1578-x

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Cemented metal-on-metal total hip replacement with 28-mm head: prospective, long-term, clinical, radiological and metal ions data

Ibrahim A. Malek¹,

Sheethal Prasad Patange Subba Rao

N.K. Rath³

et al.

Abstract: The long-term survival of Metasul(®) cemented total hip replacements using 28-mm metal-on-metal head is comparable with metal on polyethylene bearing devices.

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Cited by 6 publications

(1 citation statement)

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“… 2014 , Malek et al. 2015a ). Still, there are several publications reporting less favorable outcomes (Levai et al.…”

mentioning

confidence: 99%

Comparison of metal ion concentrations and implant survival after total hip arthroplasty with metal-on-metal versus metal-on-polyethylene articulations

et al. 2017

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Background and purposeLarge metal-on-metal (MoM) articulations are associated with metal wear and corrosion, leading to increased metal ion concentrations and unacceptable revision rates. There are few comparative studies of 28-mm MoM articulations with conventional metal-on-polyethylene (MoP) couplings. We present a long-term follow-up of a randomized controlled trial comparing MoM versus MoP 28-mm articulations, focused on metal ions and implant survival.Patients and methods85 patients with a mean age of 65 years at surgery were randomized to a MoM (Metasul) or a MoP (Protasul) bearing. After 16 years, 38 patients had died and 4 had undergone revision surgery. 13 patients were unavailable for clinical follow-up, leaving 30 patients (n = 14 MoM and n = 16 MoP) for analysis of metal ion concentrations and clinical outcome.Results15-year implant survival was similar in both groups (MoM 96% [95% CI 88–100] versus MoP 97% [95% CI 91–100]). The mean serum cobalt concentration was 4-fold higher in the MoM (1.5 μg/L) compared with the MoP cohort (0.4 μg/L, p < 0.001) and the mean chromium concentration was double in the MoM (2.2 μg/L) compared with the MoP cohort (1.0 μg/L, p = 0.05). Mean creatinine levels were similar in both groups (MoM 93 μmol/L versus MoP 92 μmol/L). Harris hip scores differed only marginally between the MoM and MoP cohorts.InterpretationThis is the longest follow-up of a randomized trial on 28-mm MoM articulations, and although implant survival in the 2 groups was similar, metal ion concentrations remained elevated in the MoM cohort even in the long term.

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“… 2014 , Malek et al. 2015a ). Still, there are several publications reporting less favorable outcomes (Levai et al.…”

mentioning

confidence: 99%

Comparison of metal ion concentrations and implant survival after total hip arthroplasty with metal-on-metal versus metal-on-polyethylene articulations

et al. 2017

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Metasul vs Cerasul bearings: a prospective, randomized study at a mean eighteen years

Andeol

Viste

Desmarchelier

et al. 2020

International Orthopaedics (SICOT)

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What Is the Long-term Survival for Primary THA With Small-head Metal-on-metal Bearings?

Steiger

Peng

Lewis

et al. 2018

Clin Orthop Relat Res

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Cemented metal-on-metal total hip replacement with 28-mm head: prospective, long-term, clinical, radiological and metal ions data

Abstract: The long-term survival of Metasul(®) cemented total hip replacements using 28-mm metal-on-metal head is comparable with metal on polyethylene bearing devices.

Cited by 6 publications

References 33 publications

Comparison of metal ion concentrations and implant survival after total hip arthroplasty with metal-on-metal versus metal-on-polyethylene articulations

Comparison of metal ion concentrations and implant survival after total hip arthroplasty with metal-on-metal versus metal-on-polyethylene articulations

Metasul vs Cerasul bearings: a prospective, randomized study at a mean eighteen years

What Is the Long-term Survival for Primary THA With Small-head Metal-on-metal Bearings?

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