Cementless Total Hip Arthroplasty with Large Diameter Metal-on-Metal Heads: Short-Term Survivorship of 8059 Hips from the Finnish Arthroplasty Register

Mokka, Jari; Mäkelä, Keijo; Virolainen, Petri; Remes, Ville; Pulkkinen, Pekka; Eskelinen, Antti

doi:10.1177/1457496913482235

Cited by 17 publications

(24 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The total amount of Bimetric/ReCap combinations was high (5464). The short-term survival of Bimetric/ReCap with Magnum bearing surface has been promising also in previous studies (3,21,22). These data support the Australian finding of low short-term revision rate of ReCap THA.…”

Section: Discussionsupporting

confidence: 85%

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

et al. 2013

Self Cite

View full text Add to dashboard Cite

Background and Aims: large headed metal-on-metal total hip arthroplasty may produce more metal ions than hip resurfacing arthroplasty. increased metal-ion levels may be associated with higher revision rates due to adverse reaction to metal debris. the purpose of our study was to compare the survivorship of three hip resurfacing arthroplasty designs with their analogous cementless large-diameter head metal-on-metal total hip arthroplasties.Material and Methods: based on data obtained from the finnish arthroplasty register, the revision risks of three metal-on-metal hip resurfacing arthroplasty/total hip arthroplasty design couples performed during 2001-2011 were analyzed using the cox regression model.Results: in the cox regression analysis for compared design pairs adjusted for age, gender, operated side, head size, diagnosis, and implant, there was no statistically significant difference in revision risk between recap hip resurfacing arthroplasty and bimetric/recap total hip arthroplasty (risk ratio = 1.43, confidence interval = 0.95-2.14, p = 0.09) or between birmingham hip resurfacing arthroplasty and synergy/birmingham hip resurfacing total hip arthroplasty (risk ratio = 1.35, confidence interval = 0.75-2.43, p = 0.31). However, the revision risk of corail and summit/articular surface replacement total hip arthroplasty (asr Hra) was significantly increased compared to asr Hra. (risk ratio = 0.73, confidence interval = 0.54-0.98, p = 0.04).

show abstract

Section: Discussionsupporting

confidence: 85%

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

et al. 2013

Self Cite

View full text Add to dashboard Cite

show abstract

“…The short-term survival of the ReCap-M2a-Magnum THA was comparable to that of conventional cemented THA based on data from the Finnish Arthroplasty Register (Mokka et al 2013). The cumulative revision percent of ReCap-M2a-Magnum THA at 5 years (3.6, CI: 2.4–5.3) is significantly lower than that of ASR THA (DePuy) (22, CI: 21–24) according to Australian registry data (AOA 2012).…”

Section: Discussionmentioning

confidence: 93%

“…Cementless LDH MoM THA has been popular in Finland the past 8 years (Mokka et al 2013). From 2005 to 2012, the ReCap-M2a-Magnum LDH MoM THA device (Biomet, Warsaw, IN) was the most common hip device at our institution, with over 1,000 implantations.…”

mentioning

confidence: 99%

Adverse reaction to metal debris after ReCap-M2A-Magnum large-diameter-head metal-on-metal total hip arthroplasty

Mokka¹,

Junnila²,

Seppänen³

et al. 2013

Acta Orthopaedica

View full text Add to dashboard Cite

Background and purposeThe clinical findings of adverse reaction to metal debris (ARMD) following large-diameter-head metal-on-metal total hip arthroplasty (LDH MoM THA) may include periarticular fluid collections, soft tissue masses, and gluteal muscle necrosis. The ReCap-M2a-Magnum LDH MoM THA was the most commonly used hip device at our institution from 2005 to 2012. We assessed the prevalence of and risk factors for ARMD with this device.Methods74 patients (80 hips) had a ReCap-M2a-Magnum LDH MoM THA during the period August 2005 to December 2006. These patients were studied with hip MRI, serum chromium and cobalt ion measurements, the Oxford hip score questionnaire, and by clinical examination. The prevalence of ARMD was recorded and risk factors for ARMD were assessed using logistic regression models. The mean follow-up time was 6.0 (5.5–6.7) years.ResultsA revision operation due to ARMD was needed by 3 of 74 patients (3 of 80 hips). 8 additional patients (8 hips) had definite ARMD, but revision was not performed. 29 patients (32 hips) were considered to have a probable or possible ARMD. Altogether, 43 of 80 hips had a definite, probable, or possible ARMD and 34 patients (37 hips) were considered not to have ARMD. In 46 of 78 hips, MRI revealed a soft tissue mass or a collection of fluid (of any size). The symptoms clicking in the hip, local hip swelling, and a feeling of subluxation were associated with ARMD.InterpretationARMD is common after ReCap-M2a-Magnum total hip arthroplasty, and we discourage the use of this device. Asymptomatic patients with a small fluid collection on MRI may not need instant revision surgery but must be followed up closely.

show abstract

“…However, it has been shown recently that the wear propensities of many MoM designs are poor (Grammatopolous et al 2009, Langton et al 2010). Large-diameter head THAs and HRAs have been used frequently in Finland during the last decade (Mokka et al 2012, Seppänen et al 2012). …”

mentioning

confidence: 99%

Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty

et al. 2013

View full text Add to dashboard Cite

Background and purpose Previous population-based registry studies have shown that larger femoral head size is associated with reduced risk of revision for dislocation. However, the previous data have not included large numbers of hip resurfacing arthroplasties or large metal-on-metal (> 36-mm) femoral head arthroplasties. We evaluated the association between femoral component head size and the risk of revision for dislocation after THA by using Finnish Arthroplasty Register data.Patients and methods 42,379 patients who were operated during 1996–2010 fulfilled our criteria. 18 different cup/stem combinations were included. The head-size groups studied (numbers of cases) were 28 mm (23,800), 32 mm (4,815), 36 mm (3,320), and > 36 mm (10,444). Other risk factors studied were sex, age group (18–49 years, 50–59 years, 60–69 years, 70–79 years, and > 80 years), and time period of operation (1996–2000, 2001–2005, 2006–2010).Results The adjusted risk ratio in the Cox model for a revision operation due to dislocation was 0.40 (95% CI: 0.26–0.62) for 32-mm head size, 0.41 (0.24–0.70) for 36-mm head size, and 0.09 (0.05–0.17) for > 36-mm head size compared to implants with a head size of 28 mm.Interpretation Larger femoral heads clearly reduce the risk of dislocation. The difference in using heads of > 36 mm as opposed to 28-mm heads for the overall revision rate at 10 years follow-up is about 2%. Thus, although attractive from a mechanical point of view, based on recent less favorable clinical outcome data on these large heads, consisting mainly of metal-on-metal prostheses, one should be cautious using these implants.

show abstract

Cementless Total Hip Arthroplasty with Large Diameter Metal-on-Metal Heads: Short-Term Survivorship of 8059 Hips from the Finnish Arthroplasty Register

Abstract: Background andConclusions: We found that cementless large diameter head metal-on-metal total hip arthroplasty had short-term survivorship compared with cemented total hip arthroplasty

Cited by 17 publications

References 25 publications

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

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

Adverse reaction to metal debris after ReCap-M2A-Magnum large-diameter-head metal-on-metal total hip arthroplasty

Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty

Contact Info

Product

Resources

About