Clinical Results of the Conserve Plus Metal on Metal Hip Resurfacing: An Independent Series

Zylberberg, Alejandro; Nishiwaki, Toru; Kim, Paul R.; Beaulé, Paul E.

doi:10.1016/j.arth.2014.08.005

Cited by 16 publications

(6 citation statements)

References 41 publications

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“…This is probably due to the fact that both the Adept and BHR have hydroxyapatite coating on their acetabular components (see Table 5). More importantly, we had a very low incidence (n ¼ 1) of adverse tissue reactions that is consistent with the low metal ion levels and adverse local tissue reaction results associated with the Conserve Plus [16] and comparable to other studies using the Conserve Plus implant with survivorship above 90% at 10 years [22,23,25].…”

Section: Discussionsupporting

confidence: 88%

Metal on Metal Hip Resurfacing in Patients 45 Years of Age and Younger at Minimum 5-Year Follow-Up

Dowding

Dobransky

Kim

et al. 2018

The Journal of Arthroplasty

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This study indicates that MoM-HR is a suitable option for young individuals, as demonstrated through improved functional scores and low revision rates. The survivorship of HR in the younger than 45 age-group was similar to that of total hip arthroplasty, as well as HR in older patients. Given the proposed benefits of HR, this procedure may be viewed as a viable option in patients aged younger than 45 years.

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Section: Discussionsupporting

confidence: 88%

Metal on Metal Hip Resurfacing in Patients 45 Years of Age and Younger at Minimum 5-Year Follow-Up

Dowding

Dobransky

Kim

et al. 2018

The Journal of Arthroplasty

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“…2007) and 95% (Zylberberg et al. 2015) have been reported for the Conserve Plus HRA, based on single-center data. The 10-year survival rate of the Conserve Plus cup was 98% with aseptic loosening as the endpoint (Hulst et al.…”

Section: Discussionmentioning

confidence: 99%

Poor 10-year survivorship of hip resurfacing arthroplasty

Seppänen¹,

Karvonen²,

Virolainen³

et al. 2016

Acta Orthopaedica

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Background and purposeIn a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associated with HRA, not only with large-diameter head metal-on-metal THA. The aim of the study was to assess medium- to long-term survivorship of HRA based on the Finnish Arthroplasty Register (FAR).Patients and methods5,068 HRAs performed during the period 2001–2013 in Finland were included. Kaplan-Meier survival analysis was used to calculate survival probabilities and their 95% confidence intervals (CIs). Cox multiple regression, with adjustment for age, sex, diagnosis, femoral head size, and hospital volume was used to analyze implant survival of HRA devices with revision for any reason as endpoint. The reference group consisted of 6,485 uncemented Vision/Bimetric and ABG II THAs performed in Finland over the same time period.ResultsThe 8-year survival, with any revision as an endpoint, was 93% (CI: 92–94) for Birmingham Hip Resurfacing (BHR), 86% (CI: 78–94) for Corin, 91% (CI: 89–94) for ReCap, 92% (CI: 89–96) for Durom, and was 72% (CI: 69–76) for the Articular Surface Replacement (ASR). The 10-year survival, with any revision as an endpoint, for reference THAs was 92% (CI: 91–92) and for all HRAs it was 86% (CI: 84–87%). Female HRA patients had about twice the revision risk of male patients. ASR had an inferior outcome: the revision risk was 4-fold higher than for BHR, the reference implant.InterpretationThe 10-year implant survival of HRAs is 86% in Finland. According to new recommendations from NICE (The National Institute for Health and Care Excellence), an HRA/THA should have a revision rate of 5% or less at 10 years. None of the HRAs studied achieved this goal.

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“…Metal-on-metal hip resurfacing has been considered an effective way to treat young and active patients with endstage osteoarthritis since the 1990s [9,13,14,30,31]. However, aseptic failure of the femoral component (component loosening or femoral neck fracture) has been reported as one of the main modes of failure, particularly in the early reports [3,12,19,21,23,25].…”

Section: Introductionmentioning

confidence: 99%

Are There Long-term Benefits to Cementing the Metaphyseal Stem in Hip Resurfacing?

Amstutz

Duff

Bhaurla

2015

Clin Orthop Relat Res

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Background Cementing the metaphyseal stem during hip resurfacing surgery improves the initial fixation of the femoral component. However, there may be long-term detrimental effects such as stress shielding or an increased risk of thermal necrosis associated with this technique. Questions/purposes We compared (1) long-term survivorship free from radiographic femoral failure, (2) validated pain scores, and (3) radiographic evidence of component fixation between hips resurfaced with a cemented metaphyseal stem and hips resurfaced with the metaphyseal stem left uncemented. Methods We retrospectively selected all the patients who had undergone bilateral hip resurfacing with an uncemented metaphyseal stem on one side, a cemented metaphyseal stem on the other side, and had both surgeries performed between July 1998 and February 2005. Fortythree patients matched these inclusion criteria. During that period, the indications for cementing the stem evolved in the practice of the senior author (HCA), passing through four phases; initially, only hips with large femoral defects had a cemented stem, then all stems were cemented, then all stems were left uncemented. Finally, stems were cemented for patients receiving small femoral components (\48 mm) or having large femoral defects (or both). Of the 43 cemented stems, two, 13, 0, and 28 came from each of those four periods. All 43 patients had complete followup at a minimum of 9 years (mean, 143 ± 21 months for the uncemented stems; and 135 ± 22 months for the cemented stems; p = 0.088). Survivorship analyses were performed with Kaplan-Meier and Cox proportional hazards ratios using radiographic failure of the femoral component as the endpoint. Pain was assessed with University of California Los Angeles (UCLA) pain scores, and radiographic femoral failure was defined as complete radiolucency around the metaphyseal stem or gross migration of the femoral component. Results There were four failures of the femoral component in the press-fit stem group while the cemented stem group had no femoral failures (p = 0.0471). With the numbers available, we found no differences between the two groups regarding pain relief or radiographic appearance other than in patients whose components developed loosening. Conclusions Cementing the metaphyseal stem improves long-term implant survival and does not alter long-term pain relief or the radiographic appearance of the proximal femur as had been a concern based on the results of finite element studies. We believe that patients with small component sizes and large femoral head defects have more to gain from the use of this technique which adds surface area for fixation, and there is no clinical downside to cementing the stem in patients with large component sizes.

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Clinical Results of the Conserve Plus Metal on Metal Hip Resurfacing: An Independent Series

Cited by 16 publications

References 41 publications

Metal on Metal Hip Resurfacing in Patients 45 Years of Age and Younger at Minimum 5-Year Follow-Up

Metal on Metal Hip Resurfacing in Patients 45 Years of Age and Younger at Minimum 5-Year Follow-Up

Poor 10-year survivorship of hip resurfacing arthroplasty

Are There Long-term Benefits to Cementing the Metaphyseal Stem in Hip Resurfacing?

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