Dislocation of large-diameter head metal-on-metal total hip arthroplasty and hip resurfacing arthroplasty

Miettinen, Simo; Mäkinen, Tuula; Laaksonen, Inari; Mäkelä, Keijo; Kettunen, Jukka; Remes, Ville

doi:10.1177/1120700018798302

Cited by 7 publications

(2 citation statements)

References 56 publications

(82 reference statements)

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“…Furthermore, it is also worth noting that patients of advanced age over 75 years have a higher risk of cognitive problems and muscular tone deficits, which may cause inability to follow the postoperative protocols and increase dislocation rates[ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Bone graft incorporation failure with inappropriate limb load transfer can lead to aseptic acetabular loosening of metal-on-metal prosthesis: A case report

Domagalski,

Dugiełło,

Rokicka

et al. 2024

World J Orthop

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BACKGROUND Aseptic acetabular loosening can result from various factors that can be categorized into groups: patient-related, surgeon-related and implant-related. We present a case of a 63-year-old patient who at first underwent a total hip arthroplasty (THA) using a metal-on-metal bearing due to hip arthrosis. Follow-up visits revealed no complications after the procedure. Two years after the THA, acetabular component loosening occurred due to subsequent trauma of the opposite hip, necessitating a revision THA using a ceramic-on-ceramic bearing. CASE SUMMARY We aim to illustrate a rare case where the primary reason for undergoing THA revision was not only incomplete bone graft incorporation but also improper limb load distribution. Following the revision arthroplasty, a 9-year follow-up visit revealed improvements in all evaluation measures on questionnaire compared to the state before surgery: Harris Hip Score (before surgery: 15; after surgery: 95), Western Ontario and McMaster Universities Arthritis Index (before surgery: 96; after surgery: 0), and Visual Analogue Scale (before surgery: 10; after surgery: 1). CONCLUSION Opposite-hip trauma caused a weight transfer to the limb after a THA procedure. This process led to a stress shielding effect, resulting in acetabular component loosening.

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Section: Discussionmentioning

confidence: 99%

Bone graft incorporation failure with inappropriate limb load transfer can lead to aseptic acetabular loosening of metal-on-metal prosthesis: A case report

Domagalski,

Dugiełło,

Rokicka

et al. 2024

World J Orthop

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show abstract

“…Several meta-analyses determined that the most effective and least risky surgical approaches are suitable minimally invasive implantation techniques that preserve soft tissues and have implants with bigger diameters of the head [ 54 ], as their dislocation requires a bigger force to destabilize the implant [ 55 , 56 ]. Therefore, bipolar prostheses and prostheses with large heads are less prone to dislocation [ 57 ].…”

Section: Preoperative Planningmentioning

confidence: 99%

Narrative Review of the Mechanism of Hip Prosthesis Dislocation and Methods to Reduce the Risk of Dislocation

Kostewicz

Szczęsny

Tomaszewski³

et al. 2022

Med Sci Monit

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Total hip arthroplasty (THA) is one of the most effective surgical procedures. It improves quality of life, increases range of motion, and reduces pain in patients with hip joint degeneration. THA allows patients to return to everyday social and professional activities. Therefore, today it is the best approach to treatment of several chronic conditions affecting the hip joint, including advanced degenerative diseases, avascular necrosis, and some traumatic events. The aim of this study was to present the mechanism of hip prosthesis dislocation, associated risk factors, and the factors reducing the risk of dislocation, as well as its consequences and methods of risk minimization. Hip dislocation is a common complication following THA. It is responsible for up to 2% to 3% failures of primary replacements, increasing even to 10% in extreme cases of patients highly predisposed to this condition. In most cases, technical errors during implant placement are responsible for the incidence. The measures taken to prevent complications include activities aimed at correct implant insertion and the selection of the most appropriate type of implant for the patient, depending on individual needs. We summarized the current knowledge of implant dislocation to help surgeons understand the changes in biomechanics of the hip after its replacement and the impact of each particular element that participates in it. This knowledge can enable a surgeon choose the most favorable surgical method and the most appropriate implant to reduce the risk of implant dislocation.

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Response to letter from Sheng Zhao, Yuanmin Zhang, Caining Wen

Pangaud¹,

Pioger²,

Pauly³

et al. 2023

Orthopaedics & Traumatology: Surgery & Research

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Dislocation of large-diameter head metal-on-metal total hip arthroplasty and hip resurfacing arthroplasty

Abstract: Dislocations occurred more often in THAs of head size ⩽ 38 mm and with a smaller anteversion angle of the acetabulum component. Hip dysplasia and post-traumatic osteoarthritis were more common in patients with dislocation.

Cited by 7 publications

References 56 publications

Bone graft incorporation failure with inappropriate limb load transfer can lead to aseptic acetabular loosening of metal-on-metal prosthesis: A case report

Bone graft incorporation failure with inappropriate limb load transfer can lead to aseptic acetabular loosening of metal-on-metal prosthesis: A case report

Narrative Review of the Mechanism of Hip Prosthesis Dislocation and Methods to Reduce the Risk of Dislocation

Response to letter from Sheng Zhao, Yuanmin Zhang, Caining Wen

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