High Revision Rate for Large-head Metal-on-metal THA at a Mean of 7.1 Years: A Registry Study

Seppänen, Matti; Laaksonen, Inari; Pulkkinen, Pekka; Eskelinen, Antti; Puhto, Ari‐Pekka; Kettunen, Jukka; Leskinen, Jukka; Manninen, Mikko; Mäkelä, Keijo

doi:10.1007/s11999.0000000000000159

Cited by 21 publications

(23 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The poorer performance of the ASR device may explain the difference in WB ion level development compared with the ReCap Magnum THR (Seppänen et al. 2018). Our data did not include any ReCap HR devices.…”

Section: Resultsmentioning

confidence: 99%

Repeated cobalt and chromium ion measurements in patients with large-diameter head metal-on-metal ReCap-M2A-Magnum total hip replacement

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background and purpose — Whole blood (WB) cobalt (Co) and chromium (Cr) ion levels have a major role in the follow-up of metal-on-metal total hip replacement (MoM THR). We investigated, first, if there was a change in WB Co or Cr levels over repeated measurements in patients with ReCap-M2A-Magnum THR, and, second, determined how many patients had WB Co or Cr levels that exceeded the safe upper limits (SUL) in the repeated whole blood metal ion assessment. Patients and methods — A Recap-M2A-Magnum THR was used in 1,329 operations (1,188 patients) at our institution between 2005 and 2012. We identified all patients (n = 319) with unilateral ReCap-M2A-Magnum implants who had undergone at least 2 repeated metal ion measurements with the first blood sample taken mean 5.5 years (1.8–9.3) after surgery and the second taken mean 2 years (0.5–3) after the first. Results — The median WB Co and Cr ion levels decreased in repeated measurements from 1.40 (0.40–63) ppb to 1.10 (0.20–68) ppb and from 1.60 (0.60–13.0) ppb to 1.10 (0.30–19.0) ppb, respectively. 7% of the Co ion values exceeded SUL at the initial measurement, and 7% at the control measurement. The proportion of Cr ion values exceeding the safe upper limit (SUL) decreased during the measurement interval from 5% to 4%. Interpretation — Repeated metal ion measurements in unilateral ReCap-M2A-Magnum patients in a mean 2-year time interval did not show any increase. Long-term ion levels are, however, not yet known.

show abstract

Section: Resultsmentioning

confidence: 99%

Repeated cobalt and chromium ion measurements in patients with large-diameter head metal-on-metal ReCap-M2A-Magnum total hip replacement

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Combined with the current findings, the results confirmed by these studies appear to verify that the DAA is the preferred surgical approach for converting a failed MoM-HRA. Metal ions can decrease the number of osteoblast cells by inhibiting their gene expression, theoretically increasing the risk of MoM-HRA failure and creating unnecessary obstacles for a future conversion [26,27]. The present results for failed MoM-HRA conversion to CoC-THA have also shown low rates of re-revision or aseptic loosening.…”

Section: Discussionmentioning

confidence: 56%

Outcomes after the conversion of metal-on-metal hip resurfacing arthroplasty to ceramic-on-ceramic total hip arthroplasty: A retrospective observational study with a mean 10-year follow-up

Mao

Lin

et al. 2020

Preprint

View full text Add to dashboard Cite

Background The purpose of this retrospective study was to assess clinical outcomes following failed metal-on-metal hip resurfacing arthroplasty (MoM-HRA) revised using ceramic-on-ceramic total hip arthroplasty (CoC-THA) via the direct anterior approach (DAA).Methods Data involving 112 patients (112 hips) with failed primary MoM-HRA that was revised using CoC-THA via the DAA during 2006 - 2018 were retrospectively analysed. The mean age was 54.6 years (45–63 years). Frequent surgical indications for conversion were aseptic loosening and femoral neck fracture. The primary endpoint was the Postel-Merle d’Aubigne functional score (PMA). Secondary endpoints were the major orthopaedic complication rate and serum metal ion levels (chromium and cobalt).Results The mean follow-up time was 10 years (range, 4 - 13 years). The mean PMA improved from 9 (4-14) to 16 (13-18) (p = 0.001). Six patients had undergone a re-revision intervention. Fourteen incidents of aseptic loosening and four periprosthetic fractures were observed. A consistent decline in mean serum metal ion levels was detected [chromium decreased from 36.6 μg/L (12.5-76.5 μg/L) prior to conversion to 2.6 μg/L (0.1-13.5 μg/L) at final follow-up (p = 0.001), cobalt decreased from 37.5 μg/L (6.7-93.2 μg/L) to 2.2 μg/L (1.2-18.4 μg/L) (p =0.003)].Conclusion Failed primary MoM-HRA converted to CoC-THA using the DAA yielded acceptable clinical outcomes.

show abstract

“…A series of disadvantages attributed to MoM cups have been frequently mentioned in previous studies. 2 , 6 , 8 , 14 These disadvantages have undeniably become key factors limiting the effect of revision. 7 , 15 Metal ions released by MoM cups affect the activity of osteoblasts at the gene level, which can make CTHA challenging to perform.…”

Section: Discussionmentioning

confidence: 99%

“…However, no effective coping strategies have been developed with the exception of prosthetic revision. 6 , 7 The occurrence of severe complications after MoM-THA associated with adverse reactions to metal debris (ARMD) are common and may be related to osteolysis and patient activity. 8 – 10 When damage to the bone and surrounding tissues is caused by MoM-THA, patients who undergo revision MoM-THA may develop secondary damage to the joints, and a high rate of postoperative complications is expected.…”

Section: Introductionmentioning

confidence: 99%

Revision of failed metal-on-metal total hip arthroplasty using cemented arthroplasty: a mean 10-year follow-up of 157 consecutive patients

Lin

Huang

et al. 2021

J Int Med Res

View full text Add to dashboard Cite

Objective This study was performed to assess the outcomes of Asian patients who underwent conversion from metal-on-metal total hip arthroplasty (MoM-THA) to cemented THA (CTHA). Methods One hundred and fifty-seven consecutive patients (157 hips) who underwent CTHA following primary MoM-THA from January 2005 to February 2015 were retrospectively analysed. The primary endpoints were the clinical outcomes. Follow-ups occurred at 3 months, 6 months, 1 year, 2 years, and then every 2 years following revision of MoM-THA. Results The mean follow-up after conversion was 10 years (range, 5–14 years). Statistically significant improvements in the mean Harris hip score were observed between the preoperative and final follow-up evaluations (62.71 ± 13.85 vs. 84.03 ± 16.21, respectively). The major orthopaedic complication rate was 16.5% (26/157). Six (3.8%) patients underwent revision at a mean of 3.5 ± 1.3 years after conversion, predominantly because of prosthesis loosening or recurrent dislocation. Nine (5.7%) patients developed prosthesis loosening at a mean of 2.6 ± 1.1 years following conversion, two of whom requested revision surgery. Eleven (7.0%) patients developed prosthesis dislocation, four of whom requested revision surgery. Conclusion CTHA may yield favourable functional outcomes and a reduced rate of major orthopaedic complications.

show abstract

High Revision Rate for Large-head Metal-on-metal THA at a Mean of 7.1 Years: A Registry Study

Abstract: Level III, therapeutic study.

Cited by 21 publications

References 10 publications

Repeated cobalt and chromium ion measurements in patients with large-diameter head metal-on-metal ReCap-M2A-Magnum total hip replacement

Repeated cobalt and chromium ion measurements in patients with large-diameter head metal-on-metal ReCap-M2A-Magnum total hip replacement

Outcomes after the conversion of metal-on-metal hip resurfacing arthroplasty to ceramic-on-ceramic total hip arthroplasty: A retrospective observational study with a mean 10-year follow-up

Revision of failed metal-on-metal total hip arthroplasty using cemented arthroplasty: a mean 10-year follow-up of 157 consecutive patients

Contact Info

Product

Resources

About