Long-Term Results of Metasul Metal-on-Metal Total Hip Arthroplasty

Saito, Shu; Ishii, Teruhisa; Mori, Sei; Hosaka, Kunihiro; Ootaki, Munenori; Tokuhashi, Yasuaki

doi:10.3928/01477447-20100625-11

Cited by 33 publications

(27 citation statements)

References 19 publications

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“…Our study, in line with recent literature on 28-mm metal-onmetal femoral heads has reported excellent survivorship rates between approximately 91 and 98 % [12][13][14][15][16][17][18][19]. With regards to implant stability, the selected studies have demonstrated six recurrent dislocations requiring revisions in greater than 1,000 hips [12][13][14][15][16][17][18][19].…”

Section: Discussionsupporting

confidence: 89%

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Long-term follow-up and metal ion trend of patients with metal-on-metal total hip arthroplasty

Bernstein

Desy

Petit

et al. 2012

International Orthopaedics (SICOT)

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Purpose Long-term studies are required to support the use of metal-on-metal (MoM) bearings in total hip arthroplasty (THA) given the concern about systemic metal ion release and reports of adverse local soft tissue reactions. The purpose of this study was to report the seven to 13-year clinical, radiographic, and metal ion results in patients following MoM THA. Methods We studied 163 prostheses after second-generation MoM THA between July 1997 and November 2003. Cobalt and chromium metal ions were collected using whole and analysed by inductively-coupled plasma-mass spectrometry. Results The mean follow-up was 8.87 years (range, 7-13 years). Four hips (2.5 %) were revised. The KaplanMeier survivorship was 91.3 % for revision for all causes, and 97.5 % when excluding the hips revised for a manufacturer's defect. Median whole blood cobalt levels peaked at a value of 2.87 μg/L at four years (p < 0.0001 vs. preoperative) and subsequently decreased to 2.0 μg/L after nine years (p00.002 vs. four years). Median chromium levels maximally increased up to 0.75 μg/L after five years (p< 0.0001 vs. pre-operative) and tended to decrease thereafter to values of 0.56 μg/L after seven years. Conclusions This seven to 13-year follow-up study indicates that the clinical and radiological results following MoM THA are satisfactory with low revision rates. Cobalt and chromium ion levels peaked at four and five years, respectively, and gradually decreased thereafter.

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Section: Discussionsupporting

confidence: 89%

“…Published Kaplan-Meier survivorships have been reported as excellent, between 91 and 98 % at long-term follow-up periods [12][13][14][15][16][17][18][19]. Long-term studies are required to support the increased use of MoM bearings in younger patients given their potential deleterious effects.…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up and metal ion trend of patients with metal-on-metal total hip arthroplasty

Bernstein

Desy

Petit

et al. 2012

International Orthopaedics (SICOT)

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“…In the literature, the Metasul bearing has demonstrated excellent survival in young patients of 100 % at 12 and 99 % at 14 years, respectively [6,7]. Similarly, minimum ten-year survival rates of 94 % and 99 %, have been reported for this articulation in older patients with uncemented THA [5,8]. However, our cohort of young patients could not support these excellent results, demonstrating only an acceptable survival rate of 91 % for all revisions at 13 years.…”

Section: Discussionmentioning

confidence: 54%

“…However, over the past few years severe concerns have been raised in relation to mainly large head diameter MoM articulations with catastrophic softtissue reactions due to excess metal debris, with possible subsequent implant failure [2,3]. In contrast, several studies report acceptable implant failure rates according to the NICE criteria [4] using the 28-mm head Metasul MoM articulation [5][6][7][8][9]. However, there are only few long-term data on the results of primary cementless THA using this articulation in young patients [6,7].…”

Section: Introductionmentioning

confidence: 99%

Minimum ten-year results of a 28-mm metal-on-metal bearing in cementless total hip arthroplasty in patients fifty years of age and younger

Innmann

Gotterbarm

Kretzer

et al. 2013

International Orthopaedics (SICOT)

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Purpose Concerns have been raised in relation to metal-onmetal (MoM) articulations with catastrophic soft-tissue reactions due to metal debris. We reviewed how small head MoM articulations perform in primary uncemented total hip arthroplasty (THA) in young patients at a minimum of ten years. Methods We retrospectively evaluated the clinical and radiographic results of the first 100 consecutive primary cementless THAs using the 28-mm Metasul MoM articulation in 91 patients younger than 50 years of age at the time of surgery. Results After 13 years, survival for the endpoint revision due to any reason was 90.9 % and 98.9 % for revision due to aseptic implant loosening. The cumulative incidence of MoM related revisions was 1.2 %. Small proximal femoral osteolysis was found in 18 % of hips. No acetabular osteolysis or loosening was detected. Two hips showed signs of femoral neck impingement with severe damage to the neck. Conclusions Early in the second decade, MoM-associated complications were rare using the 28-mm Metasul articulation, and aseptic loosening was not a major mode of failure in this cohort of young patients. Level of evidence Therapeutic Level IV.

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“…Several studies have reported good results with the Metasul at followup of more than 10 years with survival ranging from 81% to 100% (Table 2) [10,12,15,20,22,35,42,43,45]. Two other studies have reported mid-to long-term followup for small-diameter MoM THA devices other than Metasul [36,39].…”

Section: Discussionmentioning

confidence: 99%

Adverse Reactions to Metal on Metal Are Not Exclusive to Large Heads in Total Hip Arthroplasty

Lombardi

Berend

Adams

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background There is some suggestion that smaller diameter heads in metal-on-metal total hip arthroplasty (MoM THA) may be less prone to the adverse reactions to metal debris (ARMD) seen with large-diameter heads. Questions/purposes We reviewed our population of patients with small head (B 32 mm) MoM THA to determine (1) the frequency of ARMD; (2) potential risk factors for ARMD in this population; and (3) the etiology of revision and Kaplan-Meier survivorship with revision for all causes. Methods Small-diameter head MoM devices were used in 9% (347 of 3753) of primary THAs during the study period (January 1996 to March 2005. We generally used these implants in younger, more active, higher-demand patients. Three hundred hips (258 patients) had MoM THA using a titanium modular acetabular component with a cobaltchromium tapered insert and were available for review with minimum 2-year followup (mean, 10 years; range, 2-19 years). Complete followup was available in 86% of hips (300 of 347). Clinical records and radiographs were reviewed to determine the frequency and etiology of revision. Kaplan-Meier survivorship analysis was performed. Results ARMD frequency was 5% (14 of 300 hips) and represented 70% (14 of 20) of revisions performed. Using multivariate analysis, no variable tested, including height, weight, body mass index, age, cup diameter, cup angle, use of screws, stem diameter, stem type, head diameter, preoperative clinical score, diagnosis, activity level, or sex, was significant as a risk factor for revision. Twenty hips have been revised: two for infection, four for aseptic loosening, and 14 for ARMD. Kaplan-Meier analysis The institution of one or more of the authors (AVL, KRB, JBA, KLS) has received funding from Biomet, Inc (Warsaw, IN, USA), Pacira Pharmaceuticals Inc (Parsippany, NJ, USA), and Orthosensor (Dania Beach, FL, USA). One of the authors certifies that he (AVL) has or may receive payments or benefits, during the study period, an amount of more than USD 1,000,001 from Biomet, Inc, an amount of USD 10,000 to USD 100,000 from Innomed, Inc (Savannah, GA, USA), an amount of less than USD 10,000 from Pacira Pharmaceuticals Inc, and an amount of less than USD 10,000 from Orthosensor. One of the authors certifies that he (KRB) has or may receive payments or benefits, during the study period, an amount of more than USD 1,000,001 from Biomet, Inc. revealed survival free of component revision for all causes was 95% at 10 years (95% confidence interval [CI], 91%-97%), 92% at 15 years (95% CI, 87%-95%), and 72% at 19 years (95% CI, 43%-90%), and survival free of component revision for aseptic causes was 96% at 10 years (95% CI, 92%-98%), 92% at 15 years (95% CI, 88%-95%), and 73% at 19 years (95%

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Long-Term Results of Metasul Metal-on-Metal Total Hip Arthroplasty

Cited by 33 publications

References 19 publications

Long-term follow-up and metal ion trend of patients with metal-on-metal total hip arthroplasty

Long-term follow-up and metal ion trend of patients with metal-on-metal total hip arthroplasty

Minimum ten-year results of a 28-mm metal-on-metal bearing in cementless total hip arthroplasty in patients fifty years of age and younger

Adverse Reactions to Metal on Metal Are Not Exclusive to Large Heads in Total Hip Arthroplasty

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