Poor outcome of revised resurfacing hip arthroplasty

Steiger, Richard N. de; Miller, Lisa N; Prosser, Gareth; Graves, Stephen E.; Davidson, D C; Stanford, Tyman

doi:10.3109/17453671003667176

Cited by 76 publications

(57 citation statements)

References 8 publications

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“…We are unaware of other published reports of complications after revision of these devices, although others have observed similar problems after revision of hip resurfacing [9,17]. The rate of dislocation in this study was 28% overall (nine of 32 hips).…”

Section: Discussioncontrasting

confidence: 43%

“…ALTRs can cause pain, damage to local bone and soft tissue, and instability of the prosthetic joint. Although high rates of complication and rerevision have been reported after revision of largehead MoM resurfacing devices [2,9,17], to our knowledge, there are no published reports of outcomes after revision of large-head, MoM THA. We therefore sought to determine (1) complications occurring after revision, including reoperations; (2) radiologic outcome; and (3) changes in metal ion levels after revision of the bearing to metal-on-polyethylene.…”

Section: Introductionmentioning

confidence: 69%

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High Complication Rate After Revision of Large-head Metal-on-metal Total Hip Arthroplasty

Munro

Masri

Duncan

et al. 2013

Clin Orthop Relat Res

154

168

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Background Previous studies have indicated poor outcomes in patients having revision of hip resurfacing resulting from adverse local tissue reaction and pseudotumor. Questions/purposes We reviewed all patients at our institution who had revision of failed large-head metal-onmetal total hip arthroplasty to determine (1) complications including reoperations; (2) radiologic outcomes; and (3) changes in serum ions after removal of the metal bearing.Methods From our research database, we identified 32 hips in 30 patients. Revisions were performed through a posterior approach; 17 were performed with a titanium fiber-metal shell and 15 with a porous tantalum shell, and 29 of the 32 revisions were performed with large (36-or 40-mm) femoral heads. Clinical records were reviewed and interviews conducted in the clinic or by telephone. Nineteen hips had a pre-or intraoperative diagnosis of adverse local tissue reaction, three had deep infection, and 10 had loosening of the acetabular component. Results Major complications occurred in 12 (38%) of the 32 revisions. Nine of 32 hips (28%) sustained dislocations. Four of 17 fiber-metal acetabular components failed to ingrow; none of the porous tantalum cups failed to ingrow. Seven repeat revisions were performed in six patients: three for acetabular loosening, three for recurrent dislocation, and one for recurrent adverse local tissue reaction. The mean WOMAC pain score was 78 of 100 and the function score was 83 of 100. Metal ion levels decreased after revision in most patients. Conclusions As a result of the high rate of failure of the fiber metal cups, we have elected to use an enhanced fixation surface with a high-porosity cup for revision of these cases. We observed a high rate of dislocation despite the use of 36-mm and 40-mm heads.

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Section: Discussioncontrasting

confidence: 43%

Section: Introductionmentioning

confidence: 69%

High Complication Rate After Revision of Large-head Metal-on-metal Total Hip Arthroplasty

Munro

Masri

Duncan

et al. 2013

Clin Orthop Relat Res

154

168

View full text Add to dashboard Cite

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“…This was also studied by the previously mentioned AOANJRR paper [5], which reported that acetabular-only revision had a significantly higher risk of revision compared with femoral-only revision but not among the other groups (a 5-year cumulative percent revision rate of 20%, 7%, and 5%). Grammatopoulos et al [6] identified 53 hips in 51 patients that had undergone revision surgery after hip resurfacing arthroplasty, of which 16 were revised for pseudotumor formation.…”

Section: Discussionmentioning

confidence: 94%

“…Few other studies have investigated the longterm survivorship of revision for hip resurfacing arthroplasty. A previous study by the AOANJRR in 2010 [5] looked at the early rerevision rate of 397 revisions for reasons other than infection, finding a cumulative percent rerevision rate of 9% at 5 years. This current analysis has been performed on more than twice the number of revision procedures with a longer followup.…”

Section: Discussionmentioning

confidence: 99%

“…A previous report detailed the early outcome of revised hip resurfacing arthroplasty [5]. In light of recent data confirming a high rate of revision for large-diameter MoM THAs, the aims of this study were to review the outcome of revision procedures for failed hip resurfacings and to determine if there were differences depending on the type of bearing surface used at the time of revision.…”

Section: Introductionmentioning

confidence: 99%

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What Is the Rerevision Rate After Revising a Hip Resurfacing Arthroplasty? Analysis From the AOANJRR

Wong

Liu

Graves

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background More than 15,000 primary hip resurfacing arthroplasties have been recorded by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) with 884 primary procedures requiring revision for reasons other than infection, a cumulative percent revision rate at 12 years of 11%. However, few studies have reported the survivorship of these revision procedures.Questions/purposes (1) What is the cumulative percent rerevision rate for revision procedures for failed hip resurfacings? (2) Is there a difference in rerevision rate among different types of revision or bearing surfaces? Methods The AOANJRR collects data on all primary and revision hip joint arthroplasties performed in Australia and after verification against health department data, checking of unmatched procedures, and subsequent retrieval of unreported procedures is able to obtain an almost complete data set relating to hip arthroplasty in Australia. Revision procedures are linked to the known primary hip arthroplasty. There were 15,360 primary resurfacing hip arthroplasties recorded of which 884 had undergone revision and this was the cohort available to study. The types of revisions were acetabular only, femoral only, or revision of both acetabular and femoral components. With the exception of the acetabular-only revisions, all revisions converted hip resurfacing arthroplasties to conventional (stemmed) total hip arthroplasties (THAs). All initial revisions for infection were excluded. The survivorship of the different types of revisions and that of the different bearing surfaces used were estimated using the KaplanMeier method and compared using Cox proportional hazard models. Cumulative percent revision was calculated by determining the complement of the Kaplan-Meier survivorship function at that time multiplied by 100. Results Of the 884 revisions recorded, 102 underwent further revision, a cumulative percent rerevision at 10 years of 26% (95% confidence interval, 19.6-33.5). There was no difference in the rate of rerevision between acetabular revision and combined femoral and acetabular revision (hazard ratio [HR]

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Structural and Hydroxyapatite‐like Surface Functionalization of Advanced Biomimetic Prototype Interface for RA Endoprostheses to Enhance Osteoconduction and Osteointegration

Uklejewski

Rogala

Winiecki

2016

Advanced Surface Engineering Materials

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Poor outcome of revised resurfacing hip arthroplasty

Cited by 76 publications

References 8 publications

High Complication Rate After Revision of Large-head Metal-on-metal Total Hip Arthroplasty

High Complication Rate After Revision of Large-head Metal-on-metal Total Hip Arthroplasty

What Is the Rerevision Rate After Revising a Hip Resurfacing Arthroplasty? Analysis From the AOANJRR

Structural and Hydroxyapatite‐like Surface Functionalization of Advanced Biomimetic Prototype Interface for RA Endoprostheses to Enhance Osteoconduction and Osteointegration

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