Risk of cancer after primary total hip replacement: The influence of bearings, cementation and the material of the stem

Levašič, Vesna; Milošev, Ingrid; Zadnik, Vesna

doi:10.1080/17453674.2018.1431854

Cited by 17 publications

(7 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 2010 , Levasic et al. 2018 ). No increase in the risk of melanoma was found for patients treated with a MoM resurfacing device (Brewster et al.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study from Slovenia including only THAs found a slightly higher risk of overall cancer in patients treated with MoM bearing when compared with the general population or the non-MoM patients (Levasic et al. 2018 ). In that study the specific cancer types that had higher prevalence in the MoM cohort compared with the general population were skin cancers excluding melanoma and prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Midterm risk of cancer with metal-on-metal hip replacements not increased in a Finnish population

et al. 2018

View full text Add to dashboard Cite

Background and purpose — Metal-on-metal (MoM) total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) have been widely used during the early 21st century. We assessed the midterm risk of cancer of patients treated with modern MoM hip implants compared with patients with non-MoM hip implants and the general Finnish population with special interest in soft tissue sarcomas and basalioma due to the findings of our previous report.Patients and methods — All large-diameter head MoM THAs and hip resurfacings performed in Finland between 2001 and 2010 were extracted from the Finnish Arthroplasty Register (10,728 patients). Patients who underwent conventional THA formed the non-MoM reference cohort (18,235 patients). Data on cancer cases up to 2014 were extracted from the Finnish Cancer Registry. The relative risk of cancer in the general population was expressed as the ratio of observed to expected number of cases, i.e., standardized incidence ratio (SIR). Poisson regression analysis was used to compare the cancer risk between the cohorts. The mean follow-up was 7.4 years (1–14) in the MoM cohort and 8.4 years (1–14) in the non-MoM cohort.Results — The overall risk of cancer in the MoM cohort was comparable to the general Finnish population (SIR 0.9, 95% CI 0.9–1.0). Risk of basalioma in the MoM cohort was higher than in the general Finnish population (SIR 1.2, CI 1.1–1.4) and higher than in the non-MoM cohort in the stratified regression analysis (RR 1.2, CI 1.0–1.4, p = 0.02). The SIR of soft-tissue sarcoma in the MoM cohort was 1.4 (CI 0.6–2.8); the incidence was same as in the non-MoM cohort.Interpretation — Metal-on-metal hip implants are not associated with an increased overall risk of cancer during midterm follow-up.

show abstract

“… 2010 , Levasic et al. 2018 ). No increase in the risk of melanoma was found for patients treated with a MoM resurfacing device (Brewster et al.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Midterm risk of cancer with metal-on-metal hip replacements not increased in a Finnish population

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Only one Finnish study compared MoM and MoP hip prostheses [ 22 ] finding no difference in all cause cancer incidence between the procedures. One study in Slovenia found that the risk for all cancers combined as well as for prostate and skin cancer was higher with MoM compared to non-MoM procedures (RR = 1.56; 2.02 and 1.92, respectively) [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…induce malignant degeneration, the relationship has not been well demonstrated. Many studies have examined the differential risk of cancer between different bearing surfaces, results have varied [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

No increased risk of cancer associated with metal-on-metal or ceramic-on-ceramic procedures compared to other bearing surfaces in patients with total hip arthroplasty: A nationwide linked registry cohort analysis of 167,837 patients

et al. 2022

View full text Add to dashboard Cite

Objectives Studies have identified increased cancer risk among patients undergoing total hip arthroplasty (THA) compared to the general population. However, evidence of all-cause and site-specific cancer risk associated with different bearing surfaces has varied, with previous studies having short latency periods with respect to use of modern Metal-on-Metal (MoM) bearings. Using the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) linked to Australasian Association of Cancer Registries data, our aim was to evaluate risk of all-cause and site-specific cancer according to bearing surfaces in patients undergoing THA for osteoarthritis and whether risk increased with MoM bearings. Methods Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated by comparing number of observed cancer cases to expected number based on incidence rate in the Australian population. All-cause and site-specific cancer rates were calculated for all conventional stemmed THA (csTHA) and resurfacing THA (rsTHA) procedures performed for osteoarthritis. Cox proportional hazards models were used to compare cancer rates for MoM, ceramic-on-ceramic (CoC) and resurfacing procedures with a comparison group comprising metal-on-polyethylene (MoP) or ceramic-on-polyethylene (CoP) procedures. Results There were 156,516 patients with csTHA procedures and 11,321 with rsTHA procedures for osteoarthritis performed between 1999 and 2012. Incidence of all-cause cancer was significantly higher for csTHA (SIR 1.24, 95% CI 1.22–1.26) and rsTHA (SIR 1.74, 95% CI 1.39–2.04) compared to the Australian population. For csTHA, there was no significant difference in all-site cancer rates for MoM (Hazard Ratio (HR) 1.01, 95%CI 0.96–1.07) or CoC (HR 0.98, 95%CI 0.94–1.02) compared to MoP and CoP bearings. Significantly increased risk of melanoma, non-Hodgkins lymphoma, myeloma, leukaemia, prostate, colon, bladder and kidney cancer was found for csTHA and, prostate cancer, melanoma for rsTHA procedures when compared to the Australian population, although risk was not significantly different across bearing surfaces. Conclusions csTHA and rsTHA procedures were associated with increased cancer incidence compared to the Australian population. However, no excess risk was observed for MoM or CoC procedures compared to other bearing surfaces.

show abstract

“…Numerous retrospective cohort studies have been conducted to investigate the association between orthopaedic metal implants and cancer development. Some studies have reported an increased risk of certain types of cancer, including lymphoma, prostate cancer, and melanoma [19][20][21]. In particular, higher prostate and skin cancer risk was identified in a MoM cohort compared to the non-MoM cohort [19].…”

Section: Introductionmentioning

confidence: 97%

Cancer-Causing Effects of Orthopaedic Metal Implants in Total Hip Arthroplasty

Sun,

Lau,

Cheung

et al. 2024

Cancers

View full text Add to dashboard Cite

Background: Metal implants have been preferentially used in THA due to its biocompatibility, mechanical stability and durability. Yet concerns have emerged regarding their potential to release metallic ions, leading to long-term adverse effects, including carcinogenicity. This study aimed to investigate the risk of cancer development in patients with orthopaedic metal implants in total hip arthroplasty (THA). Methods: Patients with THA conducted at a local tertiary implant centre from 2001–2008 were linked to the local cancer registry and followed up to the end of 2023. Standardized incidence ratios (SIRs) for cancer incidence and its confidence interval by Poisson distribution were calculated. Survival analysis was depicted using the Kaplan–Meier method, and the log-rank test was used to assess the differences across groups. Results: The study cohort included 388 patients and 53 cancers diagnosed during follow-up, at least 5 years post THA. All-site cancer risks were increased in patients with THA (SIR: 1.97; 95% CI: 1.48–2.46), validated with chi-square analysis (chi-square = 15.2551, N = 100,388, p < 0.01). A statistically significant increase in multiple site-specific cancers including haematological cancers were identified. Conclusions: Patients with THA were found to have an increased risk for cancer compared to the general population during a mean follow-up of 16 years.

show abstract

Risk of cancer after primary total hip replacement: The influence of bearings, cementation and the material of the stem

Cited by 17 publications

References 40 publications

Midterm risk of cancer with metal-on-metal hip replacements not increased in a Finnish population

Midterm risk of cancer with metal-on-metal hip replacements not increased in a Finnish population

No increased risk of cancer associated with metal-on-metal or ceramic-on-ceramic procedures compared to other bearing surfaces in patients with total hip arthroplasty: A nationwide linked registry cohort analysis of 167,837 patients

Cancer-Causing Effects of Orthopaedic Metal Implants in Total Hip Arthroplasty

Contact Info

Product

Resources

About