Document Detail

Do survival rate and serum ion concentrations 10 years after metal-on-metal hip resurfacing provide evidence for continued use?
MedLine Citation:
PMID:  22481276     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Owing to concerns attributable to problems associated with metal-on-metal bearing surfaces, current evidence for the use of hip resurfacing is unclear. Survival rates reported from registries and individual studies are controversial and the limited long-term studies do not conclusively allow one to judge whether hip resurfacing is still a reasonable alternative to conventional THA.
QUESTIONS/PURPOSES: We asked whether the long-term survival rate of hip resurfacing is comparable to that of conventional THA and certain factors can be identified that influence serum ion concentration 10 years postoperatively. We specifically assessed (1) the 10-year survivorship in the whole cohort and in male and female patients, (2) serum concentrations of metal ions in patients with hip resurfacing who had not undergone revision surgery, and (3) potential influencing factors on the serum ion concentration.
METHODS: We retrospectively reviewed our first 95 patients who had 100 hip resurfacings performed from 1998 to 2001. The median age of the patients at surgery was 52 years (range, 28-69 years); 49% were men. We assessed the survival rate (revision for any reason as the end point), radiographic changes, and serum ion concentrations for cobalt, chromium, and molybdenum. The correlations between serum ion concentration and patient-related factors (age, sex, BMI, activity) and implant-related factors (implant size, cup inclination, stem-shaft angle) were investigated. The minimum followup was 9.3 years (mean, 10 years; range, 9.3-10.5 years).
RESULTS: The 10-year survivorship was 88% for the total cohort. The overall survival rate was greater in men (93%) than in women (84%). Median serum ion levels were 1.9 μg/L for chromium, 1.3 μg/L for cobalt, and 1.6 μg/L for molybdenum. Radiolucent lines around acetabular implants were observed in 4% and femoral neck thinning in 5%.
CONCLUSIONS: Although our overall failure rate was greater than anticipated, the relatively low serum ion levels and no revisions for pseudotumors in young male patients up to 10 years postoperatively provide some evidence of the suitability of hip resurfacing in this subgroup.
LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
Albrecht Hartmann; Jörg Lützner; Stephan Kirschner; Wolf-Christoph Witzleb; Klaus-Peter Günther
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-11     Completed Date:  2013-01-03     Revised Date:  2013-11-07    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3118-26     Citation Subset:  AIM; IM    
Department of Orthopaedic Surgery, University Hospital Carl Gustav Carus Dresden, Fetscherstr 74, 01307 Dresden, Germany.
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MeSH Terms
Arthroplasty, Replacement, Hip / adverse effects*
Equipment Failure Analysis
Hip Joint / radiography
Hip Prosthesis / adverse effects*
Ions / blood
Metals / blood*
Middle Aged
Osteoarthritis, Hip / surgery*
Prosthesis Failure*
Retrospective Studies
Reg. No./Substance:
0/Ions; 0/Metals

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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