Long-term follow-up of metal-on-metal total hip replacement

Autor: Rainer Kotz, Georg Heinze, Martina Marker, Vanee Meisinger, Wolfram Brodner, Alexander Grübl, Harald Zehetgruber, Alexander Giurea
Rok vydání: 2007
Předmět:
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society. 25(7)
ISSN: 0736-0266
Popis: Metal-on-metal articulations were reintroduced to reduce polyethylene particle-induced osteolysis. Elevated serum metal levels have been detected at short- and intermediate-term follow-up. There is little knowledge about long-term effects of increased ionic metal generation. Our study was undertaken to provide information about long-term survival, clinical outcome, radiographic appearance, and serum metal concentrations after a minimum 10 years follow-up with a metal-on-metal hip prosthesis: 105 cementless primary total hip prostheses with metal-on-metal articulating surfaces were implanted in 98 patients with a mean age of 56 years. Clinical data, radiographs, and blood samples were obtained at a follow-up visit 10 years after implantation. Serum cobalt and chromium levels were determined with use of atomic absorption spectrometry. General laboratory analyses included a full blood count and kidney function parameters. The Harris score was 92 points and the UCLA score 6 points after 10 years. Small osteolytic lesions and radiolucent lines were found in Gruen's zones 1, 7, 8, and 14. The probability of survival was 98.6%. The median serum cobalt concentration of the 22 patients with their hip replacement as the only source of cobalt was 0.75 µg/L (range, 0.3–50.1 µg/L). No patient was diagnosed with renal insufficiency during the study period. Five patients were diagnosed with a malignancy between surgery and the follow-up. We do not have evidence of an increased rate of primary malignancies nor could we detect renal failure in our study group. Serum metal levels did not differ from short- and intermediate term follow-up values. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:841–848, 2007
Databáze: OpenAIRE