Pseudotumor formation and serum ions after large head metal-on-metal stemmed total hip replacement. Risk factors, time course and revisions in 706 hips
| Autor: | M. van Rossum, Cees C. P. M. Verheyen, B. H. Bosker, M. F. Boomsma, Harmen B. Ettema, M. Maas, Boudewijn J. Kollen |
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| Přispěvatelé: | Amsterdam institute for Infection and Immunity, General Paediatrics, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Movement Sciences, Radiology and Nuclear Medicine |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Chromium Male Reoperation medicine.medical_specialty Time Factors Arthroplasty Replacement Hip Total hip replacement Prosthesis Design Granuloma Plasma Cell Osteoarthritis Hip Risk Factors medicine Humans Orthopedics and Sports Medicine Large head Ions Natural course business.industry Incidence (epidemiology) Incidence General Medicine Cobalt Middle Aged Surgery Prosthesis Failure stomatognathic diseases Time course Orthopedic surgery Metal-on-Metal Joint Prostheses Female Hip Joint Hip Prosthesis business Total hip arthroplasty |
| Zdroj: | Archives of orthopaedic and trauma surgery, 135(3), 417-425. J.F. Bergmann |
| ISSN: | 1434-3916 0936-8051 |
| Popis: | The incidence and natural course of pseudotumors in metal-on-metal total hip arthroplasties is largely unknown. The objective of this study was to identify the true incidence and risk factors of pseudotumor formation in large head metal-on-metal total hip arthroplasties. Incidence, time course and risk factors for pseudotumor formation were analysed after large femoral head MoM-THA. We defined a pseudotumor as a (semi-)solid or cystic peri-prosthetic soft-tissue mass with a diameter ≥2 cm that could not be attributed to infection, malignancy, bursa or scar tissue. All patients treated in our clinic with MoM-THA's were contacted. CT scan, metal ions and X-rays were obtained. Symptoms were recorded. After median follow-up of 3 years, 706 hips were screened in 626 patients. There were 228 pseudotumors (32.3 %) in 219 patients (35.0 %). Pseudotumor formation significantly increased after prolonged follow-up. Seventy-six hips (10.8 %) were revised in 73 patients (11.7 %), independent risk factors were identified. Best cutoff point for cobalt and chromium was 4 μg/l (68 and 77 nmol/l). This study confirms a high incidence of pseudotumors, dramatically increasing after prolonged follow-up. Risk factors for pseudotumors are of limited importance. Pain was the strongest predictor for pseudotumor presence; cobalt chromium and swelling were considered poor predictors. Cross-sectional imaging is the main screening tool during follow-up |
| Databáze: | OpenAIRE |
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