Early failure of the Ultima metal-on-metal total hip replacement in the presence of normal plain radiographs
| Autor: | S T, Donell, C, Darrah, J F, Nolan, J, Wimhurst, A, Toms, T H W, Barker, C P, Case, J K, Tucker, R, Farrar |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Adolescent Arthroplasty Replacement Hip Radiography medicine.medical_treatment Osteoarthritis Kidney Prosthesis Design Osteoarthritis Hip Young Adult Bearing surface Humans Medicine Orthopedics and Sports Medicine Postoperative Period Reduction (orthopedic surgery) Aged Aged 80 and over Hip surgery business.industry Osteonecrosis Soft tissue Middle Aged medicine.disease Magnetic Resonance Imaging Arthroplasty Prosthesis Failure Surgery Orthopedic surgery Female Hip Joint Chromium Alloys Hip Prosthesis business |
| Zdroj: | The Journal of Bone and Joint Surgery. British volume. :1501-1508 |
| ISSN: | 2044-5377 0301-620X |
| DOI: | 10.1302/0301-620x.92b11.24504 |
| Popis: | Metal-on-metal total hip replacement has been targeted at younger patients with anticipated long-term survival, but the effect of the production of metal ions is a concern because of their possible toxicity to cells. We have reviewed the results of the use of the Ultima hybrid metal-on-metal total hip replacement, with a cemented polished tapered femoral component with a 28 mm diameter and a cobalt-chrome (CoCr) modular head, articulating with a 28 mm CoCr acetabular bearing surface secured in a titanium alloy uncemented shell. Between 1997 and 2004, 545 patients with 652 affected hips underwent replacement using this system. Up to 31 January 2008, 90 (13.8%) hips in 82 patients had been revised. Pain was the sole reason for revision in 44 hips (48.9%) of which 35 had normal plain radiographs. Peri-prosthetic fractures occurred in 17 hips (18.9%) with early dislocation in three (3.3%) and late dislocation in 16 (17.8%). Infection was found in nine hips (10.0%). At operation, a range of changes was noted including cavities containing cloudy fluid under pressure, necrotic soft tissues with avulsed tendons and denuded osteonecrotic upper femora. Corrosion was frequently observed on the retrieved cemented part of the femoral component. Typically, the peri-operative findings confirmed those found on pre-operative metal artefact reduction sequence MRI and histological examination showed severe necrosis. Metal artefact reduction sequence MRI proved to be useful when investigating these patients with pain in the absence of adverse plain radiological features. |
| Databáze: | OpenAIRE |
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