Comparison of the long-term cause of failure and survivorship of four hundred and twenty seven metal-on-metal hip arthroplasties: resurfacing versus large head total hip arthroplasty
| Autor: | Michele Palazzuolo, Julien Wegrzyn, Leilani Delaune, Inès Tornare, Alexander Antoniadis |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
musculoskeletal diseases
Chromium Reoperation medicine.medical_specialty medicine.medical_treatment Arthroplasty Replacement Hip Hip resurfacing Survivorship Prosthesis Design Metal-on-metal bearing Survivorship curve medicine Humans Orthopedics and Sports Medicine Large head Retrospective Studies Trunnionosis Painful hip Original Paper business.industry Significant difference Metal debris Cobalt Arthroplasty Replacement Hip/adverse effects Chromium/adverse effects Cobalt/adverse effects Hip Prosthesis/adverse effects Metal-on-Metal Joint Prostheses/adverse effects Prosthesis Failure Complication Total hip arthroplasty Surgery Orthopedic surgery Metal-on-Metal Joint Prostheses Hip Prosthesis business |
| Zdroj: | International orthopaedics, vol. 45, no. 12, pp. 3075-3081 International Orthopaedics |
| Popis: | Introduction Comparison of mid- to long-term cause of failure and survivorship of metal-on-metal (MoM) resurfacing hip arthroplasty (RHA) and large head total hip arthroplasty (THA) remains sparse. This study aimed to identify and compare the cause of failure and survivorship of MoM RHA and THA at a minimum ten year follow-up. Methods Four hundred twenty-seven MoM hip arthroplasties (286 THA and 141 RHA) were retrospectively analyzed at a mean follow-up of 13 ± three years. Causes of failure were reported as MoM specific (i.e., adverse reaction to metal debris (ARMD) and painful hip with ion elevation) or MoM non-specific (i.e., fracture, infection, and dislocation). Chromium (Cr) and cobalt (Co) ion levels and Co/Cr ratio were compared. Survivorship was compared according to the cause of failure with revision as the endpoint. Results The rate of ARMD was significantly higher in THA (OR = 2.9 [95%-CI: 1–7]; p = 0.02). No significant difference was detected in failure rate due to other causes between the two groups (p = 0.2–0.9). Ion levels and Co/Cr ratio were both significantly higher in THA (p p = 0.01] and 15 years [73% (95%-CI: 67%–78%) vs 83% (95%-CI: 73%–90%); p = 0.01]. Conclusion RHA survivorship was significantly higher at any time point. Failure rate due to ARMD was significantly higher in THA while no significant difference in other causes of failure was observed between the two groups. This result emphasizes the role of fretting corrosion at the head-neck junction (i.e., trunnionosis) with significantly higher ion levels and Co/Cr ratio dissociation in THA. |
| Databáze: | OpenAIRE |
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