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.
Complication
Hip resurfacing
Metal-on-metal bearing
Survivorship
Total hip arthroplasty
Trunnionosis
Journal
International orthopaedics
ISSN: 1432-5195
Titre abrégé: Int Orthop
Pays: Germany
ID NLM: 7705431
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
05
02
2021
accepted:
12
04
2021
pubmed:
23
6
2021
medline:
15
12
2021
entrez:
22
6
2021
Statut:
ppublish
Résumé
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. 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. 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 < 0.01). Survivorship was significantly lower in THA compared to RHA at ten years [89% (95%-CI: 85%-91%) vs 96% (95%-CI: 91%-98%); p = 0.01] and 15 years [73% (95%-CI: 67%-78%) vs 83% (95%-CI: 73%-90%); p = 0.01]. 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.
Identifiants
pubmed: 34155524
doi: 10.1007/s00264-021-05044-y
pii: 10.1007/s00264-021-05044-y
pmc: PMC8626394
doi:
Substances chimiques
Chromium
0R0008Q3JB
Cobalt
3G0H8C9362
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3075-3081Informations de copyright
© 2021. The Author(s).
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