Sunday, April 14, 2013

Poor Short Term Outcome with a Metal-On-Metal Total Hip Arthroplasty.

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    2013 Mar 25. pii: S0883-5403(13)00064-8. doi: 10.1016/j.arth.2012.10.005. [Epub ahead of print]

     

    Source

    Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, California; Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, California.

    Abstract

    Metal-on-metal (MoM) bearings for total hip arthroplasty (THA) have come under scrutiny with reports of high failure rates. Clinical outcome studies with several commercially available MoM THA bearings remain unreported. We evaluated 78 consecutive MoM THAs from a single manufacturer in 68 patients. Sixty-six received cobalt-chrome (CoCr) monoblock and 12 received modular titanium acetabular cups with internal CoCr liners. Femoral components were titanium with modular necks. At average 2.1years postoperatively, 12 THAs (15.4%) demonstrated aseptic failure (10 revisions, 2 revision recommended). All revised hips demonstrated capsular necrosis with positive histology reaction for aseptic lymphocytic vasculitis-associated lesions/adverse local tissue reactions. Prosthetic instability following revision surgery was relatively common. Female gender was a strong risk factor for failure, though smaller cups were not. Both monoblock and modular components fared poorly. Corrosion was frequently observed around the proximal and distal end of the modular femoral necks.

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