NDLI: Metal-on-metal hip arthroplasty: does early clinical outcome justify the chance of an adverse local tissue reaction?

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Year: 2010 Volume: 468 Issue: 1

Year: 2009 Volume: 467

Year: 2008 Volume: 466

Metal-on-metal hip arthroplasty: does early clinical outcome justify the chance of an adverse local tissue reaction?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Engh, Charles A. Ho, Henry
Description	Country affiliation: United States Author Affiliation: Engh CA ( Anderson Orthopaedic Research Institute, Alexandria, VA 22307, USA.)
Abstract	UNLABELLED: Larger diameter metal-on-metal (MOM) bearing hips offer the possibility of low wear and reduced risk of dislocation. We reviewed the first 126 patients (131 hips) who had a large-head (36-mm) MOM bearing surface to report the early clinical outcome and especially to determine the occurrence of dislocation and wear-related concerns. The minimum followup was 5 years (mean, 5.6 years; range, 5-7 years). We found a 98% survivorship free of component revision. No hips had been revised for dislocation. Three hips (2%) had small femoral osteolytic lesions. Because this series of patients did not completely represent our experience with this bearing surface, we queried our database for the 828 patients (945 hips) that had the same bearing surface from April 2001 to December 2008. Three patients (0.3%) had a local reaction to the MOM bearing surface on revision-retrieved tissue. All three patients presented with elevated inflammatory indices, and a purulent-appearing joint effusion at revision. The possibility of infection and the delay in diagnosing a reaction to the MOM bearing with pathology complicated management of these three patients. We continue to use this bearing surface because the 5-year results are comparable to other bearing surfaces, however, we counsel patients that a local adverse reaction to the MOM bearing surface may be a factor contributing to reoperation. LEVEL OF EVIDENCE: Level IV, retrospective clinical cohort. See Guidelines for Authors for a complete description of levels of evidence.
File Format	HTM / HTML
ISSN	0009921X
e-ISSN	15281132
DOI	10.1007/s11999-009-1063-8
Journal	Clinical Orthopaedics and Related Researchtextregistered
Issue Number	2
Volume Number	468
Language	English
Publisher	Springer
Publisher Date	2010-02-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Orthopaedics Arthroplasty, Replacement, Hip Adverse Effects Foreign-body Reaction Etiology Hip Joint Surgery Hip Prosthesis Hypersensitivity Instrumentation Dislocations Prevention & Control Kaplan-meier Estimate Osteolysis Patient Selection Prosthesis Design Prosthesis Failure Radiography Reoperation Retrospective Studies Risk Assessment Time Factors
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery Sports Science

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