Comparison of Harris Hip Scores and Revision Rates in Metal-on-Metal Versus Non-Metal-on-Metal Total Hip Arthroplasty.

INTRODUCTION This study compares functional outcome scores and revision rates between metal-on-metal (MoM) and non-MoM total hip arthroplasty patients. METHODS A cohort of 75 patients who underwent implantation of the same dual modular hip arthroplasty between the years of 2004 and 2010 was enrolled. Patients were subsequently evaluated in 2015 to 2017 for joint revision history and functionality, as measured by the Harris hip score (HHS). Patients requiring a revision arthroplasty were not included in the HHS analysis. RESULTS A total of 49 patients had MoM implants (65.3%), and 26 patients had non-MoM implants (34.8%). At a mean follow-up of 7.6 years, 10.2% (5/49) of MoM prostheses required revision, whereas 3.8% (1/26) of non-MoM prostheses required revision (P = 0.334). The mean HHS in the MoM cohort was 89.8, compared with 88.1 in the non-MoM cohort (P = 0.69). CONCLUSION HHSs were not notably different between cohorts. The MoM cohort had three times as many revisions as the non-MoM cohort, but given the numbers available, this difference did not reach significance. Given the clinical importance of these revision data, further study is warranted to determine survivorship of the MoM versus non-MoM total hip arthroplasty at long-term follow-up.

[1]  J. Henckel,et al.  Retrieval Findings of Recalled Dual-Taper Hips , 2018, The Journal of bone and joint surgery. American volume.

[2]  T. Gross,et al.  Metal-on-metal hip resurfacing in patients younger than 50 years: a retrospective analysis , 2017, Journal of Orthopaedic Surgery and Research.

[3]  S. Goldring,et al.  Nano-analyses of wear particles from metal-on-metal and non-metal-on-metal dual modular neck hip arthroplasty. , 2017, Nanomedicine : nanotechnology, biology, and medicine.

[4]  M. Teeter,et al.  Metal-on-Metal Compared With Metal-on-Polyethylene: The Effect on Trunnion Corrosion in Total Hip Arthroplasty. , 2017, The Journal of arthroplasty.

[5]  R. Sierra,et al.  The Utility of Metal Ion Trends in Predicting Revision in Metal-on-Metal Total Hip Arthroplasty. , 2017, The Journal of arthroplasty.

[6]  Nolan M. Wessell,et al.  Ultrasound findings in asymptomatic patients with modular metal on metal total hip arthroplasty , 2017, Skeletal Radiology.

[7]  A. Hart,et al.  Clinical significance of corrosion of cemented femoral stems in metal-on-metal hips: a retrieval study , 2016, International Orthopaedics.

[8]  P. Boisrenoult,et al.  Small diameter metal-on-metal total hip arthroplasty at 13 years - a follow-up study. , 2015, Orthopaedics & traumatology, surgery & research : OTSR.

[9]  S. Knuutila,et al.  Genetic alterations in periprosthetic soft-tissue masses from patients with metal-on-metal hip replacement. , 2015, Mutation research.

[10]  P. Campbell,et al.  Do Retrieval Analysis and Blood Metal Measurements Contribute to Our Understanding of Adverse Local Tissue Reactions? , 2014, Clinical orthopaedics and related research.

[11]  Peter Pilot,et al.  Treatment of pseudotumors after metal-on-metal hip resurfacing based on magnetic resonance imaging, metal ion levels and symptoms. , 2014, The Journal of arthroplasty.

[12]  Jacob T. Munro,et al.  High Complication Rate After Revision of Large-head Metal-on-metal Total Hip Arthroplasty , 2014, Clinical orthopaedics and related research.

[13]  E. Chang,et al.  Relationship of plasma metal ions and clinical and imaging findings in patients with ASR XL metal-on-metal total hip replacements. , 2013, The Journal of bone and joint surgery. American volume.

[14]  C. Overgaard,et al.  Fatal cardiomyopathy after revision total hip replacement for fracture of a ceramic liner. , 2013, The bone & joint journal.

[15]  Joseph Daniel,et al.  Pseudotumors associated with total hip arthroplasty. , 2012, The Journal of bone and joint surgery. American volume.

[16]  P. Campbell,et al.  Failure modes of 433 metal-on-metal hip implants: how, why, and wear. , 2011, The Orthopedic clinics of North America.

[17]  M. Wimmer,et al.  Polyethylene and metal wear particles: characteristics and biological effects , 2011, Seminars in Immunopathology.

[18]  S. Tower Arthroprosthetic cobaltism: neurological and cardiac manifestations in two patients with metal-on-metal arthroplasty: a case report. , 2010, The Journal of bone and joint surgery. American volume.

[19]  M. Bhandari,et al.  The Harris hip score: Do ceiling effects limit its usefulness in orthopedics? , 2010, Acta orthopaedica.

[20]  S. Kurtz,et al.  The epidemiology of bearing surface usage in total hip arthroplasty in the United States. , 2009, The Journal of bone and joint surgery. American volume.

[21]  M. Wimmer,et al.  Metal-on-metal bearing surfaces. , 2009, The Journal of the American Academy of Orthopaedic Surgeons.

[22]  H. Malchau,et al.  Is the Harris Hip Score System Useful to Study the Outcome of Total Hip Replacement? , 2001, Clinical orthopaedics and related research.