Béchir Ayoub1, Sophie Putman1, Pierre Cholewinski1, Amandine Paris2, Henri Migaud1, Julien Girard3. 1. Université de Lille Nord de France, Lille, France; Service d'orthopédie C, Hôpital Roger Salengro, Place de Verdun, Centre Hospitalier Régional Universitaire de Lille (CHRU de Lille), Lille Cedex, France. 2. Université de Lille Nord de France, Lille, France; Service d'orthopédie pédiatrique, Hôpital Jeanne de Flandre, CHRU de Lille, Lille, France. 3. Université de Lille Nord de France, Lille, France; Service d'orthopédie C, Hôpital Roger Salengro, Place de Verdun, Centre Hospitalier Régional Universitaire de Lille (CHRU de Lille), Lille Cedex, France; Département de médecine du sport, Faculté de médecine de Lille, Université de Lille 2, Lille, France.
Abstract
BACKGROUND: Total hip arthroplasty with metal-on-metal (MoM) bearings has been suspected to cause adverse reactions to metal debris (ARMD), with the incidence varying greatly by implant type and patient gender. The prevalence of ARMD from small-diameter MoM bearings in women is unknown, especially after 10 years of follow-up (FU). METHODS: Cementless 28-mm MoM total hip arthroplasty bearings (Metasul) were implanted consecutively in 42 active women between 1996 and 2002. They were reviewed after a minimum of 10 years' FU with clinical, laboratory, radiological, and ultrasound assessments. RESULTS: Mean FU was 15.9 years (range, 13-18). The mean Postel-Merle d'Aubigné and Oxford scores were 16.9 (range, 13-18) and 15.1 (range, 12-24), respectively, at FU. Mean cup inclination angle was 46.3° (range, 35°-57°). No femoral osteolysis was detected, but limited acetabular osteolysis (11%) over the screw holes occurred in 5 cases. No liquid or solid synovial reactions or ARMD were apparent on ultrasound, even in the 5 cases of pelvic osteolysis. Mean chromium levels were 1.32 μg/L (range, 0.1-7.9) and cobalt levels were 1.85 μg/L (range, 0.35-13.6). Cobalt was >3 μg/L in only 3 cases. The 15.9-year survivorship was 95% (range, 94.1%-98.9%). CONCLUSION: Reliable results were obtained with 28-mm MoM bearings, notably in young, active patients. This implant configuration requires very accurate positioning. No ARMD was seen in this group at 16 years' FU.
BACKGROUND: Total hip arthroplasty with metal-on-metal (MoM) bearings has been suspected to cause adverse reactions to metal debris (ARMD), with the incidence varying greatly by implant type and patient gender. The prevalence of ARMD from small-diameter MoM bearings in women is unknown, especially after 10 years of follow-up (FU). METHODS: Cementless 28-mm MoM total hip arthroplasty bearings (Metasul) were implanted consecutively in 42 active women between 1996 and 2002. They were reviewed after a minimum of 10 years' FU with clinical, laboratory, radiological, and ultrasound assessments. RESULTS: Mean FU was 15.9 years (range, 13-18). The mean Postel-Merle d'Aubigné and Oxford scores were 16.9 (range, 13-18) and 15.1 (range, 12-24), respectively, at FU. Mean cup inclination angle was 46.3° (range, 35°-57°). No femoral osteolysis was detected, but limited acetabular osteolysis (11%) over the screw holes occurred in 5 cases. No liquid or solid synovial reactions or ARMD were apparent on ultrasound, even in the 5 cases of pelvic osteolysis. Mean chromium levels were 1.32 μg/L (range, 0.1-7.9) and cobalt levels were 1.85 μg/L (range, 0.35-13.6). Cobalt was >3 μg/L in only 3 cases. The 15.9-year survivorship was 95% (range, 94.1%-98.9%). CONCLUSION: Reliable results were obtained with 28-mm MoM bearings, notably in young, active patients. This implant configuration requires very accurate positioning. No ARMD was seen in this group at 16 years' FU.
Authors: Wenzel Waldstein; Ulrich Koller; Bernhard Springer; Paul Kolbitsch; Wolfram Brodner; Reinhard Windhager; Richard Lass Journal: Bone Joint Res Date: 2020-05-16 Impact factor: 5.853
Authors: Tobias Reiner; Matthias C Klotz; Kirsten Seelmann; Fabian Hertzsch; Moritz M Innmann; Marcus R Streit; Timo A Nees; Babak Moradi; Christian Merle; Jan Philippe Kretzer; Tobias Gotterbarm Journal: Materials (Basel) Date: 2020-01-24 Impact factor: 3.623