Component Position and Metal Ion Levels in Computer-Navigated Hip Resurfacing Arthroplasty

2017 ◽  
Vol 32 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Stephen M. Mann ◽  
Manuela Kunz ◽  
Randy E. Ellis ◽  
John F. Rudan
2011 ◽  
Vol 42 (2) ◽  
pp. 169-180 ◽  
Author(s):  
David J. Langton ◽  
Thomas J. Joyce ◽  
Navjeet Mangat ◽  
James Lord ◽  
Maarten Van Orsouw ◽  
...  

2020 ◽  
Author(s):  
Weiguang Yu ◽  
Mao Shuai ◽  
Jinluan Lin ◽  
Baomin Chen ◽  
Mingdong Zhao ◽  
...  

Abstract Background The purpose of this retrospective study was to assess clinical outcomes following failed metal-on-metal hip resurfacing arthroplasty (MoM-HRA) revised using ceramic-on-ceramic total hip arthroplasty (CoC-THA) via the direct anterior approach (DAA).Methods Data involving 112 patients (112 hips) with failed primary MoM-HRA that was revised using CoC-THA via the DAA during 2006 - 2018 were retrospectively analysed. The mean age was 54.6 years (45–63 years). Frequent surgical indications for conversion were aseptic loosening and femoral neck fracture. The primary endpoint was the Postel-Merle d’Aubigne functional score (PMA). Secondary endpoints were the major orthopaedic complication rate and serum metal ion levels (chromium and cobalt).Results The mean follow-up time was 10 years (range, 4 - 13 years). The mean PMA improved from 9 (4-14) to 16 (13-18) (p = 0.001). Six patients had undergone a re-revision intervention. Fourteen incidents of aseptic loosening and four periprosthetic fractures were observed. A consistent decline in mean serum metal ion levels was detected [chromium decreased from 36.6 μg/L (12.5-76.5 μg/L) prior to conversion to 2.6 μg/L (0.1-13.5 μg/L) at final follow-up (p = 0.001), cobalt decreased from 37.5 μg/L (6.7-93.2 μg/L) to 2.2 μg/L (1.2-18.4 μg/L) (p =0.003)].Conclusion Failed primary MoM-HRA converted to CoC-THA using the DAA yielded acceptable clinical outcomes.


2009 ◽  
Vol 91-B (10) ◽  
pp. 1287-1295 ◽  
Author(s):  
D. J. Langton ◽  
A. P. Sprowson ◽  
T. J. Joyce ◽  
M. Reed ◽  
I. Carluke ◽  
...  

2008 ◽  
Vol 90 (Suppl 3) ◽  
pp. 125-133 ◽  
Author(s):  
Christian Heisel ◽  
Nikolaus Streich ◽  
Michael Krachler ◽  
Eike Jakubowitz ◽  
J Philippe Kretzer

2020 ◽  
pp. 112070002095735
Author(s):  
Catherine Van Der Straeten

Background: Total hip arthroplasty (THA) in patients younger than 50 years poses significant challenges including postoperative limitations of activity and higher failure rates. Sub-par outcomes of hip resurfacing arthroplasty (HRA) in registries remain controversial due to multiple confounders. Favourable HRA results in some studies are often regarded as irreproducible. The aim of this study is to analyse HRA outcomes in a large international cohort. Patients and methods: We compiled a database of 11,382 HRA patients ⩽50 years from an international group of 27 experienced HRA centres from 13 countries. 18 different metal-on-metal (MoM) HRA designs were included with a mean follow-up of 7.6 years. Outcomes were implant survivorship, revision rates, causes for revision, clinical scores and metal ion levels. Outcomes were compared between genders, sizes, implant types and pre-operative diagnoses. Results: Overall cumulative Kaplan-Meier survivorship was 88.9% at 22 years (95% CI: 88.3–89.5%). 2 HRA designs (DePuy Articular Surface Replacement (ASR), and Corin Cormet Hip Resurfacing System (CORMET)) led to inferior results while all others yielded similar survivorships. Excluding ASR and CORMET, implant survivorship in 11,063 cases was 95% at 10 years and 90% at 22 years. In men, implant survivorship was excellent: 99% at 10 years and 92.5% at 21 years. In females, implant survivorship was 90% at 10 years and 81.3% at 22 years. The overall revision rate was 3.6% with most common reasons for revision being implant loosening and adverse local tissue reactions. The best survivorship was found in patients with osteoarthritis (95% CI, 92.1–93.3% at 22 years), the poorest was among dysplastic hips (78.3%; 95% CI, 76.5–80.1% at 20 years, p < 0.001). Conclusions: Comparable revision rates demonstrated here may mitigate some concerns for safety and longevity of MoM HRA implants. Higher demands for activity and functionality in younger patients make HRA a potential alternative to THA.


2015 ◽  
Vol 1114 ◽  
pp. 247-252 ◽  
Author(s):  
Marius Niculescu ◽  
Dan Laptoiu ◽  
Florin Miculescu ◽  
Iulian Vasile Antoniac

Hip resurfacing arthroplasty is an very interesting and controversial orthopedic concept in the last years [1]. In order to avoid the previous problems associated with the classical hip prosthesis type metal-polyethylene [2], different manufacturer propose the metal-metal prosthesis based on the reproducible quality of manufacturing of metallic components using Co-Cr alloys and better component fixation. Problems that have been encountered to be the reason for failing of the prosthesis can be different (dislocation, femoral neck fractures, vascular damage, avascular necrosis, raised metal ion levels), and could be related to three main aspects: factors related to the patients, surgical intervention and prosthesis [3, 4]. But a very important aspect is the biomaterials used, that will be discussed in the present paper in correlation with biomechanics and clinical aspects. Our study maked on a lot of retrieved BHR prosthesis used in one Romanian orthopaedic clinic present a higher rate of failure than the other similar studies made by other authors [5]. Starting from this point, we analyze carefully many components of the failed BHR prosthesis using stereomicroscopy, scanning electron microscopy (SEM) and EDS. Based on our experimental results especially at the interfaces metal-cement-bone, we identify different potential causes of failure but the main conclusion was that the cementation technique and poor quality of the patient bone are the reasons for most of hip resurfacing prosthesis failure. As future recommendations for the orthopaedic surgeons we could mention the carefully analysis of bone quality for each candidate using advanced techniques like DEXA and a correlation between the bone cement used for prosthesis fixation and the cementation technique.


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