Outcome of revision arthroplasty for failed metal-on-metal total hip replacements; is there a relation with metal ions?

Hip Int. 2017 May 12;27(3):235-240. doi: 10.5301/hipint.5000460. Epub 2017 Feb 3.

Abstract

Purpose: We aimed to assess the early outcome following revision arthroplasty for failed metal-on-metal (MoM) total hip replacements (THR) due to adverse reaction to metal debris (ARMD).

Methods: We reviewed 106 consecutive revision arthroplasties. Case notes and radiological investigations were reviewed to assess the complications. Oxford Hip Score (OHS) and Euroqol (EQ-5D-3L) scores were used to assess the functional outcome and improvement of quality of life.

Results: At a mean follow-up of 20 months (12-48 months), the mean OHS was 28.7. Pain improved in 61% patients. A majority of patients were in level 2 for all the EQ-5D-3L dimensions. The overall complication rate was 16%. Survivorship free from further revision for any cause was 94.3% at 48 months. There was no correlation between pre-revision blood metal ions and the final outcome.

Conclusions: Revision surgery for failed MoM hip replacement due to ARMD is associated with a relatively higher rate of complications and risk of chronic pain. There is poor correlation between serum metal ions and development of ARMD and outcome following revision surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / methods*
  • Female
  • Follow-Up Studies
  • Hip Joint / surgery
  • Hip Prosthesis / adverse effects*
  • Humans
  • Ions / adverse effects
  • Joint Diseases / surgery*
  • Male
  • Metal-on-Metal Joint Prostheses / adverse effects*
  • Metals / adverse effects
  • Metals / chemistry*
  • Middle Aged
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation
  • Retrospective Studies
  • Risk Factors
  • Time Factors

Substances

  • Ions
  • Metals