Revision of Articular Surface Replacement (ASR) Total Hip Arthroplasty: Correlation of Perioperative Data and Early Post-Revision Outcome Results

J Arthroplasty. 2015 Sep;30(9):1607-17. doi: 10.1016/j.arth.2015.04.010. Epub 2015 Apr 11.

Abstract

The articular surface replacement (ASR) total hip arthroplasty (THA) showed accelerated failure rates due to adverse-reaction to metal debris (ARMD). Literature correlating preoperative with intraoperative revision findings respectively post-revision outcome results are rare. 30 of 99 available ASR THA were revised due to ARMD. Mean post-revision follow-up term was 2.3 years. In part, preoperative data did not correlate with intraoperative revision findings. ARMD was even found in asymptomatic patients with non-elevated ion levels. Postoperative pain and metal ions decreased significantly (P ≤ 0.016). Cobalt decreased faster than chrome. Patients with intraoperative pseudotumors, osteolysis or bilateral THA did not have higher pre- or postoperative ion values (P ≥ 0.053). Females showed higher postoperative chrome levels (P=0.031). One major post-revision complication (femoral nerve palsy) and one re-revision (late onset infection) occurred.

Keywords: ASR; articular surface replacement; outcome; revision; total hip arthroplasty.

MeSH terms

  • Adult
  • Arthroplasty, Replacement, Hip / instrumentation
  • Arthroplasty, Replacement, Hip / methods*
  • Cartilage Diseases
  • Chromium / chemistry
  • Cobalt / chemistry
  • Female
  • Femoral Nerve / injuries
  • Femoral Nerve / pathology
  • Hip Prosthesis*
  • Humans
  • Male
  • Metals
  • Middle Aged
  • Osteolysis
  • Pain, Postoperative / prevention & control*
  • Postoperative Period
  • Prosthesis Design
  • Prosthesis Failure
  • Range of Motion, Articular
  • Reoperation / instrumentation
  • Reoperation / methods*
  • Treatment Outcome
  • Young Adult

Substances

  • Metals
  • Chromium
  • Cobalt