Revision of failed metal-on-metal total hip arthroplasty using cemented arthroplasty: a mean 10-year follow-up of 157 consecutive patients

J Int Med Res. 2021 Jan;49(1):300060520969478. doi: 10.1177/0300060520969478.

Abstract

Objective: This study was performed to assess the outcomes of Asian patients who underwent conversion from metal-on-metal total hip arthroplasty (MoM-THA) to cemented THA (CTHA).

Methods: One hundred and fifty-seven consecutive patients (157 hips) who underwent CTHA following primary MoM-THA from January 2005 to February 2015 were retrospectively analysed. The primary endpoints were the clinical outcomes. Follow-ups occurred at 3 months, 6 months, 1 year, 2 years, and then every 2 years following revision of MoM-THA.

Results: The mean follow-up after conversion was 10 years (range, 5-14 years). Statistically significant improvements in the mean Harris hip score were observed between the preoperative and final follow-up evaluations (62.71 ± 13.85 vs. 84.03 ± 16.21, respectively). The major orthopaedic complication rate was 16.5% (26/157). Six (3.8%) patients underwent revision at a mean of 3.5 ± 1.3 years after conversion, predominantly because of prosthesis loosening or recurrent dislocation. Nine (5.7%) patients developed prosthesis loosening at a mean of 2.6 ± 1.1 years following conversion, two of whom requested revision surgery. Eleven (7.0%) patients developed prosthesis dislocation, four of whom requested revision surgery.

Conclusion: CTHA may yield favourable functional outcomes and a reduced rate of major orthopaedic complications.

Keywords: Conversion; complication; metal-on-metal; outcome; revision; total hip arthroplasty.

MeSH terms

  • Arthroplasty, Replacement, Hip* / adverse effects
  • Follow-Up Studies
  • Hip Prosthesis*
  • Humans
  • Metal-on-Metal Joint Prostheses* / adverse effects
  • Reoperation
  • Retrospective Studies