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. 2008 Feb;466(2):340-6.
doi: 10.1007/s11999-007-0045-y. Epub 2008 Jan 10.

THA using metal-on-metal articulation in active patients younger than 50 years

Christian P Delaunay  1 , François Bonnomet, Philippe Clavert, Philippe Laffargue, Henri Migaud
Affiliations

THA using metal-on-metal articulation in active patients younger than 50 years

Christian P Delaunay et al. Clin Orthop Relat Res. 2008 Feb.

Abstract

The main concern of patients with longer life expectancies and of patients who are younger and more active is the longevity of their total hip arthroplasty. We retrospectively reviewed 83 cementless total hip arthroplasties in 73 patients implanted with metal-on-metal articulation. All patients were younger than 50 years old (average age, 41 years) at the time of the index procedure, and 80% of the patients had an activity level graded 4 or 5 when measured with the system of Devane et al. A 28-mm Metasul articulation was used with three different cementless titanium acetabular components. At the most recent followup (average, 7.3 years), the average Merle d'Aubigné-Postel score improved from a preoperative 11.1 points to 17.4 points. We observed no radiographic evidence of component loosening. Ten acetabular components had lucency limited to one zone. The 10-year survivorship with the end point of revision (ie, exchange of at least one prosthetic or bearing component) was 100% (95% confidence interval, 90%-100%). Metasul bearings with cementless acetabular components remain promising in this high-risk younger patient population. However, additional followup strategies are recommended to determine any possible long-term deleterious effects associated with the dissemination of metallic ions.

Level of evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Figures

Fig. 1A–C
Fig. 1A–C
Three acetabular components used in the study were (A) the Armor-Allofit press-fit acetabular component with titanium fiber-mesh and adjuvant screws; (B) the Alloclassic-CSF grit-blasted threaded acetabular component; and (C) the press-fit hydroxyapatite acetabular component with hydroxyapatite coating.
Fig. 2
Fig. 2
This 8.4-year postoperative followup radiograph shows a primary Alloclassic-SL femoral component and CSF-threaded acetabular component with 28-mm Metasul bearings. The patient is an active (Grade 5 of Devane et al. [16]) truck driver who was 46 years old at the time of the index surgery.
See this image and copyright information in PMC

References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1080/00016470310014157', 'is_inner': False, 'url': 'https://doi.org/10.1080/00016470310014157'}, {'type': 'PubMed', 'value': '12899543', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12899543/'}]}
    2. Aldinger PR, Thomsen M, Mau H, Ewerbeck V, Breusch SJ. Cementless Spotorno tapered titanium stems: excellent 10–15-year survival in 141 young patients. Acta Orthop Scand. 2003;74:253–258. - PubMed
    1. None
    2. Australian Orthopaedic Association. National Joint Replacement Registry: Annual Report. Adelaide, Australia: Australian Orthopaedic Association; 2006.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1302/0301-620X.79B2.7326', 'is_inner': False, 'url': 'https://doi.org/10.1302/0301-620x.79b2.7326'}, {'type': 'PubMed', 'value': '9119865', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/9119865/'}]}
    2. Brodner W, Bitzan P, Meisinger V, Kaider A, Gottsauner-Wolf F, Kotz R. Elevated serum cobalt with metal-on-metal articulating surfaces. J Bone Joint Surg Br. 1997;79:316–321. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/j.arth.2004.09.020', 'is_inner': False, 'url': 'https://doi.org/10.1016/j.arth.2004.09.020'}, {'type': 'PubMed', 'value': '15578562', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15578562/'}]}
    2. Brodner W, Grohs JG, Bancher-Todesca D, Dorotka R, Meisinger V, Gottsauner-Wolf F, Kotz R. Does the placenta inhibit the passage of chromium and cobalt after metal-on-metal total hip arthroplasty? J Arthroplasty. 2004;19(Suppl 3):102–106. - PubMed
    1. None
    2. Canadian Institute for Health Information. Canadian Joint Replacement Registry. Ottawa, Ontario. Canada: Canadian Institute for Health Information;2006.

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