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. 2018 May 7;15(2):586-590.
doi: 10.1016/j.jor.2018.05.041. eCollection 2018 Jun.

Long-term results of metal on metal total hip arthroplasty in younger patients (<55yrs)

Muhammad Umar  1 , Noman Jahangir  2 , Qasim Malik  1 , Steven Kershaw  1 , Keith Barnes  1 , Syam Morapudi  1
Affiliations

Long-term results of metal on metal total hip arthroplasty in younger patients (<55yrs)

Muhammad Umar et al. J Orthop. .

Erratum in

Abstract

Introduction: Metal on Metal (MoM) hip arthroplasty saw a new era of popularity with development of its second generation bearing surfaces, in the first decade of this century. However, by the end of that decade, concerns had been raised due to metal debris related complications.We aimed to determine the survival of MoM stemmed hip replacement in younger population. We also studied the rate of revision related to adverse reaction to metal debris (ARMD) along with reviewing the clinical and radiological progress of MoM hip arthroplasty in younger age (<55 yrs) group.

Patients & methods: This is a retrospective cohort study of patients 55 yrs old or younger, who had metal on metal (MoM) hip arthroplasty for osteoarthritis. We had 109 procedures performed on 90 patients with a mean follow up of 10 years. All patients were reviewed as per MHRA guidelines in planned follow-up clinics. Data analyses were performed using SPSS.

Results: Survival of implant in our younger cohort was 88.1% at a mean age if 10 years, with revision for any cause as an endpoint. Most of the patients were happy with the outcome of their hip replacement as they were able to perform activities of daily living and work without compromise. Mean Oxford hip score was 43.Altogether, there were 12 revisions, 7 of these were for metallosis and associated symptoms. Average time to revision was 7 years. Other analysis revealed mean acetabular cup inclination angle to be 49 degrees but no significant correlation was found between this angle and serum metal ion levels. Serum Chromium and Cobalt levels were significantly higher in revision group.

Discussion: Metal on metal hip arthroplasty prime popularity time has gone. In younger population, although revision rates are higher, the surviving implants give a very good outcome in terms of patient satisfaction. Most of the patients report a desired outcome of 'forgotten hip'.

Keywords: Hip arthroplasty; Metal ions; Metal on metal; Oxford hip score; Younger patients.

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Figures

Fig. 1
Fig. 1
Our cohort patient distribution at final follow-up.
Fig. 2
Fig. 2
Functional outcome of MoM THR in younger patients – Oxford Hip Score – very good results with Mean 43.2 in non-revised patients.
Fig. 3
Fig. 3
Kaplan Meier Survival of MoM THR in younger patients (88.1%) – revision for all causes as endpoint.
Fig. 4
Fig. 4
Kaplan Meier Survival of MoM THR in younger patients (99%) – revision for aseptic loosening as endpoint.
See this image and copyright information in PMC

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