Five-year follow-up of a prospective randomised trial comparing ceramic-on-metal and metal-on-metal bearing surfaces in total hip arthroplasty

Schouten, Rowan; Malone, Alex; Frampton, Chris; Tiffen, C.; Hooper, Gary J.

doi:10.1302/0301-620x.99b10.bjj-2016-0905.r1

Cited by 18 publications

(11 citation statements)

References 20 publications

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“…After 5 years of follow-up, ion values remain stationary in patients with CoM bearing, while they have an upward trend in patients with MoM bearing. 33 Engh et al, 25 on the other hand, did not detect a statistically significant difference in Cr-Co values between MoMs and CoMs at a follow-up of 5 years.…”

Section: Discussionmentioning

confidence: 89%

“…When compared to the other studies of the effect of hip arthroplasty on Cr and Co ion levels, Cr results were not significantly different from the overall mean of the other studies, while Co results were significantly lower (p < 0.001). 4,8,25,[29][30][31][32][33][34] Figure 3 depicts Cr and Co levels in our sample in comparison to the general Italian population and to the estimated overall mean of published studies.…”

Section: Resultsmentioning

confidence: 99%

“…The revision rate of the implants in our study was zero (0%) showing that there were no patients with severe complications. Engh et al, 25 Hill et al 32 and Schouten et al 33 reported higher revision rates: 1.5% (194 patients at 50 months follow-up), 3.1% (271 patients at 34 months follow-up) and 5.3% (110 patients at 60 months follow-up) respectively. All implants were osseointegrated and there were no signs of significant osteolysis or implant loosening.…”

Section: Discussionmentioning

confidence: 95%

“…In our study, higher values of Cr were found in patients at 5-year follow-up, while Co levels were lower in patients with longer-term follow-up. Schouten et al 33 reported in 1 of his studies that the increase in blood Cr-Co levels is substantially overlapping in the first 2 years after surgery, whether MoM or CoM bearings have been implanted. After 5 years of follow-up, ion values remain stationary in patients with CoM bearing, while they have an upward trend in patients with MoM bearing.…”

Section: Discussionmentioning

confidence: 99%

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Ceramic-on-metal bearing in short stem total hip arthroplasty: ions, functional and radiographic evaluation at mid-term follow-up

et al. 2020

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Introduction: The aim of this study is to evaluate clinical, radiographic and laboratory results of ceramic-on-metal (CoM) (hybrid hard bearing) in total hip arthroplasty (THA), associated with a short stem implant. Methods: From a cohort of 37 patients suffering from primary or secondary hip osteoarthritis who underwent THA using CoM bearing, 19 were suitable for this study. All procedures were performed by the same surgeon using a posterior-lateral approach. All patients were compared clinically using the Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS), 12-item Short Form Health Survey (SF12F/M), and radiographically (offset, CD angle, limb length discrepancy, cup inclination and anteversion, subsidence, osseointegration, heterotopic ossification). Blood samples were collected in order to evaluate chromium (Cr) and cobalt (Co) ions level. Radiographic evaluations were carried out by 3 different blinded surgeons. A statistical analysis was performed. Results: At a mean follow-up of 97 (73–125) months all implanted stems were well-positioned and osseointegrated. Clear improvements were observed for clinical scores comparing preoperative and postoperative values. Radiographic evaluation showed a good ability to restore proper articular geometry. Cr ion analysis revealed values below the safety threshold except for 1 case. Serum levels of Co were below the threshold in all patients. There was a statistically significant correlation only between Cr metal ions and length of follow-up. Conclusions: CoM bearing has proven to be reliable and safe at a mean 8-year follow-up for patients in whom the components were correctly implanted. The rise of blood metal ions was minimal and involved neither systemic or local toxicity nor influenced clinical results.

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Section: Discussionmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Ceramic-on-metal bearing in short stem total hip arthroplasty: ions, functional and radiographic evaluation at mid-term follow-up

et al. 2020

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“…This study involved 44 patients with an average follow-up of over 9 years. In the literature, it is possible to find several papers on the subject, but few of them have a such long term follow up [ 20 , 21 ]. We were able to appreciate how all the implants were optimally osseointegrated and no patient needed revision.…”

Section: Discussionmentioning

confidence: 99%

Ceramic-on-metal coupling in THA: long term clinical and radiographic outcomes using two different short stems

Logroscino

Saracco

Maccauro

et al. 2022

BMC Musculoskelet Disord

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Background Hip prosthetic replacement surgery is the gold standard for patients affected by symptomatic osteoarthritis. The ceramic-on-metal hybrid hard-on-hard bearing was initially launched on the market with the purpose of reducing adhesive and corrosion wear, loss of metal debris and ions and risk of fracture and squeaking. However, this bearing was withdrawn from the market, in the apprehension of local and systemic toxicity. The aim of this study is to evaluate the reliability and safety of ceramic-on-metal bearing at long term follow-up. Methods From 2 cohorts of patients suffering of hip osteoarthritis who underwent total hip arthroplasty using ceramic-on-metal bearing with two different short stems, 19 of the GROUP A and 25 of the GROUP B were suitable for this study. All patients were compared clinically using the Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS), 12-item Short Form Health Survey (SF12P/M), and radiographically. Blood samples were collected in order to evaluate chromium and cobalt ions level. The two groups were compared in terms of metal ions blood levels, and finally all the implanted prostheses were compared with a healthy control group. Results All the implanted stems were well-positioned and osseointegrated at a mean follow-up of 114 months. Improvements were observed for all clinical scores comparing preoperative and postoperative values in both groups. Radiographic evaluation showed a good ability to restore proper articular geometry. Chromium and cobalt ion analysis revealed values below the safety threshold except for 1 case in GROUP A (cup malposition) and 2 cases in GROUP B (6.1%). No revision occurred. Conclusions Ceramic-on-metal bearing is safe and reliable at long term follow-up in association to short stems arthroplasty, if the implant is correctly positioned. Chromium and cobalt metal ions blood levels evaluation should be performed annually.

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Overview of Robotics in Total Hip Arthroplasty

Dalrymple,

Ibrahim,

Kayani

et al. 2023

Hip Arthroplasty

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Five-year follow-up of a prospective randomised trial comparing ceramic-on-metal and metal-on-metal bearing surfaces in total hip arthroplasty

Abstract: While both bearing combinations have since been withdrawn these results provide useful information for planning clinical surveillance of CoM THAs and warrants continued monitoring. Cite this article: 2017;99-B:1298-1303.

Cited by 18 publications

References 20 publications

Ceramic-on-metal bearing in short stem total hip arthroplasty: ions, functional and radiographic evaluation at mid-term follow-up

Ceramic-on-metal bearing in short stem total hip arthroplasty: ions, functional and radiographic evaluation at mid-term follow-up

Ceramic-on-metal coupling in THA: long term clinical and radiographic outcomes using two different short stems

Overview of Robotics in Total Hip Arthroplasty

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