Letter to the Editor: Do Complication Rates Differ by Gender After Metal-on-metal Hip Resurfacing Arthroplasty? A Systematic Review

Are Females at Greater Risk for Revision Surgery After Hip Resurfacing Arthroplasty With the Articular Surface Replacement Prosthesis?

“…A systematic review from 2015 exploring the effect of sex on complications after hip resurfacing arthroplasties found that female patients were at greater risk of adverse local tissue reaction, dislocation, aseptic loosening, and revision surgery [11]. However, female sex as a causative factor has been questioned, because implant size and positioning, anatomic differences, and the primary diagnosis might serve as confounders [1,27]. Another conclusion of the systematic review was that arthroplasty research data often lack an adequate description of the sex distribution and its association with outcomes.…”

“…Therefore, we conducted an analysis of data from a prospective multicenter cohort study monitoring the hip resurfacing arthroplasty using the ASR TM prosthesis to ask the following questions: (1) What is the association between sex and implant survival, and the presence of adverse local tissue reaction in arthroplasties with MoM hip prostheses; and (2) are there differences between sexes in metal ion levels and patient-reported outcome measures (PROMs) in patients with arthroplasties with MoM hip resurfacing systems?…”

“…Questions/purposes We wished (1) to assess the associations between sex and implant survival, and adverse local tissue reaction; and (2) to report the differences between sexes in metal ion levels and patient-reported outcome measures. Methods One thousand two hundred fifty-two patients (1390 hips) who underwent hip resurfacing arthroplasty with implantation of the ASR TM prosthesis from April 2003 to July 2010 were eligible for enrollment in a multicenter followup study of the ASR TM Hip Resurfacing System after the voluntary recall of this device was initiated by DePuy in 2010.…”