Results of Conserve Plus® Metal-On-Metal Hip Resurfacing for Post-Traumatic Arthritis and Osteonecrosis

Abstract

The safety and efficacy of metal-on-metal surface arthroplasty in post-traumatic arthritis and post-traumatic osteonecrosis (PT OA and PT ON) cases has not previously been thoroughly investigated. This study compared the outcomes of metal-on-metal hip resurfacing (HR) in patients performed for an indication of OA secondary to trauma to compared to PT ON. Metal-on-metal resurfacing arthroplasties were performed on 62 hips, 43 with PT OA and 19 with PT ON with secondary osteoarthritis. There were 51 males and 11 females. All patients were followed up clinically and radiographically with a mean follow-up of 87.2 months. Clinical outcome scores, survivorship, and radiographs were compared between the PT OA and PT ON group. The clinical outcomes for the PT ON and PT OA groups were similar with a survival rate of 95% (95% CI 82.1% to 98.8%) for the PT OA group alone at 8 years and 91% for those with PT OA with ON at 8 years (95% CI 50.8%-98.7%). The Kaplan-Meier survivorship curves for the cohorts of PT OA and PT ON patients were not statistically significantly different (Log rank, p=0.6036). Metal-on-metal hip resurfacing appears to be a safe and effective procedure for the treatment of both post-traumatic osteoarthritis and osteonecrosis.

Long-Term Results of Total Hip Arthroplasty with 28-Millimeter Cobalt-Chromium Femoral Heads on Highly Cross-Linked Polyethylene in Patients 50Years and Less

“…Additionally, recent registry data indicates increased failure rates of RSA at 10-year follow-up [11, 40, 47]. Specifically in young males with osteoarthritis, resurfacing has shown excellent early and mid-term survival [19, 44], but increased problems at greater than eight years follow-up, with failures due to loosening or head collapse between 9-11%[38, 52]. Although failure rates of those with a preoperative diagnosis of ON in our study population approached statistical significance (p=0.129), we believe our results suggest a more predictable long-term survivorship of contemporary THA with a HXLPE bearing surface in this specific at-risk subgroup.…”

Total hip arthroplasty for posttraumatic osteoarthritis following acetabular fracture: A systematic review of characteristics, outcomes, and complications

“…Twenty-five articles were excluded after full text review for the following reasons: seven non-English language articles, 10 , 11 , 12 , 13 , 14 , 15 , 16 eight articles describing acute fracture management or lacking delayed THA, 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 eight articles with insufficient sample size (case reports and review articles), 5 , 6 , 25 , 26 , 27 , 28 , 29 , 30 one article with insufficient outcome data or follow-up duration, 31 and one article with co-occurring femur fractures and other ipsilateral injuries. 32 Cases of disagreement were resolved by discussion, and if no consensus was reached a third review author (SN) was consulted to make the decision. We recorded the selection process in a PRISMA flow diagram.…”

Do Hardened Femoral Heads Reduce Blood Metal Ion Concentrations after Hip Resurfacing?

“…It is important to remember that MoM is currently the only bearing technology that allows to perform hip resurfacing while preserving bone on both the femoral and the acetabular sides because it is the only material providing sufficient strength to manufacture thin monoblock acetabular components with a reliable cementless fixation. Hip resurfacing has already shown excellent results in multiple studies at 10 years in patients with large components and good bone quality (32-33-34) and very favourable result in a variety of other conditions (35-36-37-38). Although the differences in serum metal ion concentrations observed in this study are small in magnitude and the clinical results comparable, the use of a differential hardness bearing may still be considered over the use of a conventional heat-treated CoCr bearing because of the potential reduction in wear shown in vitro for this technology and there are no negatives to using the forged femoral component.…”