Revision of metal-on-metal resurfacing arthroplasty of the hip

Haan, R. De; Campbell, Pat; Su, Edwin P.; Smet, Koen A. De

doi:10.1302/0301-620x.90b9.19891

Cited by 210 publications

(201 citation statements)

References 25 publications

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“…Previously, a few studies were directed at proper femoral component stem orientation in HRA [19,26,27]. However, it now appears proper placement of the acetabular component may be even more critical to the success of this procedure [8,9,11,21,30]. We investigated the value of using a single intraoperative portable crosstable AP radiograph to improve the accuracy of placing the acetabular component within a target range of inclination.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies reported revision rates of 1% to 5% at an average of 5 to 7 years in young and active patients after HRA [2,15,21,28]. Even though femoral neck fracture and femoral loosening were formerly reported as the most common failure modes in these studies [2,4,21], revision related to the acetabular component is being recognized more frequently in recent reports [8,11]. Previously, higher dislocation rates and increased wear rates were well-documented in standard THA with improper acetabular inclination angles [12,20,22,31].…”

Section: Introductionmentioning

confidence: 99%

“…The use of hip resurfacing arthroplasty (HRA) has been resurgent with the development of modern designs of metal-on-metal bearings since the late 1990s [2,4,7,8,11,15,21,28]. Recent studies reported revision rates of 1% to 5% at an average of 5 to 7 years in young and active patients after HRA [2,15,21,28].…”

Section: Introductionmentioning

confidence: 99%

“…P. Gross, F. Liu (&), L. Webb Midlands Orthopaedics, p. a., 1910 Blanding Street, Columbia, SC 29201-3520, USA e-mail: grossortho@yahoo.com; feilresearch@gmail.com angles were greater than 55°in 39-mm metal-on-metal bearing hip implants [31]. Also, while several studies [3,8] suggest the upper limit for ideal inclination angle for large metal bearings is approximately 55°, we found no data suggesting a lower limit.…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative Radiographs for Placing Acetabular Components in Hip Resurfacing Arthroplasty

Gross

Liu

Webb

2011

Clinical Orthopaedics &Amp; Related Research

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Background Various clinical and biomechanical studies suggest certain acetabular positions may be associated with higher wear and failure rates in modern metal-on-metal hip resurfacing arthroplasties. However, there are no widely available, reliable, and cost-effective surgical techniques that ensure surgeons are able to place an acetabular component within the safe range of inclination angles after hip resurfacing surgeries. Questions/purposes We investigated the accuracy of intraoperative radiographs to determine the acetabular inclination angle in resurfacing arthroplasty procedures. Patients and Methods The study group included the first 100 resurfacing arthroplasties performed after we started routinely checking the intraoperative acetabular inclination angles. The acetabular component was repositioned if the intraoperative acetabular inclination angle was out of the target range of 30°to 50°. The control group included the previous 100 resurfacing arthroplasties performed without the benefit of intraoperative radiographs. A posterior minimally invasive surgical approach was used in both groups. Demographics and diagnoses were similar in both groups. ResultsThe average (± SD) difference between the intraoperative and 6-week radiographs was 2.7°± 2.5°. The acetabular inclination angles at 6-week followup were within the targeted range more frequently in the study group than in the control group (outliers: 4% versus 29%). Conclusions These data suggest a single intraoperative radiograph is a quick, reliable, and cost-effective method for ensuring the acetabular inclination angle is within the targeted range. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intraoperative Radiographs for Placing Acetabular Components in Hip Resurfacing Arthroplasty

Gross

Liu

Webb

2011

Clinical Orthopaedics &Amp; Related Research

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“…Twelve articles remained after 198 articles were screened [4,11,12,18,24,28,30,34,38,43,44,48] (Fig. 3).…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

Engh

Padgett

2014

Clin Orthop Relat Res

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Background Wear and corrosion occurring in patients with hip and knee arthroplasty are common causes of failure leading to revision surgery. A variety of surgical approaches to these problems have been described, with varying efficacy. Polyethylene wear, metal-on-metal (MoM) hip bearing wear, and problems associated with modular taper corrosion are the areas of greatest clinical impact; results of revisions for these problems are likely to dictate a large portion of revision resources for the foreseeable future, and so they call for specific study. Questions/purposes We identified the most frequently reported procedures to treat hip polyethylene wear, knee polyethylene wear, MoM wear after THA, and modular taper corrosion and determined the timing and reasons these failed. Methods We performed systematic reviews of the published literature on the four topics using MEDLINE 1 and Embase in October 2013; searches were supplemented by hand searches of bibliographies. Prespecified criteria resulted in the identification of 38 relevant articles, of which 33 were either case reports or Level IV evidence. Followup was generally at short term and ranged from 0.2 to 8 years. Results The most frequently reported procedures for treating clinically important wear were a partial or complete revision. When treating polyethylene wear, the more frequently reported reasons for hip and knee rerevisions were loosening, continued wear, and instability. Soft tissue reactions were more common and occasionally extensive in patients with MoM or modular taper corrosion. Patients with soft tissue reactions had more complications and higher rerevision rates. Conclusions Studies with longer followup and higher levels of evidence are needed to direct the treatment of wear and corrosion. When soft tissue damage secondary to MoM wear or taper corrosion is present, the results of treatment can be poor. There is an urgent need to better understand these two mechanisms of failure.

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Surface engineering: A low wearing solution for metal‐on‐metal hip surface replacements

et al. 2009

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Increased patient blood and serum levels of Co and Cr and dissemination of metal wear particles throughout organs and tissues are the primary concerns with metal-on-metal surface replacements. Surface engineering, providing a ceramic bearing surface on a metal substrate, could provide a solution. This study investigated thick (>10 lm) arc evaporation plasma vapor deposition chromium nitride (CrN) coated surface replacements in terms of wear, ion levels, and wear particles in a 10 million cycle hip simulator study, compared to a contemporary metal-on-metal surface replacement. The ion levels were measured by inductively coupled plasma mass spectroscopy. The wear particles were imaged by field emission gun scanning electron microscopy. The CrN-coated bearings had 80% lower wear than the MoM controls. The Cr and Co ion levels in the lubricant of the CrN bearings were 73 and 98% lower than in the MoM controls. The wear particles produced were in the nanometer size range and round to oval in morphology. The CrN coating could provide a reduction in the wear and ion release of MoM surface replacements, thereby reducing the perceived risks to the patient associated with these prostheses. '

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Revision of metal-on-metal resurfacing arthroplasty of the hip

Cited by 210 publications

References 25 publications

Intraoperative Radiographs for Placing Acetabular Components in Hip Resurfacing Arthroplasty

Intraoperative Radiographs for Placing Acetabular Components in Hip Resurfacing Arthroplasty

The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

Surface engineering: A low wearing solution for metal‐on‐metal hip surface replacements

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