Is second generation metal-on-metal primary total hip arthroplasty with a 28 mm head a worthy option?: a 12- to 18-year follow-up study

J Arthroplasty. 2013 Dec;28(10):1828-33. doi: 10.1016/j.arth.2013.06.022. Epub 2013 Jul 25.

Abstract

To determine whether MoM THA with a small head is still worthy of use, we investigated survivorship, complications, and factors influencing failure. Of 149 consecutive patients (195 hips), 141 (180 hips) of mean age 43 (19-55) years were available for review at a mean of 14.4 years postoperatively. Survivorship for cup revision for any cause was 97.8% at 18.4 years postoperatively. Nine hips generated complaints of groin pain; six showed periacetabular osteolysis, one had pain without radiological change, and two were diagnosed as symptomatic pseudotumors. Four of six hips with periacetabular osteolysis or aseptic loosening were revised. Surgery- and patient-related factors had no effect in results. Our results are encouraging, however, further study will be necessary to determine the incidence and fates of pseudotumors after MoM THA with a small head.

Keywords: metal on metal; pseudotumor; small head; survivorship; total hip arthroplasty.

MeSH terms

  • Adult
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / instrumentation*
  • Biocompatible Materials
  • Female
  • Follow-Up Studies
  • Hip Joint / surgery*
  • Hip Prosthesis* / adverse effects
  • Humans
  • Joint Diseases / diagnosis
  • Joint Diseases / surgery*
  • Male
  • Metals
  • Middle Aged
  • Prosthesis Design
  • Young Adult

Substances

  • Biocompatible Materials
  • Metals