ArticleInternational orthopaedics2018
Outcomes after revision of metal on metal hip resurfacing to total arthroplasty using the direct anterior approach.
Article in International orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 26 citations in OpenAlex.
- Article
- Evaluation of Direct Anterior Approach for Revision Total Hip Arthroplasty: A Systematic Review.Hip & pelvis · 2021Review
- Uncemented versus cemented arthroplasty after metal-on-metal total hip replacement in patients with femoral neck fractures: a retrospective study.The Journal of international medical research · 2021Article
- Revision of failed metal-on-metal total hip arthroplasty using cemented arthroplasty: a mean 10-year follow-up of 157 consecutive patients.The Journal of international medical research · 2021Article
- The early- to medium-term results of a hemispherical, porous coated acetabular shell with multiple different bearing combinations are excellent with the exception of metal-on-metal.International orthopaedics · 2020Article
- Favourable clinical outcomes following cemented arthroplasty after metal-on-metal total hip replacement: a retrospective study with a mean follow-up of 10 years.BMC musculoskeletal disorders · 2020Article
- Triflange acetabular reconstruction for pelvic discontinuity through a direct anterior approach.Arthroplasty today · 2019Article
- Pleomorphic clinical spectrum of metallosis in total hip arthroplasty.International orthopaedics · 2019Article
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Authors and funding
4 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFunction after revision total hip arthroplasty (THA) in failed metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) is variable, but post-operative complication rates are reportedly high. We hypothesized HRA conversion to THA using the direct anterior approach (DAA) would be associated with optimal outcome.
methodsSeventeen MoM-HRAs in 15 patients (seven males, eight females) were revised through the DAA. The mean age was 45 years (28-59 yrs). The most common indications for revision were aseptic loosening of the acetabular component or of the femoral component and femoral neck fracture. In 16 hips, a conversion to a ceramic-on-ceramic (CoC) (13 hips) or to a metal-on polyethylene (MOP) (2), or to a large-head MoM (1) THA was done. An isolated femoral revision was done in one hip.
resultsAfter 6.7 ± 3 years, no hip had required a re-revision. The Postel-Merle d'Aubigne (PMA) functional score improved from 9 (4-14) to 16 (12-18) (p < 0.001). An intra-operative fracture of the greater trochanter (one hip) and dysesthesia of the lateral femoral cutaneous nerve (four hips) were reported. Mean serum chromium concentration decreased from 33.2 μg/L (11.8-62 μg/L) pre-operatively to 5.8 μg/L (0.4-35.5 μg/L) post-operatively (p < 0.001), and mean serum cobalt concentration decreased from 35.8 μg/L (6.3-85.5 μg/L) to 4.7 μg/L (0.26-25.7 μg/L) (p = 0.003).
conclusionRevision of failed MoM-HRA using the DAA resulted in an acceptable clinical outcome, no specific complication and no further surgery. A consistent decline in serum ion levels may be expected following HRA conversion to THA.
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