Evidence map›Paper›PMID 30581557›Full record

ArticleBone & joint research2018

Wear performance of retrieved metal-on-metal Pinnacle hip arthroplasties implanted before and after 2007.

S Bergiers, H S Hothi, J Henckel, A Eskelinen, J Skinner, A Hart

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Article in Bone & joint research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

S BergiersInstitute of Orthopaedics and Musculoskeletal Science, University College London, and the Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
H S HothiInstitute of Orthopaedics and Musculoskeletal Science, University College London, and the Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
J HenckelInstitute of Orthopaedics and Musculoskeletal Science, University College London, and the Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
A EskelinenOrthopaedic Surgeon, The Coxa Hospital for Joint Replacement, Tampere, Finland.
J SkinnerStanmore, Middlesex, UK.
A HartLimb Reconstruction Unit, Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK; The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesPrevious studies have suggested that metal-on-metal (MoM) Pinnacle (DePuy Synthes, Warsaw, Indiana) hip arthroplasties implanted after 2006 exhibit higher failure rates. This was attributed to the production of implants with reduced diametrical clearances between their bearing surfaces, which, it was speculated, were outside manufacturing tolerances. This study aimed to better understand the performance of Pinnacle Systems manufactured before and after this event.

methodsA total of 92 retrieved MoM Pinnacle hips were analyzed, of which 45 were implanted before 2007, and 47 from 2007 onwards. The 'pre-2007' group contained 45 implants retrieved from 21 male and 24 female patients, with a median age of 61.3 years (interquartile range (IQR) 57.1 to 65.5); the '2007 onwards' group contained 47 implants retrieved from 19 male and 28 female patients, with a median age of 61.8 years (IQR 58.5 to 67.8). The volume of material lost from their bearing and taper surfaces was measured using coordinate and roundness measuring machines. These outcomes were then compared statistically using linear regression models, adjusting for potentially confounding factors.

resultsThere was no significant difference between the taper and bearing wear rates of the 'pre-2007' and '2007 onwards' groups (p = 0.67 and p = 0.39, respectively). Pinnacles implanted from 2007 onwards were revised after a mean time of 50 months, which was significantly earlier than the 'pre-2007' hips (96 months) (p < 0.001). A reduction in the time to revision was present year on year from 2003 to 2011.

conclusionWe found no difference in the wear rate of these implants based on the year of implantation. The 'pre-2007' hips had a two-fold greater time to revision than those implanted after 2007; this may be due to the increased surveillance of MoM hips following UK regulatory advice and several high-profile failures. Interestingly, we observed a decreasing trend in the mean time to revision every year from 2003 onwards.

Indexed as

Material lossMetal-on-metalRetrievalWear analysis

Identifiers

PMID30581557
PMCPMC6269595

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