ArticleBone & joint open2022
Ten-year results of a prospective cohort of large-head metal-on-metal total hip arthroplasty : a concise follow-up of a previous report.
Article in Bone & joint open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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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.
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Who cites it
5 citing papers in PubMed, 3 citations in OpenAlex.
- Inflammatory Pseudotumor After Total Hip Arthroplasty-An Increasingly Recognized Complication.Orthopaedic surgery · 2026Review
- Establishing the Frequency of the HLA Class II Pseudotumour 'at Risk' Genotype: A Pilot Epidemiologic Analysis.ANZ journal of surgery · 2025Article
- Failure of Metal-on-Metal Total Hip Arthroplasty: The First Reported Case from the Caribbean and the Need for a National Joint Registry.Journal of orthopaedic case reports · 2025Article
- The role of femoral head size in metal-on-metal hip arthroplasty: analysis of a cohort of 3813 patients with long term follow-up.Archives of orthopaedic and trauma surgery · 2024Article
- Long-term clinical outcomes of the Biomet M2a-38: a retrospective review of 335 total hip arthroplasty cases.Journal of orthopaedic surgery and research · 2023Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsLarge-diameter metal-on-metal (MoM) total hip arthroplasty (THA) has demonstrated unexpected high failure rates and pseudotumour formation. The purpose of this prospective cohort study is to report ten-year results in order to establish revision rate, prevalence of pseudotumour formation, and relation with whole blood cobalt levels.
methodsAll patients were recalled according to the guidelines of the Dutch Orthopaedic Association. They underwent clinical and radiographical assessments (x-ray and CT scan) of the hip prosthesis and whole blood cobalt ion measurements. Overall, 94 patients (95 hips) fulfilled our requirements for a minimum ten-year follow-up.
resultsMean follow-up was 10.9 years (10 to 12), with a cumulative survival rate of 82.4%. Reason for revision was predominantly pseudotumour formation (68%), apart from loosening, pain, infection, and osteolysis. The prevalence of pseudotumour formation around the prostheses was 41%, while our previous report of this cohort (with a mean follow-up of 3.6 years) revealed a 39% prevalence. The ten-year revision-free survival with pseudotumour was 66.7% and without pseudotumour 92.4% (p < 0.05). There was poor discriminatory ability for cobalt for pseudotumour formation.
conclusionThis prospective study reports a minimum ten-year follow-up of large-head MoM THA. Revision rates are high, with the main reason being the sequelae of pseudotumour formation, which were rarely observed after five years of implantation. Blood ion measurements show limited discriminatory capacity in diagnosing pseudotumour formation. Our results evidence that an early comprehensive follow-up strategy is essential for MoM THA to promptly identify and manage early complications and revise on time. After ten years follow-up, we do not recommend continuing routine CT scanning or whole cobalt blood measurements, but instead enrolling these patients in routine follow-up protocols for THA. Cite this article:
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