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Long-term follow-up and metal ion trend of patients with metal-on-metal total hip arthroplasty

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Abstract

Purpose

Long-term studies are required to support the use of metal-on-metal (MoM) bearings in total hip arthroplasty (THA) given the concern about systemic metal ion release and reports of adverse local soft tissue reactions. The purpose of this study was to report the seven to 13-year clinical, radiographic, and metal ion results in patients following MoM THA.

Methods

We studied 163 prostheses after second-generation MoM THA between July 1997 and November 2003. Cobalt and chromium metal ions were collected using whole and analysed by inductively-coupled plasma-mass spectrometry.

Results

The mean follow-up was 8.87 years (range, 7–13 years). Four hips (2.5 %) were revised. The Kaplan-Meier survivorship was 91.3 % for revision for all causes, and 97.5 % when excluding the hips revised for a manufacturer’s defect. Median whole blood cobalt levels peaked at a value of 2.87 μg/L at four years (p < 0.0001 vs. pre-operative) and subsequently decreased to 2.0 μg/L after nine years (p = 0.002 vs. four years). Median chromium levels maximally increased up to 0.75 μg/L after five years (p < 0.0001 vs. pre-operative) and tended to decrease thereafter to values of 0.56 μg/L after seven years.

Conclusions

This seven to 13-year follow-up study indicates that the clinical and radiological results following MoM THA are satisfactory with low revision rates. Cobalt and chromium ion levels peaked at four and five years, respectively, and gradually decreased thereafter.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, McGill University Health Centre, 1650 Cedar Avenue, Room B5.159.6, Montreal, Quebec, Canada, H3G 1A4

    Mitchell Bernstein & Nicholas M. Desy

  2. Division of Orthopaedic Surgery, Lady Davis Institute for Medical Research, SMBD-Jewish General Hospital, 3755 Chemin de la Côte Ste-Catherine, Montreal, Quebec, Canada, H3T 1E2

    Alain Petit

  3. Division of Orthopaedic Surgery, McGill University and Lady Davis Institute for Medical Research, SMBD-Jewish General Hospital, 3755 Chemin de la Côte Ste-Catherine, Montreal, Quebec, Canada, H3T 1E2

    David J. Zukor, Olga L. Huk & John Antoniou

  4. Department of Orthopaedics, SMBD-Jewish General Hospital, Room E-003, 3755, Chemin de la Côte Ste-Catherine, Montreal, QC, Canada, H3T 1E2

    John Antoniou

Authors
  1. Mitchell Bernstein
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  2. Nicholas M. Desy
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  3. Alain Petit
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  4. David J. Zukor
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  5. Olga L. Huk
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  6. John Antoniou
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Correspondence to John Antoniou.

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Bernstein, M., Desy, N.M., Petit, A. et al. Long-term follow-up and metal ion trend of patients with metal-on-metal total hip arthroplasty. International Orthopaedics (SICOT) 36, 1807–1812 (2012). https://doi.org/10.1007/s00264-012-1570-1

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  • DOI: https://doi.org/10.1007/s00264-012-1570-1

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