Long-Term Outcomes After Metal-on-Metal Total Hip Arthroplasty With a 28-mm Head: A 17-to 23-Year Follow-Up Study of a Previous Report
- Authors
- Moon, Jun-Ki; Kim, Yeesuk; Hwang, Kyu-Tae; Yang, Jae-Hyuk; Oh, Young-Ha; Kim, Young-Ho
- Issue Date
- Jul-2018
- Publisher
- CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
- Keywords
- metal-on-metal; small head; total hip arthroplasty; osteolysis; survivorship
- Citation
- JOURNAL OF ARTHROPLASTY, v.33, no.7, pp.2165 - 2172
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF ARTHROPLASTY
- Volume
- 33
- Number
- 7
- Start Page
- 2165
- End Page
- 2172
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/149769
- DOI
- 10.1016/j.arth.2018.02.089
- ISSN
- 0883-5403
- Abstract
- Background
Second-generation, metal-on-metal total hip arthroplasty (MoM THA) using a 28-mm head has shown favorable results compared with large head MoM THA. The purpose of this study is to evaluate the long-term outcomes of cementless primary MoM THA with a 28-mm head and the incidence of osteolysis using computed tomography.
Methods
A total of 92 patients (53 men and 39 women) who underwent primary cementless MoM THA (114 hips) with a 28-mm head were enrolled in this study. Their mean age was 46.2 years at the time of surgery. The mean follow-up duration was 20 years. The Harris hip score, presence of thigh or groin pain, radiographic results, presence of peri-implant osteolysis, histologic analysis, and Kaplan-Meier survival curves were evaluated.
Results
The mean preoperative Harris hip score of 50.5 improved to 85.1 at the final follow-up. Eight patients (8 hips) experienced groin pain, but none had thigh pain. Twelve revisions (6.2%) were performed including 10 hips for aseptic loosening with osteolysis and 2 hips for periprosthetic fracture around the stem. At 23 years, 91% of patients were free from revision of the acetabular component due to aseptic loosening and 90.1% were free from revision of both femoral and acetabular components due to any reason. Osteolysis was identified around the cup in 12 cases (10.5%) and around the stem in 7 cases (6.1%).
Conclusion
MoM THA with a 28-mm head showed a relatively low rate of aseptic implant loosening at a mean follow-up of 20 years.
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