Pinnacle Ultamet metal-on-metal total hip arthroplasty survivorship: average 10-year follow-up
Background: It is unclear whether a connection exists between femoral head size, offset, neck length, and cup abduction angles, and rate of revision in metal-on-metal (MoM) total hip arthroplasty (THA) implant systems. Methods: A retrospective review of MoM THA completed by a single surgeon with a s...
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doaj-24f2b436e02b4d29a37ae9b6ae159e522020-11-25T01:53:21ZengElsevierArthroplasty Today2352-34412020-09-0163596600.e1Pinnacle Ultamet metal-on-metal total hip arthroplasty survivorship: average 10-year follow-upKristen LaHaise, BS0Daniel Mandell, MD1Samuel Golenbock, MS2Kassandra Hopkins, BA3David Mattingly, MD4Department of Research, New England Baptist Hospital, Boston, MA, USA; Corresponding author. Department of Research, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120, USA. Tel.: +1 617 754 5662.Department of Orthopedic Surgery, New England Baptist Hospital, Boston, MA, USADepartment of Research, New England Baptist Hospital, Boston, MA, USADepartment of Research, New England Baptist Hospital, Boston, MA, USADepartment of Orthopedic Surgery, New England Baptist Hospital, Boston, MA, USABackground: It is unclear whether a connection exists between femoral head size, offset, neck length, and cup abduction angles, and rate of revision in metal-on-metal (MoM) total hip arthroplasty (THA) implant systems. Methods: A retrospective review of MoM THA completed by a single surgeon with a single implant between 2003 and 2008 was conducted. Patient demographics, implant data, radiographs, and revision details were collected at follow-up. Incidence rates for revision and osteolysis were calculated in regard to the femoral head size, stem offset, neck length, and cup abduction angles. Results: Six hundred and ninety two THAs were identified, with 79% of patients returning for a median follow-up of 10.3 years (interquartile range = 6.0-12.3). The median time to revision was 7.5 years (interquartile range = 5.3-9.9) among 27 total revision surgeries. The overall incidence rate of revision was 5.4 revisions per 1000 person-years, 3.0 revisions per 1000 person-years for adverse local tissue reaction. Hips with a cup abduction angle of ≤40° had revisions at nearly twice the rate of those with an angle of 41°-50° (incidence rate ratio = 1.98, 95% confidence interval: 0.92, 4.29). Hips with a 9 mm neck length had an increased rate of revision (incidence rate ratio = 5.94, 95% confidence interval: 1.33, 26.55) relative to those with a neck length of 0 mm. Rates of osteolysis were similar between implants of different head sizes, neck lengths and cup abduction angles. Conclusions: MoM implant systems with longer necks and smaller cup abduction angles may lead to increased need for revision. Results from this study suggest a need for closer long-term follow-up of MoM THA systems.http://www.sciencedirect.com/science/article/pii/S2352344120300236Metal-on-metalTotal hip arthroplastyRevisionOsteolysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kristen LaHaise, BS Daniel Mandell, MD Samuel Golenbock, MS Kassandra Hopkins, BA David Mattingly, MD |
spellingShingle |
Kristen LaHaise, BS Daniel Mandell, MD Samuel Golenbock, MS Kassandra Hopkins, BA David Mattingly, MD Pinnacle Ultamet metal-on-metal total hip arthroplasty survivorship: average 10-year follow-up Arthroplasty Today Metal-on-metal Total hip arthroplasty Revision Osteolysis |
author_facet |
Kristen LaHaise, BS Daniel Mandell, MD Samuel Golenbock, MS Kassandra Hopkins, BA David Mattingly, MD |
author_sort |
Kristen LaHaise, BS |
title |
Pinnacle Ultamet metal-on-metal total hip arthroplasty survivorship: average 10-year follow-up |
title_short |
Pinnacle Ultamet metal-on-metal total hip arthroplasty survivorship: average 10-year follow-up |
title_full |
Pinnacle Ultamet metal-on-metal total hip arthroplasty survivorship: average 10-year follow-up |
title_fullStr |
Pinnacle Ultamet metal-on-metal total hip arthroplasty survivorship: average 10-year follow-up |
title_full_unstemmed |
Pinnacle Ultamet metal-on-metal total hip arthroplasty survivorship: average 10-year follow-up |
title_sort |
pinnacle ultamet metal-on-metal total hip arthroplasty survivorship: average 10-year follow-up |
publisher |
Elsevier |
series |
Arthroplasty Today |
issn |
2352-3441 |
publishDate |
2020-09-01 |
description |
Background: It is unclear whether a connection exists between femoral head size, offset, neck length, and cup abduction angles, and rate of revision in metal-on-metal (MoM) total hip arthroplasty (THA) implant systems. Methods: A retrospective review of MoM THA completed by a single surgeon with a single implant between 2003 and 2008 was conducted. Patient demographics, implant data, radiographs, and revision details were collected at follow-up. Incidence rates for revision and osteolysis were calculated in regard to the femoral head size, stem offset, neck length, and cup abduction angles. Results: Six hundred and ninety two THAs were identified, with 79% of patients returning for a median follow-up of 10.3 years (interquartile range = 6.0-12.3). The median time to revision was 7.5 years (interquartile range = 5.3-9.9) among 27 total revision surgeries. The overall incidence rate of revision was 5.4 revisions per 1000 person-years, 3.0 revisions per 1000 person-years for adverse local tissue reaction. Hips with a cup abduction angle of ≤40° had revisions at nearly twice the rate of those with an angle of 41°-50° (incidence rate ratio = 1.98, 95% confidence interval: 0.92, 4.29). Hips with a 9 mm neck length had an increased rate of revision (incidence rate ratio = 5.94, 95% confidence interval: 1.33, 26.55) relative to those with a neck length of 0 mm. Rates of osteolysis were similar between implants of different head sizes, neck lengths and cup abduction angles. Conclusions: MoM implant systems with longer necks and smaller cup abduction angles may lead to increased need for revision. Results from this study suggest a need for closer long-term follow-up of MoM THA systems. |
topic |
Metal-on-metal Total hip arthroplasty Revision Osteolysis |
url |
http://www.sciencedirect.com/science/article/pii/S2352344120300236 |
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