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3. Hip resurfacing arthroplasty in young patients: international high-volume centres’ report on the outcome of 11,382 metal-on-metal hip resurfacing arthroplasties in patients ⩽50 years at surgery

Author

Van Der Straeten, Catherine, primary, Gross, Thomas P, additional, Amstutz, Harlan, additional, Brooks, Peter J, additional, Samuel, Linsen T., additional, Su, Edwin P, additional, Pritchett, James W, additional, Kim, Paul, additional, Shimmin, Andrew, additional, Walter, William L., additional, Sugano, Nobuhiko, additional, McMinn, Derek, additional, Daniel, Joseph, additional, Treacy, Ronan, additional, Cobb, Justin, additional, Latham, Jeremy, additional, De Smet, Koen, additional, Girard, Julien, additional, Günther, Klaus-Peter, additional, Winter, Eugen, additional, Strenzke, Joseph, additional, Schulte-Mattler, Martin, additional, Völker, Raimund, additional, Moroni, Antonio, additional, Micera, Giovanni, additional, Calistri, Alessandro, additional, van Susante, Job, additional, Araujo, Sergio, additional, Quelhas, Monjardim, additional, Aleixo, Hugo, additional, Ribas, Manel, additional, Gonzalez-Adrio, Rafael, additional, Marin-Peña, Oliver, additional, and Lage, Lafayette, additional

Published
2020
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4. Hip resurfacing arthroplasty in young patients: international high-volume centres’ report on the outcome of 11,382 metal-on-metal hip resurfacing arthroplasties in patients ⩽50 years at surgery

Author

Van Der Straeten, Catherine, Gross, Thomas P, Amstutz, Harlan, Brooks, Peter J, Samuel, Linsen T., Su, Edwin P, Pritchett, James W, Kim, Paul, Shimmin, Andrew, Walter, William L., Sugano, Nobuhiko, McMinn, Derek, Daniel, Joseph, Treacy, Ronan, Cobb, Justin, Latham, Jeremy, De Smet, Koen, Girard, Julien, Günther, Klaus-Peter, Winter, Eugen, Strenzke, Joseph, Schulte-Mattler, Martin, Völker, Raimund, Moroni, Antonio, Micera, Giovanni, Calistri, Alessandro, van Susante, Job, Araujo, Sergio, Quelhas, Monjardim, Aleixo, Hugo, Ribas, Manel, Gonzalez-Adrio, Rafael, Marin-Peña, Oliver, and Lage, Lafayette

Abstract

Background: Total hip arthroplasty (THA) in patients younger than 50 years poses significant challenges including postoperative limitations of activity and higher failure rates. Sub-par outcomes of hip resurfacing arthroplasty (HRA) in registries remain controversial due to multiple confounders. Favourable HRA results in some studies are often regarded as irreproducible. The aim of this study is to analyse HRA outcomes in a large international cohort.Patients and methods: We compiled a database of 11,382 HRA patients ⩽50 years from an international group of 27 experienced HRA centres from 13 countries. 18 different metal-on-metal (MoM) HRA designs were included with a mean follow-up of 7.6 years. Outcomes were implant survivorship, revision rates, causes for revision, clinical scores and metal ion levels. Outcomes were compared between genders, sizes, implant types and pre-operative diagnoses.Results: Overall cumulative Kaplan-Meier survivorship was 88.9% at 22 years (95% CI: 88.3–89.5%). 2 HRA designs (DePuy Articular Surface Replacement (ASR), and Corin Cormet Hip Resurfacing System (CORMET)) led to inferior results while all others yielded similar survivorships. Excluding ASR and CORMET, implant survivorship in 11,063 cases was 95% at 10 years and 90% at 22 years. In men, implant survivorship was excellent: 99% at 10 years and 92.5% at 21 years. In females, implant survivorship was 90% at 10 years and 81.3% at 22 years. The overall revision rate was 3.6% with most common reasons for revision being implant loosening and adverse local tissue reactions. The best survivorship was found in patients with osteoarthritis (95% CI, 92.1–93.3% at 22 years), the poorest was among dysplastic hips (78.3%; 95% CI, 76.5–80.1% at 20 years, p <0.001).Conclusions: Comparable revision rates demonstrated here may mitigate some concerns for safety and longevity of MoM HRA implants. Higher demands for activity and functionality in younger patients make HRA a potential alternative to THA.

Published
2022
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5. Clinical and Radiographic outcomes of the Birmingham Hip Resurfacing Arthroplasty at a Minimum follow-up of 10 Years: Results from an Independent Centre.

Author

Moroni, Antonio, Miscione, Maria Teresa, Orsini, Riccardo, Micera, Giovanni, Mosca, Salvatore, Sinapi, Fabrizio, De Girolamo, Laura, and Banfi, Giuseppe

Subjects
*HIP joint radiography, *EVALUATION of medical care, *LONGITUDINAL method, *ORTHOPEDIC surgery, *TIME, *TOTAL hip replacement
Abstract

Background Metal-on-metal hip resurfacing (MoMHR) has been proposed as an effective surgical treatment for young and active patients with symptomatic hip disease. Recently, good clinical and radiographic outcomes have been reported by the designer surgeons at a 15.3 years follow-up; however, results at long follow-up by non-designer surgeons are less satisfactory. The aim of the study was to investigate if MoMHR can produce satisfactory clinical and radiographic results and if survival rate can be high even if the procedure is performed by non-designer surgeons. Methods All patients were assessed about implant survival. All patients completed an Oxford Hip Score (OHS), Harris Hip Score (HHS) and a University of California Los Angeles (UCLA) activity score preoperatively, at 1 year and at last available follow-up; at this time, a standard anteroposterior weight-bearing radiograph was performed. Results The survival rate with revision for any reason is 96%, similar to those obtained by designer surgeons. All the clinical scores improved over time: according to the OHS the survivors are asymptomatic and according to the UCLA maintain a high level of function. 6 remodellings of the femoral neck and 2 heterotopic bone formations were seen, but they were asymptomatic. Conclusions As designer surgeons have already shown, MoMHR can provide in active patients a durable treatment for hip arthritis, with low risk of revision and good results at 10 years follow-up, even if the procedure is performed by non-designer surgeons. [ABSTRACT FROM AUTHOR]

Published
2018
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6. Clinical and Radiographic outcomes of the Birmingham Hip Resurfacing Arthroplasty at a Minimum follow-up of 10 Years: Results from an Independent Centre

Author

Maria Teresa Miscione, Riccardo Orsini, Antonio Moroni, Fabrizio Sinapi, Salvatore Mosca, Laura de Girolamo, Giovanni Micera, Giuseppe Banfi, Moroni, Antonio, Miscione, Maria Teresa, Orsini, Riccardo, Micera, Giovanni, Mosca, Salvatore, Sinapi, Fabrizio, De Girolamo, Laura, and Banfi, Giuseppe

Subjects
Male, Time Factors, Databases, Factual, Hip resurfacing, Arthroplasty, Replacement, Hip, medicine.medical_treatment, Kaplan-Meier Estimate, Oxford hip score, California, Osteoarthritis, Hip, Cohort Studies, 0302 clinical medicine, Retrospective Studie, Medicine, Age Factor, Hip Prosthesi, Orthopedics and Sports Medicine, 030212 general & internal medicine, Academic Medical Centers, 030222 orthopedics, Age Factors, Middle Aged, Prosthesis Failure, Academic Medical Center, Treatment Outcome, medicine.anatomical_structure, Metal-on-metal hip arthroplasty, Metal-on-Metal Joint Prostheses, Female, Hip Joint, medicine.symptom, Human, Adult, Reoperation, medicine.medical_specialty, Time Factor, Risk Assessment, Asymptomatic, Follow-Up Studie, 03 medical and health sciences, Humans, Survival rate, Proportional Hazards Models, Retrospective Studies, Femoral neck, Hip surgery, business.industry, Long-term result, Arthroplasty, Surgery, Radiography, Harris Hip Score, Proportional Hazards Model, Hip Prosthesis, Cohort Studie, Metal-on-Metal Joint Prosthese, business, Follow-Up Studies
Abstract

Metal-on-metal hip resurfacing (MoMHR) has been proposed as an effective surgical treatment for young and active patients with symptomatic hip disease. Recently, good clinical and radiographic outcomes have been reported by the designer surgeons at a 15.3 years follow-up; however, results at long follow-up by non-designer surgeons are less satisfactory. The aim of the study was to investigate if MoMHR can produce satisfactory clinical and radiographic results and if survival rate can be high even if the procedure is performed by non-designer surgeons. Background: Metal-on-metal hip resurfacing (MoMHR) has been proposed as an effective surgical treatment for young and active patients with symptomatic hip disease. Recently, good clinical and radiographic outcomes have been reported by the designer surgeons at a 15.3 years follow-up; however, results at long follow-up by non-designer surgeons are less satisfactory. The aim of the study was to investigate if MoMHR can produce satisfactory clinical and radiographic results and if survival rate can be high even if the procedure is performed by non-designer surgeons. Methods: All patients were assessed about implant survival. All patients completed an Oxford Hip Score (OHS), Harris Hip Score (HHS) and a University of California Los Angeles (UCLA) activity score preoperatively, at 1 year and at last available follow-up; at this time, a standard anteroposterior weight-bearing radiograph was performed. Results: The survival rate with revision for any reason is 96%, similar to those obtained by designer surgeons. All the clinical scores improved over time: according to the OHS the survivors are asymptomatic and according to the UCLA maintain a high level of function. 6 remodellings of the femoral neck and 2 heterotopic bone formations were seen, but they were asymptomatic. Conclusions: As designer surgeons have already shown, MoMHR can provide in active patients a durable treatment for hip arthritis, with low risk of revision and good results at 10 years follow-up, even if the procedure is performed by non-designer surgeons.

Published
2017

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