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- Title
Pseudotumours, cobalt and clinical outcome in small head metal-on-metal versus conventional metal-on-polyethylene total hip arthroplasty.
- Authors
van der Veen, Hugo C; Reininga, Inge HF; Zijlstra, Wierd P; Boomsma, Martijn F; Bulstra, Sjoerd K; van Raay, Jos JAM
- Abstract
Background: Metal-on-metal total hip arthroplasty (MoM THA) is associated with the formation of pseudotumours. Studies mainly concern pseudotumour formation in large head MoM THA. We performed a long-term follow-up study, comparing pseudotumour incidence in small head metal-on-metal (SHMoM) THA with conventional metal-on-polyethylene (MoP) THA. Predisposing factors to pseudotumour formation were assessed. Methods: From a previous randomised controlled trial comparing SHMoM (28 mm) cemented THA with conventional MoP cemented THA, patients were screened using a standardised CT protocol for the presence of pseudotumours. Serum cobalt levels and functional outcome were assessed. Results: 56 patients (33 MoP and 23 MoM) were recruited after mean follow-up of 13.4 years (SD 0.5). The incidence of pseudotumours was 1 (5%) in the SHMoM THA cohort and 3 (9%) in the MoP THA cohort. Prosthesis survival was 96% for both SHMoM and MoP THAs. Serum cobalt levels did not exceed acceptable clinical values (<5 µg/L) whereas no differences in cobalt levels were detected at follow-up between both groups. Oxford and Harris Hip Scores were good and did not differ between SHMoM and MoP THA. Conclusions: This long-term follow-up study shows a low incidence of pseudotumour formation and good functional outcome in cemented head-taper matched SHMoM and MoP THA.
- Subjects
BONE cements; COBALT; COMPARATIVE studies; COMPUTED tomography; HIP joint; JOINT diseases; LONGITUDINAL method; MEDICAL protocols; POLYETHYLENE; COMPLICATIONS of prosthesis; RISK assessment; SURGICAL complications; TOTAL hip replacement; TREATMENT effectiveness; DISEASE incidence; DISEASE risk factors
- Publication
Hip International, 2020, Vol 30, Issue 1, p56
- ISSN
1120-7000
- Publication type
Article
- DOI
10.1177/1120700019832877