Cementless Metasul metal-on-metal total hip arthroplasty in patients less than fifty years old.
BACKGROUND
Durable results of total hip arthroplasty have been difficult to achieve in young patients. We reviewed the intermediate-term clinical and radiographic results in a series of active, higher-demand patients who were less than fifty years old when they underwent cementless total hip arthroplasty with the use of the Metasul metal-on-metal articulation.


METHODS
Seventy total hip arthroplasties were performed in sixty-two patients who were younger than fifty years of age (average age, thirty-seven years). Two patients (two hips) had had a resection arthroplasty because of deep infection less than five years postoperatively and were excluded. Sixty patients (sixty-eight hips) were available for complete clinical and radiographic analysis after a mean duration of follow-up of seven years.


RESULTS
The mean preoperative Harris hip score of 49 points improved to 95 points at the time of final follow-up; fifty-six patients (93%) had an excellent result. No component was seen to be loose radiographically at the time of final follow-up. Only one focal area of pelvic osteolysis in one patient and two small focal areas of femoral osteolysis in another patient were identified. The hip with focal pelvic osteolysis underwent revision surgery with a liner change and bone-grafting of the osteolytic lesion around a stable component.


CONCLUSIONS
At a mean of seven years after arthroplasties with a Metasul metal-on-metal articulation, there was a low rate of osteolysis and aseptic loosening in this group of young patients. However, additional follow-up is necessary to determine any possible long-term deleterious effects associated with this metal-on-metal articulation.
Kim
Shin-Yoon
SY
Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, Sam-Duck 2 Ga 50, Jung-Gu, Daegu 700-721, Korea. syukim@knu.ac.kr
Kyung
Hee-Soo
HS
Ihn
Joo-Chul
JC
Cho
Myung-Rae
MR
Koo
Kyung-Hoi
KH
Kim
Chang-Yoon
CY
D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D002484:Cementation; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography