title: Cementless total hip arthroplasty with a metal-on-metal bearing in patients younger than 50 years.
abstract: Total hip arthroplasty (THA) longevity is the primary concern in young patients. Metal-on-metal articulations were reintroduced to reduce polyethylene particle-induced osteolysis and improve survivorship; to date, based on issued reports, this strategy appears to have been successful. In this study, the authors investigated metal-on-metal articulation survivorship and osteolysis incidence in young patients (19-50 years old at index operations) and retrospectively reviewed cementless metal-on-metal THAs in 70 patients (78 hips) with a mean follow-up of 12.4 years. Metasul articulation was used with the Wagner acetabular component in all. Survivorship with revision for any cause was 98.7% (95% confidence interval, 98%-100%), and survivorship due to the development of osteolysis for any lesion was 97.5% (95% confidence interval, 95%-99%). Mean Harris hip score improved from 51 to 95 points at final follow-up. The findings of this study indicate that outcomes of cementless THA with a metal-on-metal bearing in young patients are satisfactory. However, longer-term studies in larger cohorts are required to determine whether metal-on-metal articulations are really a favorable option in young patients.
authors.affiliation: Department of Orthopaedic Surgery, Hanyang University Hospital, Seongdong-gu, Seoul, South Korea.
authors.forename: Kyu-Tae
authors.initials: KT
authors.lastname: Hwang
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Kim
authors.forename: Yee-Suk
authors.initials: YS
authors.lastname: Kim
authors.forename: Il-Yong
authors.initials: IY
authors.lastname: Choi
mesh_terms: D000328:Adult; D000367:Age Factors; D001172:Arthritis, Rheumatoid / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005271:Femur Head Necrosis / Q000601:surgery*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D008297:Male; D008670:Metals; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery; D010014:Osteolysis / Q000453:epidemiology / Q000601:surgery; D010020:Osteonecrosis / Q000601:surgery*; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D008670:Metals