title: Gender is a significant factor for failure of metal-on-metal total hip arthroplasty.
abstract: Metal-on-metal (MoM) articulations offers low wear, larger head size, and increased stability. Reports of early failure are troubling and include failure of ingrowth and metal articulation problems such as metallosis, hypersensitivity, pseudotumor, and unexplained pain. This study investigates the survivorship of modern MoM articulations by gender. We reviewed 1589 primary MoM THA in 1363 patients, with minimum 2-year follow-up for 1212 hips. Follow-up averaged 60 months. There were 643 female patients and 719 male patients. The incidence of cup revision was significantly higher in women than in men (8.2% vs 2.7%; P = .0000), as was incidence of aseptic loosening (4.3% vs 1.1%; P = .0006), and failure for metal-bearing complications (2.2% vs 0.6%; P = .0126). There appear to be gender factors influencing the success of MoM THA, which may include hormonal, anatomic, or functional differences.
authors.affiliation: Joint Implant Surgeons, Inc., New Albany, Ohio 43054, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Latteier
authors.forename: Keith R
authors.initials: KR
authors.lastname: Berend
authors.forename: Adolph V
authors.initials: AV
authors.lastname: Lombardi
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Ajluni
authors.forename: Brian E
authors.initials: BE
authors.lastname: Seng
authors.forename: Joanne B
authors.initials: JB
authors.lastname: Adams
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005271:Femur Head Necrosis / Q000601:surgery; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D004204:Joint Dislocations / Q000453:epidemiology; D008297:Male; D008670:Metals; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000453:epidemiology; D012189:Retrospective Studies; D012727:Sex Characteristics
chemical_list: D008670:Metals