Cementless large-head metal-on-metal total hip arthroplasty in patients younger than 60 years--a multicenter early result.
Large-head metal-on-metal total hip arthroplasty has the theoretical advantages of less wear and better range of motion than traditional polyethylene bearings and seems to be a better choice for young and active patients. We conducted a retrospective study and reported the early results of using such prostheses in 59 patients (70 hips) with a mean age of 43.1 years (range, 23-59 years) at the time of surgery. Osteonecrosis of the femoral head accounted for most diagnoses. Harris Hip Scores and hip range of motion both significantly improved (p<0.001) at an average follow-up of 32.6 months (range, 24-48 months). Only one intraoperative calcar fissure was encountered, and it was fixated by cerclage wiring; there was no infection, dislocation, or osteolysis around either the cup or the stem at the latest follow-up. A postoperative gap in the acetabular component was noted in 24 hips, with a mean depth of 1.11 mm, but this was not correlated with the functional score (p=0.291). Transient thigh pain, which resolved after 6 months, was observed in six patients but was not related to either the postoperative gap or cup inclination (p=1.000 and p=0.664, respectively). All patients resumed their original jobs and recreational activities with little discomfort. Thus far, large-head metal-on-metal total hip arthroplasty has shown excellent early results. The long-term results and the effects of metal debris and potentially elevated serum metal ion levels require further observation.
Department of Orthopaedics, National Cheng Kung University Hospital, Tainan, Taiwan.
Po-Ting
PT
Wu
Chih-Jen
CJ
Wang
Cheng-Yo
CY
Yen
Ji-Shen
JS
Jian
Kuo-An
KA
Lai
D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D001843:Bone Cements / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008670:Metals / Q000737:chemistry*; D008875:Middle Aged; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000601:surgery; D010146:Pain / Q000209:etiology; D011182:Postoperative Care; D011859:Radiography; D016059:Range of Motion, Articular / Q000187:drug effects; D055815:Young Adult
D001843:Bone Cements; D008670:Metals