title: Clinical and radiographic outcomes of 139 hips with articular surface replacement total hip arthroplasty*.
abstract: BACKGROUND
  The articular surface replacement (ASR) total hip arthroplasty (THA) was recently recalled from the market due to high failure rates. This modality was used frequently by surgeons at our medical center.
  
  
  OBJECTIVE
  To assess the clinical and radiographic outcomes in patients following the surgery and determine the revision rate in our cohort.
  
  
  METHODS
  Between 2007 and 2010 139 hips were operated on and evaluated in our clinic. All patients underwent a clinical interview, function and pain evaluation, as well as physical examination and radiographic evaluation. When necessary, patients were sent for further tests, such as measuring cobalt-chromium levels and magnetic resonance hip imaging.
  
  
  RESULTS
  With an average follow-up of 42 months the revision rate was 2% (3/139). Patients reported alleviation of pain (from 8.8 to 1.7 on the Visual Analog Scale, P < 0.001), good functional outcomes on the Harris Hip Score, and improved quality of life. Overall satisfaction was 7.86 on the reversed VAS. For patients who required further tests, clinical and radiographic outcomes were significantly poorer than for the rest of the cohort. Average blood ion levels were high above the normal (cobalt 31.39 ppb, chromium 13.32 ppb), and the rate of inflammatory collection compatible with pseudotumors on MRI was 57%.
  
  
  CONCLUSIONS
  While our study favors the use of the ASR implant both clinically and radiographically, some patients with abnormal ion levels and inflammatory collections on MRI might require revision in the future.
authors: Department of Orthopedics, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. Assafkadar@hotmail.com
authors: Assaf
authors: A
authors: Kadar
authors: Department of Orthopedics, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors: Ran
authors: R
authors: Ankory
authors: Department of Orthopedics, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors: Haggay
authors: H
authors: Sherman
authors: Department of Radiology, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors: Iris
authors: I
authors: Eshed
authors: Department of Orthopedics, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors: Nadav
authors: N
authors: Shasha
authors: Department of Orthopedics, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors: Aviram
authors: A
authors: Gold
authors: Department of Orthopedics, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors: Aharon
authors: A
authors: Menahem
authors: Department of Orthopedics, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors: Moshe
authors: M
authors: Salai
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002857:Chromium / Q000097:blood*; D003035:Cobalt / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D017060:Patient Satisfaction; D011788:Quality of Life; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies
chemical_list: D002857:Chromium; D003035:Cobalt