title: Outcome of Revision Total Hip Arthroplasty in Management of Failed Metal-on-Metal Hip Arthroplasty.
abstract: This is a retrospective review of the functional outcomes and complications of revision total hip arthroplasty (THA) of failed metal-on-metal (MoM) hip arthroplasty.
  
  
  
  A total of 20 revision THAs were performed in 19 patients. Of them, 2 cases were failed hip resurfacing, and 18 cases were failed (MoM) THA. The mean age at revision (THA) was 59.35 years (standard deviation [SD] 9.83).
  
  
  
  The mean follow-up was 45 months (SD 13.98). The indications of revision were aseptic loosening of acetabular component without adverse local tissue reaction (ALTR; 10 hips), aseptic loosening of the acetabular and femoral components without ALTR (1 hip), painful hip associated with ALTR (6 hips), iliopsoas impingement associated with a large-diameter femoral head or malpositioned acetabular component (3 hips). The acetabular components were revised in 18 hips using Trabecular Metal Modular cups. The femoral components were revised in 3 hips. A constrained acetabular liner was used in 5 hips. The Harris hip score significantly improved from 48.4 (SD 12.98) to 83.25 (SD 10.08). There were 2 complications (1 foot drop and 1 superficial infection) and 1 failure (recurrent dislocation) that required revision to a constrained liner.
  
  
  
  Early results of revision THA of failed MoM hip arthroplasty showed improvement in pain and functional outcome. No case of failed bone ingrowth was noted with the use of Trabecular Metal Modular cups. Extensive soft tissue and abductor muscles dysfunctions were common. A constrained acetabular component with repair of the hip abductors might be beneficial.
authors.affiliation: Orthopaedic Department, Mansoura University, Mansoura, Egypt; Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Wael A
authors.initials: WA
authors.lastname: Rahman
authors.affiliation: Mount Sinai Hospital, Toronto, Ontario, Canada; Instituto Traumatologico, Santiago, Chile.
authors.forename: Tomás
authors.initials: T
authors.lastname: Amenábar
authors.affiliation: Mount Sinai Hospital, Toronto, Ontario, Canada; College of Medicine, Taibah University, Al Madinah Al Munawarah, Kingdom of Saudi Arabia.
authors.forename: Bandar M
authors.initials: BM
authors.lastname: Hetaimish
authors.affiliation: Division of Orthopaedic Surgery, Lower Extremity Reconstructive Surgery, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Oleg A
authors.initials: OA
authors.lastname: Safir
authors.affiliation: Division of Orthopaedic Surgery, Lower Extremity Reconstructive Surgery, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Kuzyk
authors.affiliation: Division of Orthopaedic Surgery, Lower Extremity Reconstructive Surgery, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Allan E
authors.initials: AE
authors.lastname: Gross
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005269:Femur / Q000601:surgery; D005270:Femur Head / Q000601:surgery; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D061825:Metal-on-Metal Joint Prostheses; D008875:Middle Aged; D011475:Prosthesis Failure / Q000209:etiology*; D012086:Reoperation; D012189:Retrospective Studies
keywords: complication; constrained liner; failed metal-on-metal hip arthroplasty; revision hip arthroplasty; trabecular metal cup