Outcome of revision arthroplasty for failed metal-on-metal total hip replacements; is there a relation with metal ions?
OBJECTIVE
We aimed to assess the early outcome following revision arthroplasty for failed metal-on-metal (MoM) total hip replacements (THR) due to adverse reaction to metal debris (ARMD).


METHODS
We reviewed 106 consecutive revision arthroplasties. Case notes and radiological investigations were reviewed to assess the complications. Oxford Hip Score (OHS) and Euroqol (EQ-5D-3L) scores were used to assess the functional outcome and improvement of quality of life.


RESULTS
At a mean follow-up of 20 months (12-48 months), the mean OHS was 28.7. Pain improved in 61% patients. A majority of patients were in level 2 for all the EQ-5D-3L dimensions. The overall complication rate was 16%. Survivorship free from further revision for any cause was 94.3% at 48 months. There was no correlation between pre-revision blood metal ions and the final outcome.


CONCLUSIONS
Revision surgery for failed MoM hip replacement due to ARMD is associated with a relatively higher rate of complications and risk of chronic pain. There is poor correlation between serum metal ions and development of ARMD and outcome following revision surgery.
University Hospital of Wales, Cardiff - UK.
Hafiz J
HJ
Iqbal
University Hospital of Wales, Cardiff - UK.
Waheeb A K
WAK
Al-Azzani
University Hospital of Wales, Cardiff - UK.
Esther
E
Jackson-Taylor
University Hospital of Wales, Cardiff - UK.
Elizabeth
E
Clatworthy
University Hospital of Wales, Cardiff - UK.
Alun
A
John
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007477:Ions / Q000009:adverse effects; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D061825:Metal-on-Metal Joint Prostheses / Q000009:adverse effects*; D008670:Metals / Q000009:adverse effects / Q000737:chemistry*; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D007477:Ions; D008670:Metals