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Published on: February 27, 2018
The argument for the use of Metasul as an articulation surface in total hip replacement
Lawrence D Dorr1, William T Long, Leighellen Sirianni
1The Arthritis Institute, 501 E. hardy Street, Suite 300, Inglewood, CA 90301, USA. patricia.paul@tenethealth.com
Abstract:
Metasul metal-on-metal articulations have been used for 15 years in approximately 300,000 total hip replacements. We have used Metasul articulations in three clinical studies and have shown clinical success as measured by Harris hip scores and patient self-assessment; we also have had the usual mechanical complications. The only complications have been mechanical, including two cup loosenings and 24 dislocations in a total of 582 patients (619 hips; 3.8%) who had Metasul articulations and were included in these studies. In the randomized study, the group who had Metasul articulations had no clinical results or complications different from the control ceramic-on-polyethylene group. Authors of retrieval results in the literature report low annual linear wear rates and no consequences of elevated Co ion levels. Currently, the scientific evidence of the results of using the Metasul articulation would recommend its continued use in any patient who does not have compromised renal function.
Insights
Metasul metal-on-metal hip replacements show clinical success with typical mechanical complications. Evidence supports continued use for patients without kidney issues.
Area of Science:
- Orthopedic surgery
- Biomaterials science
Background:
- Metasul metal-on-metal articulations have been utilized in approximately 300,000 total hip replacements over 15 years.
- Clinical success has been demonstrated through Harris hip scores and patient self-assessment in previous studies.
Purpose of the Study:
- To evaluate the clinical outcomes and complications associated with Metasul articulations in total hip replacements.
- To compare the performance of Metasul articulations against ceramic-on-polyethylene bearings.
Main Methods:
- Three clinical studies involving Metasul articulations were reviewed.
- A randomized study compared Metasul to ceramic-on-polyethylene bearings.
- Patient outcomes were assessed using Harris hip scores and self-assessment.
Main Results:
- Mechanical complications included two cup loosenings and 24 dislocations in 582 patients (619 hips), a 3.8% rate.
- No significant differences in clinical results or complications were observed between Metasul and ceramic-on-polyethylene groups in the randomized study.
- Literature reports low annual linear wear rates and no adverse effects from elevated cobalt ion levels for Metasul implants.
Conclusions:
- The scientific evidence supports the continued use of Metasul articulations in total hip replacements.
- Metasul implants are recommended for patients without compromised renal function.
- Further research may explore long-term outcomes and specific patient populations.
