Related Experiment Video
Updated: May 30, 2026
09:51
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Accelerating failure rate of the ASR total hip replacement
D J Langton1, S S Jameson, T J Joyce
1Northern Deanery, Goldcrest Way, Newcastle upon Tyne NE15 8NY, UK. djlangton22@doctors.org.uk
The Journal of Bone and Joint Surgery. British Volume
|July 20, 2011
Summary
Adverse tissue reactions are a concern with metal-on-metal (MoM) hip replacements. The Articular Surface Replacement (ASR) hip system showed high failure rates, with wear at the modular junction being a key factor in adverse reactions.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Implant Wear Analysis
Background:
- Metal-on-metal (MoM) hip replacements have raised concerns due to adverse soft-tissue reactions.
- National Joint Registry data indicate varying failure rates among different hip resurfacing designs.
Purpose of the Study:
- To update failure rates associated with metal debris for the Articular Surface Replacement (ASR) hip system.
- Investigate the causes of adverse tissue reactions in MoM hip replacements.
Main Methods:
- Kaplan-Meier survival analysis was used to determine failure rates for ASR resurfacing and total hip replacement (THR).
- Serum cobalt concentrations were measured in patients.
- Revised components underwent co-ordinate measuring machine analysis to assess wear patterns.
Main Results:
- ASR resurfacing had a 25% failure rate at six years; ASR THR had a 48.8% failure rate.
- 26.1% of patients with a minimum two-year follow-up had elevated serum cobalt levels (>7 μg/l).
- Adverse tissue reactions in resurfacing were linked to abnormal bearing surface wear; THR failures showed trunnion-taper interface damage.
Conclusions:
- Wear at the modular junction is a significant factor in adverse tissue reactions following large-diameter MoM THR implantation.
- The findings highlight the importance of wear analysis in understanding MoM hip replacement failures.
