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Metal on metal total hip arthroplasty using modular acetabular shells.

Adam A Liudahl¹, Steve S Liu, Devon D Goetz

¹University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.

The Journal of Arthroplasty

|March 16, 2013

Summary

Metal on metal bearings in total hip arthroplasty show excellent short-term results with a low revision rate. Long-term monitoring is essential for these hip implants to detect any potential issues.

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Area of Science:

Orthopedic Surgery
Biomaterials Science

Background:

Metal on metal bearings were reintroduced for total hip arthroplasty (THR) in the U.S. about ten years ago.
These implants utilize a modular acetabular shell with dome screw fixation augmentation.

Purpose of the Study:

To evaluate the clinical outcomes and implant survival of metal on metal bearings in total hip arthroplasty.
To assess the incidence of osteolysis and functional recovery in patients receiving these implants.

Main Methods:

A consecutive series of 148 patients (169 hips) underwent total hip arthroplasty with metal on metal bearings.
Follow-up ranged from 3 to 8 years, with an average of 4.7 years.
Outcomes assessed included revision rates, osteolysis, and Harris Hip Score.

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Main Results:

Only one component required revision due to femoral loosening.
Three hips showed proximal femoral osteolysis, and three hips demonstrated pelvic osteolysis.
The average follow-up Harris Hip Score was excellent at 94.

Conclusions:

Metal on metal bearings in total hip arthroplasty demonstrated excellent short-term outcomes with a low revision rate.
While initial results are promising, continued long-term surveillance is crucial for identifying any late failures or concerns associated with these implants.