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Comparison of Harris Hip Scores and Revision Rates in Metal-on-Metal Versus Non-Metal-on-Metal Total Hip Arthroplasty
Nicholas B Frisch1, Tahsin M Rahman, Brian Darrith
1From the Department of Orthopaedic Surgery, Ascension Providence Rochester Hospital, Rochester, MI (Dr. Frisch), Wayne State University School of Medicine, Detroit, MI (Mr. Rahman and Mr. Patel), and the Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI (Dr. Darrith and Dr. Silverton).
Introduction:
This study compares functional outcome scores and revision rates between metal-on-metal (MoM) and non-MoM total hip arthroplasty patients.
Methods:
A cohort of 75 patients who underwent implantation of the same dual modular hip arthroplasty between the years of 2004 and 2010 was enrolled. Patients were subsequently evaluated in 2015 to 2017 for joint revision history and functionality, as measured by the Harris hip score (HHS). Patients requiring a revision arthroplasty were not included in the HHS analysis.
Results:
A total of 49 patients had MoM implants (65.3%), and 26 patients had non-MoM implants (34.8%). At a mean follow-up of 7.6 years, 10.2% (5/49) of MoM prostheses required revision, whereas 3.8% (1/26) of non-MoM prostheses required revision (P = 0.334). The mean HHS in the MoM cohort was 89.8, compared with 88.1 in the non-MoM cohort (P = 0.69).
Conclusion:
HHSs were not notably different between cohorts. The MoM cohort had three times as many revisions as the non-MoM cohort, but given the numbers available, this difference did not reach significance. Given the clinical importance of these revision data, further study is warranted to determine survivorship of the MoM versus non-MoM total hip arthroplasty at long-term follow-up.
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