Metal ion levels and revision rates in metal-on-metal hip resurfacing arthroplasty: a comparative study

Robinson, P. G., Wilkinson, A. J. and Meek, R. M.D. (2014) Metal ion levels and revision rates in metal-on-metal hip resurfacing arthroplasty: a comparative study. Hip International, 24(2), pp. 123-128. (doi: 10.5301/hipint.5000113) (PMID:24500833)

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Abstract

Metal-on-metal (MoM) bearings in hip surgery are related to increased blood levels of metal ions. The nature of the relationship between ion levels and failure is still not fully understood. This study compares three cohorts of patients, 120 patients in each cohort, treated with a hip resurfacing arthroplasty, grouped by brand and diameter of femoral component on average four years postoperatively: Birmingham Hip Resurfacing ≥50 mm, Durom resurfacing ≥50 mm and Durom resurfacing <50 mm. The median blood ion levels of cobalt and chromium were significantly lower in the cohort with the large Durom resurfacing than the other two cohorts (P<0.05). The large BHR and large Durom HRA had revision rates of 3.3%. The small Durom HRA had a revision rate of 8.3%.<p></p> Elevated blood ion levels can indicate a failing MoM bearing. The large BHR and large Durom HRA have similar revision rates yet the large Durom HRA had significantly lower metal ion levels. When similar ion levels were reported for BHR and small Durom the latter had significantly higher revision rates. This suggests ion levels do not absolutely predict the rate of HRA failure. Since MoM generation of metal ions is not the sole reason of failure, regular clinical and radiographic follow-up should also be in place for patients with these joints.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wilkinson, Dr Andrew
Authors: Robinson, P. G., Wilkinson, A. J., and Meek, R. M.D.
College/School:College of Medical Veterinary and Life Sciences > School of Molecular Biosciences
Journal Name:Hip International
Publisher:Wichtig Publishing
ISSN:1120-7000
ISSN (Online):1724-6067

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