Outcome of revised metal-on-metal hip arthroplasties: a Dutch arthroplasty register study

Background Preliminary results of metal-on-metal (MoM) hip arthroplasty were satisfactory, but since 2004 data showed high failure rates. National joint replacement registries are multi-centre databases comprised of thousands of subjects and implants which allow for identifying variables predictive...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2022-12, Vol.142 (12), p.4025-4032
Main Authors: Jelsma, Jetse, van Kuijk, S. M. J., Spekenbrink-Spooren, A., Grimm, B., Heyligers, I. C., Schotanus, M. G. M.
Format: Article
Language:English
Subjects:
Arthritis
Bone surgery
Hip Arthroplasty
Hip joint
Joint replacement surgery
Medicine
Medicine & Public Health
Mortality
Orthopedics
Patient satisfaction
Polyethylene
Risk factors
Surgical outcomes
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Summary:Background Preliminary results of metal-on-metal (MoM) hip arthroplasty were satisfactory, but since 2004 data showed high failure rates. National joint replacement registries are multi-centre databases comprised of thousands of subjects and implants which allow for identifying variables predictive of implant failure. The aim of the current study was to estimate re-revision rates after revision of a primary MoM hip arthroplasty in the Dutch Arthroplasty Register (LROI) and to assess potential predictor variables of re-revision of these MoM hip arthroplasties. Methods Eligible procedures were those with a revision for any reason except infection, after an initial primary surgery with a hip resurfacing (HRA) or large-head MoM (LH-MoM) total hip arthroplasty (THA). The probability of re-revision for both types of MoM hip arthroplasty over time was estimated using the cumulative incidence function taking mortality as a competing risk into account. A proportional sub-distribution hazards regression model was used to assess potential predictor variables of re-revision of these MoM hip arthroplasties. Results A total of 3476 records of revised implants were included, of which 873 (25.2%) were MoM implants. Over the course of follow-up, 101 (11.5%) MoM implants were re-revised. During follow-up 36 (4.3%) patients who received a MoM-implant at primary arthroplasty and a revision afterwards had died. The regression model showed that for primary MoM implants a MoM articulation after revision (HR 2.48; 95% CI 1.53–4.03, p  
ISSN:1434-3916
0936-8051
1434-3916
DOI:10.1007/s00402-021-04257-5