Survival rates of different bearing surfaces with the same model of stem in total hip arthroplasty: predictive factors for revision surgery

Introduction Few studies have examined the survival rates of total hip arthroplasty (THA) with the same femoral stem, and the predictive factors leading to the revision of stemmed metal-on-metal (MoM) THA remain unknown. We determined the long-term survival rate of stemmed MoM THA compared with that...

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Published in:Archives of orthopaedic and trauma surgery 2023-07, Vol.143 (7), p.4501-4510
Main Authors: Ikeda, Shinichi, Kaku, Nobuhiro, Hosoyama, Tsuguaki, Tsumura, Hiroshi
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement, Hip - methods
Hip Arthroplasty
Hip Prosthesis
Humans
Joint replacement surgery
Medicine
Medicine & Public Health
Metal-on-Metal Joint Prostheses
Metals
Orthopedics
Polyethylene
Prosthesis Design
Prosthesis Failure
Reoperation - methods
Risk Factors
Survival Rate
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Summary:Introduction Few studies have examined the survival rates of total hip arthroplasty (THA) with the same femoral stem, and the predictive factors leading to the revision of stemmed metal-on-metal (MoM) THA remain unknown. We determined the long-term survival rate of stemmed MoM THA compared with that of metal-on-polyethylene (MoP) bearing THA, the effect of head size and cup placement angle on revision rate, and predictors of revision. Materials and methods A total of 130 hips in 110 patients who underwent primary THA by the same surgeon were included. M2a-RingLoc with a metal-on-polyethylene bearing (group P, 53 hips), M2a-Taper with MoM bearing (group T, 44 hips), and M2a-Magnum with MoM bearing (group M, 33 hips) were used. The mean age at surgery was 63.1 ± 9.5 years, and the mean postoperative follow-up duration was 133.7 ± 39.1 months. Whole blood metal ion concentrations were measured preoperatively and postoperatively, and magnetic resonance imaging was performed to identify aseptic local tissue reactions (ALTRs). Kaplan–Meier survivorship analysis and multiple logistic regression analysis were performed. Results The THA survival rate up to the maximum postoperative follow-up period was 96.2% at 173 months, 46.6% at 179 months, and 47.8% at 145 months in groups P, T, and M, respectively, with revision as the endpoint. The stemmed MoM THA recorded a very low survival rate ( p  
ISSN:1434-3916
0936-8051
1434-3916
DOI:10.1007/s00402-022-04706-9