Revision surgery of metal-on-metal hip arthroplasties for adverse reactions to metal debris: A clinical update
Background and purpose — The initial outcomes following metal-on-metal hip arthroplasty (MoMHA) revision surgery performed for adverse reactions to metal debris (ARMD) were poor. Furthermore, robust thresholds for performing ARMD revision are lacking. This article is the second of 2. The first artic...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Medical Journals Sweden
2018-05-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.1080/17453674.2018.1440455 |
| _version_ | 1818498583695982592 |
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| author | Gulraj S Matharu Antti Eskelinen Andrew Judge Hemant G Pandit David W Murray |
| author_facet | Gulraj S Matharu Antti Eskelinen Andrew Judge Hemant G Pandit David W Murray |
| author_sort | Gulraj S Matharu |
| collection | DOAJ |
| description | Background and purpose — The initial outcomes following metal-on-metal hip arthroplasty (MoMHA) revision surgery performed for adverse reactions to metal debris (ARMD) were poor. Furthermore, robust thresholds for performing ARMD revision are lacking. This article is the second of 2. The first article considered the various investigative modalities used during MoMHA patient surveillance (Matharu et al. ). The present article aims to provide a clinical update regarding ARMD revision surgery in MoMHA patients (hip resurfacing and large-diameter MoM total hip arthroplasty), with specific focus on the threshold for performing ARMD revision, the surgical strategy, and the outcomes following revision. Results and interpretation — The outcomes following ARMD revision surgery appear to have improved with time for several reasons, among them the introduction of regular patient surveillance and lowering of the threshold for performing revision. Furthermore, registry data suggest that outcomes following ARMD revision are influenced by modifiable factors (type of revision procedure and bearing surface implanted), meaning surgeons could potentially reduce failure rates. However, additional large multi-center studies are needed to develop robust thresholds for performing ARMD revision surgery, which will guide surgeons’ treatment of MoMHA patients. The long-term systemic effects of metal ion exposure in patients with these implants must also be investigated, which will help establish whether there are any systemic reasons to recommend revision of MoMHAs |
| first_indexed | 2024-12-10T20:17:35Z |
| format | Article |
| id | doaj.art-70921e3252c3471faa2ece3175d07d18 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-12-10T20:17:35Z |
| publishDate | 2018-05-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-70921e3252c3471faa2ece3175d07d182022-12-22T01:35:10ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822018-05-0189327828810.1080/17453674.2018.14404551440455Revision surgery of metal-on-metal hip arthroplasties for adverse reactions to metal debris: A clinical updateGulraj S Matharu0Antti Eskelinen1Andrew Judge2Hemant G Pandit3David W Murray4University of Oxford, Nuffield Orthopaedic CentreCoxa Hospital for Joint ReplacementUniversity of Oxford, Nuffield Orthopaedic CentreUniversity of Oxford, Nuffield Orthopaedic CentreUniversity of Oxford, Nuffield Orthopaedic CentreBackground and purpose — The initial outcomes following metal-on-metal hip arthroplasty (MoMHA) revision surgery performed for adverse reactions to metal debris (ARMD) were poor. Furthermore, robust thresholds for performing ARMD revision are lacking. This article is the second of 2. The first article considered the various investigative modalities used during MoMHA patient surveillance (Matharu et al. ). The present article aims to provide a clinical update regarding ARMD revision surgery in MoMHA patients (hip resurfacing and large-diameter MoM total hip arthroplasty), with specific focus on the threshold for performing ARMD revision, the surgical strategy, and the outcomes following revision. Results and interpretation — The outcomes following ARMD revision surgery appear to have improved with time for several reasons, among them the introduction of regular patient surveillance and lowering of the threshold for performing revision. Furthermore, registry data suggest that outcomes following ARMD revision are influenced by modifiable factors (type of revision procedure and bearing surface implanted), meaning surgeons could potentially reduce failure rates. However, additional large multi-center studies are needed to develop robust thresholds for performing ARMD revision surgery, which will guide surgeons’ treatment of MoMHA patients. The long-term systemic effects of metal ion exposure in patients with these implants must also be investigated, which will help establish whether there are any systemic reasons to recommend revision of MoMHAshttp://dx.doi.org/10.1080/17453674.2018.1440455 |
| spellingShingle | Gulraj S Matharu Antti Eskelinen Andrew Judge Hemant G Pandit David W Murray Revision surgery of metal-on-metal hip arthroplasties for adverse reactions to metal debris: A clinical update Acta Orthopaedica |
| title | Revision surgery of metal-on-metal hip arthroplasties for adverse reactions to metal debris: A clinical update |
| title_full | Revision surgery of metal-on-metal hip arthroplasties for adverse reactions to metal debris: A clinical update |
| title_fullStr | Revision surgery of metal-on-metal hip arthroplasties for adverse reactions to metal debris: A clinical update |
| title_full_unstemmed | Revision surgery of metal-on-metal hip arthroplasties for adverse reactions to metal debris: A clinical update |
| title_short | Revision surgery of metal-on-metal hip arthroplasties for adverse reactions to metal debris: A clinical update |
| title_sort | revision surgery of metal on metal hip arthroplasties for adverse reactions to metal debris a clinical update |
| url | http://dx.doi.org/10.1080/17453674.2018.1440455 |
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