Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris?
<h4>Aims</h4> <p>To determine the outcomes following revision surgery of metal-on-metal hip arthroplasties (MoMHA) performed for adverse reactions to metal debris (ARMD), and to identify factors predictive of re-revision.</p> <h4>Patients and Methods</h4> <p&g...
| Main Authors: | , , , |
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| Format: | Journal article |
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British Editorial Society of Bone and Joint Surgery
2017
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| _version_ | 1797104107133075456 |
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| author | Matharu, GS Judge, A Pandit, HG Murray, DW |
| author_facet | Matharu, GS Judge, A Pandit, HG Murray, DW |
| author_sort | Matharu, GS |
| collection | OXFORD |
| description | <h4>Aims</h4> <p>To determine the outcomes following revision surgery of metal-on-metal hip arthroplasties (MoMHA) performed for adverse reactions to metal debris (ARMD), and to identify factors predictive of re-revision.</p> <h4>Patients and Methods</h4> <p>We performed a retrospective observational study using National Joint Registry (NJR) data on 2535 MoMHAs undergoing revision surgery for ARMD between 2008 and 2014. The outcomes studied following revision were intra-operative complications, mortality and rerevision surgery. Predictors of re-revision were identified using competing-risk regression modelling.</p> <h4>Results</h4> <p>Intra-operative complications occurred in 40 revisions (1.6%). The cumulative five-year patient survival rate was 95.9% (95% confidence intervals (CI) 92.3 to 97.8). Re-revision surgery was performed in 192 hips (7.6%). The cumulative five-year implant survival rate was 89.5% (95% CI 87.3 to 91.3). Predictors of re-revision were high body mass index at revision (subhazard ratio (SHR) 1.06 per kg/m2 increase, 95% CI 1.02 to 1.09), modular component only revisions (head and liner with or without taper adapter; SHR 2.01, 95% CI 1.19 to 3.38), ceramic-on-ceramic revision bearings (SHR 1.86, 95% CI 1.23 to 2.80), and acetabular bone grafting (SHR 2.10, 95% CI 1.43 to 3.07). These four factors remained predictive of re-revision when the missing data were imputed.</p> <h4>Conclusions</h4> <p>The short-term risk of re-revision following MoMHA revision surgery performed for ARMD was comparable with that reported in the NJR following all-cause non-MoMHA revision surgery. However, the factors predictive of re-revision included those which could be modified by the surgeon, suggesting that rates of failure following ARMD revision may be reduced further.</p> |
| first_indexed | 2024-03-07T06:29:09Z |
| format | Journal article |
| id | oxford-uuid:f55db972-cff0-4e82-a61e-07483fa40f25 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T06:29:09Z |
| publishDate | 2017 |
| publisher | British Editorial Society of Bone and Joint Surgery |
| record_format | dspace |
| spelling | oxford-uuid:f55db972-cff0-4e82-a61e-07483fa40f252022-03-27T12:26:52ZWhich factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f55db972-cff0-4e82-a61e-07483fa40f25Symplectic Elements at OxfordBritish Editorial Society of Bone and Joint Surgery2017Matharu, GSJudge, APandit, HGMurray, DW <h4>Aims</h4> <p>To determine the outcomes following revision surgery of metal-on-metal hip arthroplasties (MoMHA) performed for adverse reactions to metal debris (ARMD), and to identify factors predictive of re-revision.</p> <h4>Patients and Methods</h4> <p>We performed a retrospective observational study using National Joint Registry (NJR) data on 2535 MoMHAs undergoing revision surgery for ARMD between 2008 and 2014. The outcomes studied following revision were intra-operative complications, mortality and rerevision surgery. Predictors of re-revision were identified using competing-risk regression modelling.</p> <h4>Results</h4> <p>Intra-operative complications occurred in 40 revisions (1.6%). The cumulative five-year patient survival rate was 95.9% (95% confidence intervals (CI) 92.3 to 97.8). Re-revision surgery was performed in 192 hips (7.6%). The cumulative five-year implant survival rate was 89.5% (95% CI 87.3 to 91.3). Predictors of re-revision were high body mass index at revision (subhazard ratio (SHR) 1.06 per kg/m2 increase, 95% CI 1.02 to 1.09), modular component only revisions (head and liner with or without taper adapter; SHR 2.01, 95% CI 1.19 to 3.38), ceramic-on-ceramic revision bearings (SHR 1.86, 95% CI 1.23 to 2.80), and acetabular bone grafting (SHR 2.10, 95% CI 1.43 to 3.07). These four factors remained predictive of re-revision when the missing data were imputed.</p> <h4>Conclusions</h4> <p>The short-term risk of re-revision following MoMHA revision surgery performed for ARMD was comparable with that reported in the NJR following all-cause non-MoMHA revision surgery. However, the factors predictive of re-revision included those which could be modified by the surgeon, suggesting that rates of failure following ARMD revision may be reduced further.</p> |
| spellingShingle | Matharu, GS Judge, A Pandit, HG Murray, DW Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris? |
| title | Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris? |
| title_full | Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris? |
| title_fullStr | Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris? |
| title_full_unstemmed | Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris? |
| title_short | Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris? |
| title_sort | which factors influence the rate of failure following metal on metal hip arthroplasty revision surgery performed for adverse reactions to metal debris |
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