A new study about adverse reactions to metal debris after Metal on Metal THR and Hip Resurfacing shows the current follow-up guidelines worldwide are not cost effective or evidence-based.
The follow-up guidelines for metal-on-metal (MoM) hip arthroplasty and hip resurfacing from five worldwide authorities worldwide, including the U.K. were included.
Findings showed large differences between cost per patients. U.S. costs were three-times more than MHRA costs…
…Australia vs. U.S. and Canada guidelines were about six-times more costly for asymptomatic patients.… Read the rest
The clinical implications of elevated blood metal ion concentrations in
asymptomatic patients with MoM hip resurfacings: a cohort study
David J Langton, Raghavendra P Sidaginamale, Thomas J Joyce, Shonali Natu,
Peter Blain, Robert Drysdale Jefferson, Stephen Rushton, Antoni V F Nargol
Full Study Here
January 31, 2014
To determine whether elevated blood cobalt (Co) concentrations are associated
with early failure of metal-on-metal (MoM) hip resurfacings secondary to adverse
reaction to metal debris (ARMD).
Single centre orthopaedic unit.
Following the identification of complications potentially related to metal wear
debris, a blood metal ion screening programme was instigated at our unit in 2007
for all patients with Articular Surface Replacement (ASR) and Birmingham MoM hip
resurfacings. Patients were followed … Read the rest
D.H. Williams; U. Masood; and M.N. Norton
Royal Cornwall Hospital, Truro, Cornwall TR1 3LJ, UK.
Decreased head-neck ratio diameter and component malposition in total hip arthroplasty are factors known to result in impingement, increased rates of dislocation, wear and failure. In addition to these complications, impingement of the femoral neck on the acetabular component of a hip resurfacing may result in femoral neck fracture and loosening of the acetabular component. Little is known regarding the optimum femoral and acetabular hip resurfacing component position to avoid impingement.
In the first part of this study we analyzed the radiographic component position of 131 consecutive hip resurfacings. In the second part the effect of three component variables on the range of motion to impingement were analyzed
Metal ion release following hip replacement not strongly related to patient activity medical study
Metal ion release following hip replacement not strongly related to patient activity Read Complete Article by Clicking Here The amount of patient activity following metal-on-metal hip resurfacing arthroplasty seems to show little correlation to metal ion release, according to study presented here. Amir Kamali, PhD, presented his team’s findings at the 56th Annual Meeting of the Orthopedic Research Society.Kamali reported that his group looked at 25 consecutive male patients who underwent a unilateral, 50-mm diameter metal-on-metal hip resurfacing… …”I should mention here that at 1, 2, and 4 years, the average metal ion levels were similar between these implants, meaning they had gone well into their steady state,” Kamali said…
The effect of component size and orientation on the concentrations of metal ions after resurfacing arthroplasty of the hip 2008
Link Read Complete Article by Clicking Here
D. J. Langton, MRCS, Orthopaedic Research Register1; S. S. Jameson, MRCS, Specialist Registrar, Trauma and Orthopaedics1; T. J. Joyce, MSc, PhD, MA, BEng, Lecturer in Bioengineering2; J. Webb, MRCS, Specialist Registrar, Trauma and Orthopaedics1; and A. V. F. Nargol, FRCS(Tr & Orth), Consultant Orthopaedic Surgeon1 1 Joint Replacement Unit, University Hospital of North Tees, Hardwick, Stockton-on-Tees TS19 8PE, UK. 2 Newcastle University, Claremont Road, Newcastle upon Tyne NE1 7RU, UK.Increased concentrations of metal ions after metal-on-metal resurfacing arthroplasty of the hip remain a concern. Although there has been no proven link to long-term health problems or early
Surgical Description and Early Review 200
Michael A. Jacobs, MD1,
Robin N. Goytia, MD1 and Tarun
1 5601 Loch Raven Boulevard,
Russell Morgan Building, Suite 402, Baltimore, MD 21239
Background: Recently, metal-on-metal hip resurfacing has
enjoyed a resurgence as an alternative to hip
arthroplasty in properly selected patients. The
purpose of the present study was to report the
early results of hip resurfacing through an anterolateral
approach and to describe the technique with
modifications that have been made as experience
with the procedure has increased…
…Conclusions: The early results associated with a
new generation of hip resurfacing devices are
promising. The anterolateral approach affords the
surgeon excellent exposure with the advantage of
increased hip stability and potentially improved … Read the rest
MRI Useful for Predicting Failure of Metal-on-Metal Hip ImplantsOriginal Link http://www.hss.edu/newsroom_metal-on-metal-tissue-damage-before-pain.asp
New York – May 15, 2013Metal-on-metal hip implants can cause inflammation of the joint lining (synovitis) long before symptoms appear, and magnetic resonance imaging (MRI) can be used to identify this inflammation, according to a new study by researchers at Hospital for Special Surgery. The study, which appears in an upcoming issue of the Journal of Bone & Joint Surgery, demonstrates that MRI can be used to identify implants that are going to fail before people become symptomatic. “The study shows that synovitis exists in asymptomatic people in a fairly high prevalence,” said Hollis Potter, M.D., chief of the Division of Magnetic Resonance Imaging at Hospital for Special… Read the rest
Staples significantly increase risk of postoperative infection studyMarch 2010
Original LinkThe use of staples to close wounds following orthopedic surgery – especially hip surgery – is associated with a significantly greater risk of wound infection than traditional suturing, according to orthopedic researchers from Norwich, England. Six clinical trials Toby O. Smith, MSc, BSc (Hons), MCSP, and colleagues analyzed the results of six trials that compared staples and sutures used for wound closure following orthopedic procedures in adult patients. The six clinical trials involved 683 wounds. Of these cases, 322 patients underwent suture closure and 351 patients had staple closure, according to a British Medical Journal press release. The authors found that wounds closed with staples were more than three times as likely to… Read the rest
Complete Study Here:
Objectives To compare 10 year mortality rates
among patients undergoing metal-on-metal hip resurfacing and total hip
replacement in England.
Setting English hospital episode statistics
database linked to mortality records from the Office for National
Population All adults who underwent primary
elective hip replacement for osteoarthritis from April 1999 to March 2012.
The exposure of interest was prosthesis type: cemented total hip
replacement, uncemented total hip replacement, and metal-on-metal hip
resurfacing. Confounding variables included age, sex, Charlson comorbidity
index, rurality, area deprivation, surgical volume, and year of operation.
Results 7437 patients undergoing metal-on-metal
hip resurfacing were matched to 22 311 undergoing cemented total hip
replacement; 8101 patients undergoing metal-on-metal hip resurfacing were
matched to 24 303 undergoing uncemented total hip replacement. … Read the rest
Adoption of Hip Resurfacing Arthroplasty at Hospital for Special Surgery: a Cohort Study
Edwin P. Su and Sherwin L. Su June 4, 2010
Background Hip resurfacing arthroplasty (HRA) is an alternative to traditional total hip replacement (THR) that allows for the preservation of femoral bone. It is a more technically difficult procedure that has led some researchers to report an unsatisfactory learning curve (Berend et al., J Bone Joint Surg Am Suppl 2:89–92, 2011; Mont et al., Clin Orthop Relat Res 465:63–70, 2007).
Purpose The purpose of this study was to investigate the adoption of HRA at our institution, examining the clinical results, revision rate, and modes of failure. Additionally, a comparison of three different implant systems was performed.
Methods A retrospective review of a … Read the rest
Joseph Daniel, Director of Research at the McMinn Center in Birmingham UK, talks about the 10 year survival of double heat-treated resurfacings from 1996 and the effect that these heat treatments had on this series of hip resurfacings.
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|Surgeon Volume Influences Rate of Total Hip Replacement Revision – A DGReview of :”Early failures of total hip replacement: Effect of surgeon volume” Arthritis & Rheumatism 04/28/2004 By Emma Hitt, PhDPatients treated by surgeons who perform few total hip replacements (THR) per year are more likely to undergo revision THR, particularly within the first 18 months of surgery, than are patients treated by high-volume surgeons, a new report suggests.Hip prostheses function well for up to 20 years in at least 80% of patients, and failure rates are less than 1% per year. However, it is unclear whether failure rates vary by surgeon and hospital volumes. Elena Losina, MD, with the Department of Biostatistics, at the Boston University School of Public Health, Massachusetts, United States, and|