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Outcome and serum ion determination up to 11 years after implantation of a cemented metal-on-metal hip prosthesis

Background and purpose Little is known about the long-term outcome of cemented metal-on-metal hip arthroplasties. We evaluated a consecutive series of metal-on-metal polyethylene-backed cemented hip arthroplasties implanted in patients under 60 years of age. Methods 109 patients (134 joint replaceme...

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Autores principales: Lazennec, Jean-Yves, Boyer, Patrick, Poupon, Joel, Rousseau, Marc-Antoine, Roy, Carine, Ravaud, Philippe, Catonné, Yves
Formato: Texto
Lenguaje:English
Publicado: Informa Healthcare 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823177/
https://www.ncbi.nlm.nih.gov/pubmed/19404797
http://dx.doi.org/10.3109/17453670902947408
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author Lazennec, Jean-Yves
Boyer, Patrick
Poupon, Joel
Rousseau, Marc-Antoine
Roy, Carine
Ravaud, Philippe
Catonné, Yves
author_facet Lazennec, Jean-Yves
Boyer, Patrick
Poupon, Joel
Rousseau, Marc-Antoine
Roy, Carine
Ravaud, Philippe
Catonné, Yves
author_sort Lazennec, Jean-Yves
collection PubMed
description Background and purpose Little is known about the long-term outcome of cemented metal-on-metal hip arthroplasties. We evaluated a consecutive series of metal-on-metal polyethylene-backed cemented hip arthroplasties implanted in patients under 60 years of age. Methods 109 patients (134 joint replacements) were followed prospectively for mean 9 (7–11) years. The evaluation included clinical score, radiographic assessment, and blood sampling for ion level determination. Results At the final review, 12 hips had been revised, mainly because of aseptic loosening of the socket. Using revision for aseptic loosening as the endpoint, the survival rate at 9 years was 91% for the cup and 99% for the stem. In addition, 35 hips showed radiolucent lines at the bone-cement interface of the acetabulum and some were associated with osteolysis. The median serum cobalt and chromium levels were relatively constant over time, and were much higher than the detection level throughout the study period. The cobalt level was 1.5 μg/L 1 year after implantation, and 1.44 μg/L 9 years after implantation. Interpretation Revisions for aseptic loosening and radiographic findings in the sockets led us to halt metal-on-metal-backed polyethylene cemented hip arthroplasty procedures. If the rigidity of the cemented socket is a reason for loosening, excessive release of metal ions and particles may be involved. Further investigations are required to confirm this hypothesis and to determine whether subluxation, microseparation, and hypersensitivity also play a role.
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spelling pubmed-28231772010-02-18 Outcome and serum ion determination up to 11 years after implantation of a cemented metal-on-metal hip prosthesis Lazennec, Jean-Yves Boyer, Patrick Poupon, Joel Rousseau, Marc-Antoine Roy, Carine Ravaud, Philippe Catonné, Yves Acta Orthop Research Article Background and purpose Little is known about the long-term outcome of cemented metal-on-metal hip arthroplasties. We evaluated a consecutive series of metal-on-metal polyethylene-backed cemented hip arthroplasties implanted in patients under 60 years of age. Methods 109 patients (134 joint replacements) were followed prospectively for mean 9 (7–11) years. The evaluation included clinical score, radiographic assessment, and blood sampling for ion level determination. Results At the final review, 12 hips had been revised, mainly because of aseptic loosening of the socket. Using revision for aseptic loosening as the endpoint, the survival rate at 9 years was 91% for the cup and 99% for the stem. In addition, 35 hips showed radiolucent lines at the bone-cement interface of the acetabulum and some were associated with osteolysis. The median serum cobalt and chromium levels were relatively constant over time, and were much higher than the detection level throughout the study period. The cobalt level was 1.5 μg/L 1 year after implantation, and 1.44 μg/L 9 years after implantation. Interpretation Revisions for aseptic loosening and radiographic findings in the sockets led us to halt metal-on-metal-backed polyethylene cemented hip arthroplasty procedures. If the rigidity of the cemented socket is a reason for loosening, excessive release of metal ions and particles may be involved. Further investigations are required to confirm this hypothesis and to determine whether subluxation, microseparation, and hypersensitivity also play a role. Informa Healthcare 2009-04-29 2009-04-01 /pmc/articles/PMC2823177/ /pubmed/19404797 http://dx.doi.org/10.3109/17453670902947408 Text en Copyright: © Nordic Orthopedic Federation http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.
spellingShingle Research Article
Lazennec, Jean-Yves
Boyer, Patrick
Poupon, Joel
Rousseau, Marc-Antoine
Roy, Carine
Ravaud, Philippe
Catonné, Yves
Outcome and serum ion determination up to 11 years after implantation of a cemented metal-on-metal hip prosthesis
title Outcome and serum ion determination up to 11 years after implantation of a cemented metal-on-metal hip prosthesis
title_full Outcome and serum ion determination up to 11 years after implantation of a cemented metal-on-metal hip prosthesis
title_fullStr Outcome and serum ion determination up to 11 years after implantation of a cemented metal-on-metal hip prosthesis
title_full_unstemmed Outcome and serum ion determination up to 11 years after implantation of a cemented metal-on-metal hip prosthesis
title_short Outcome and serum ion determination up to 11 years after implantation of a cemented metal-on-metal hip prosthesis
title_sort outcome and serum ion determination up to 11 years after implantation of a cemented metal-on-metal hip prosthesis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823177/
https://www.ncbi.nlm.nih.gov/pubmed/19404797
http://dx.doi.org/10.3109/17453670902947408
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