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Women show higher revision rates after metal-on-metal hip resurfacing

Rylander LS. J Arthroplasty. 2010. doi:10.1016/j.arth.2010.09.001.

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Female gender, smaller implant size and osteonecrosis were associated with lower device survival, according to this prospective study.

Lucas S. Rylander, MD, of Southern Illinois University School of Medicine in Springfield, Ill., and colleagues studied patient characteristics and radiographic findings in 89 patients undergoing total hip resurfacing. Thirteen hips (14.6%) in this group have been revised.

Overall, the results showed that female gender, smaller implants and a diagnosis of osteonecrosis were linked to lower device survival, according to the investigators. They found no significant differences in acetabular cup angle and stem angle between the revised and unrevised hips.

Among the first 25 hips in this study, revision rates were 24%. Revision rates were 8% for the last 64 hips. Women accounted for 56% of the first 25 patients and 23% of the remaining participants. The investigators could not attribute the lower device survival in patients the first 25 patients to acetabular or femoral component malpositioning. The most likely explanation was the significantly higher proportion of women enrolled early in the study, they wrote.