Study explores predictors of failure after MoM hip arthroplasty revision for adverse reactions to metal debris

Issue: June 2017

Although investigators found the short-term re-revision risk of patients who underwent metal-on-metal hip arthroplasty for adverse reactions to metal debris was similar to that of all-cause non-metal-on-metal hip revision using data of the National Joint Registry for England and Wales, they noted the predictors of re-revision in the metal hip group included surgeon-modifiable factors.

Researchers performed a retrospective observational study of 2,535 metal-on-metal (MoM) hip arthroplasties in the national registry that underwent revision surgery for adverse reactions to metal debris between 2008 and 2014. Investigators evaluated patients for intraoperative complications, mortality and re-revision surgery.

Investigators noted 40 revisions in which intraoperative complications occurred. They found the cumulative 5-year survival rate for patients was 95.9% and 192 cases required re-revision. The cumulative implant survival rate at 5 years was 89.5%.

High BMI at revision, modular component only revisions, ceramic-on-ceramic revision bearings and acetabular bone grafting were predictors of re-revision surgery and after missing data were entered into the results, these factors remained predictive. – by Monica Jaramillo

Disclosures: Matharu reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

Matharu GS, et al. Bone Joint J. 2017;doi: 0.1302/0301-620X.99B7.