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Low Incidence of Groin Pain and Early Failure with Large Metal Articulation Total Hip Arthroplasty

  • Symposium: Papers Presented at the Annual Meetings of The Hip Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Large-diameter metal-on-metal articulations reportedly improve stability and wear in THAs. However, some reports suggest some patients have unexplained hip and early failures with these implants. Thus, the potential benefits may be offset by these concerns. However, the incidence of these problems is not clearly established.

Questions/purposes

We therefore assessed hip pain, function, osteolysis, and complications in patients with large-diameter metal-on-metal THA.

Patients and Methods

We retrospectively reviewed 611 patients who had 681 large-diameter metal-on-metal THAs with the same cup and head design. The average age at operation was 62 years, 53% of the THAs were in men, and the average body mass index was 32 kg/m2. The diagnosis was osteoarthritis in 92% of the THAs. The minimum followup was 24 months (mean, 37 months; range, 24–60 months).

Results

Nine of the 611 patients (1.5%) experienced moderate or severe pain in the hip region that we considered to be coming from an extraarticular source in each case. Harris hip scores for pain averaged 42 points. Total Harris hip scores averaged 93 points. Cup abduction averaged 42°, and cup anteversion averaged 26°. There were no infections. Three cups (0.4%) were considered radiographically loose. All were secondary to inadequate seating of the shell.

Conclusion

Our observations suggest with this implant the concerns of higher incidences of groin pain, early failures, and adverse tissue reactions were not confirmed. Early successes or failures with large-diameter metal-on-metal articulations may be implant specific.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Philip M. Faris, MD, and Robert A. Malinzak, MD, who along with E. Michael Keating, MD, John B. Meding, MD, and Michael E. Berend, MD, were the orthopaedic surgeons for the patient population included in this study.

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Authors and Affiliations

  1. The Center for Hip and Knee Surgery, St Francis Hospital Mooresville, 1199 Hadley Road, Mooresville, IN, 46158, USA

    John B. Meding MD, Lindsey K. Meding, E. Michael Keating MD & Michael E. Berend MD

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  1. John B. Meding MD
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  2. Lindsey K. Meding
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  3. E. Michael Keating MD
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  4. Michael E. Berend MD
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Correspondence to John B. Meding MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institutional approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Meding, J.B., Meding, L.K., Keating, E.M. et al. Low Incidence of Groin Pain and Early Failure with Large Metal Articulation Total Hip Arthroplasty. Clin Orthop Relat Res 470, 388–394 (2012). https://doi.org/10.1007/s11999-011-2069-6

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  • DOI: https://doi.org/10.1007/s11999-011-2069-6

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