Abstract
The objectives of this study are to investigate the long-term results after the second-generation metal-on-metal cementless total hip arthroplasty (THA) and to validate continued use for metal-on-metal bearing couples.
Between 1997 and 2002, 87 patients (97 hips) underwent the Metasul metal-on-metal cementless total hip arthroplasty. Seven patients died, and 12 patients were lost before 10-year follow-up. Seventeen patients (18 hips) underwent reoperation. The remaining 51 patients (60 hips) with more than 10-year follow-up without reoperation were reviewed clinically. The average age was 59.9 years, and the average follow-up period was 12.3 years.
The average Merle D’Aubigné and Postel hip scores were improved from 8.5 preoperatively to 16.3 at the latest follow-up. All of the femoral components and acetabular components without reoperation were well fixed at the latest follow-up. Osteolysis was seen for seven hips and three of them were revised. The main reasons for reoperation were pseudotumor formation in three hips, pelvic osteolysis in three hips, and pain due to impingement in three hips. Five reoperations were associated with the liner dissociation of the APR cup. Survival rates at 15 years were 71.2 % defined with the endpoint as reoperation and 94.9 % defined with the endpoint as revision for aseptic loosening.
The problems of the second-generation metal-on-metal cementless THA in the long-term follow-up were the locking mechanism failure of the early type of the cup and the relatively small-diameter head prone to prosthetic impingement. There is little benefit for continued use of metal-on-metal bearings in THA.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Amuwa C, Dorr LD. The combined anteversion technique for acetabular component anteversion. J Arthroplasty. 2008;23(7):1068–70.
Dastane M, Wan Z, Deshmane P, et al. Primary hip arthroplasty with 28-mm Metasul articulation. J Arthroplasty. 2011;26(4):662–4.
Eswaramoorthy V, Moonot P, Kalairajah Y, et al. The Metasul metal-on-metal articulation in primary total hip replacement: clinical and radiological results at ten years. J Bone Joint Surg Br. 2008;90(10):1278–83.
Graves SE, Rothwell A, Tucker K, et al. A multinational assessment of metal-on-metal bearings in hip replacement. J Bone Joint Surg Am. 2011;93 Suppl 3:43–7.
Holloway I, Walter WL, Zicat B, et al. Osteolysis with a cementless second generation metal-on-metal cup in total hip replacement. Int Orthop. 2009;33(6):1537–42.
Langton DJ, Jameson SS, Joyce TJ, et al. The effect of component size and orientation on the concentrations of metal ions after resurfacing arthroplasty of the hip. J Bone Joint Surg Br. 2008;90(9):1143–51.
Langton DJ, Jameson SS, Joyce TJ, et al. Early failure of metal-on-metal bearings in hip resurfacing and large-diameter total hip replacement: a consequence of excess wear. J Bone Joint Surg Br. 2010;92(1):38–46.
Langton DJ, Joyce TJ, Jameson SS, et al. Adverse reaction to metal debris following hip resurfacing: the influence of component type, orientation and volumetric wear. J Bone Joint Surg Br. 2011;93(2):164–71.
Lewinnek GE, et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978;60(2):217–20.
Malik A, Dorr LD, Long WT. Impingement as a mechanism of dissociation of a metasul metal-on-metal liner. J Arthroplasty. 2009;24(2):323.e13–e16.
Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg Br. 1993;75(2):228–32.
Randelli F, Banci L, D’Anna A, et al. Cementless metasul metal-on-metal total hip arthroplasties at 13 years. J Arthroplasty. 2012;27(2):186–92.
Saito S, Ishii T, Mori S, et al. Long-term results of metasul metal-on-metal total hip arthroplasty. Orthopedics. 2010;11:33(8).
Sugano N, Nishii T, Miki H, et al. Mid-term results of cementless total hip replacement using a ceramic-on-ceramic bearing with and without computer navigation. J Bone Joint Surg Br. 2007;89(4):455–60.
Usrey MM, Noble PC, Rudner LJ, et al. Does neck/liner impingement increase wear of ultrahigh-molecular-weight polyethylene liners? J Arthroplasty. 2006;21(6 Suppl 2):65–71.
Widmer KH, Zurfluh B. Compliant positioning of total hip components for optimal range of motion. J Orthop Res. 2004;22(4):815–21.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 EFORT
About this chapter
Cite this chapter
Haraguchi, K., Koyanagi, J., Tsuda, K., Fujiwara, K. (2014). Results of the Long-Term Follow-Up Study After the Metasul Metal-on-Metal Cementless Total Hip Arthroplasty. In: Knahr, K. (eds) Tribology in Total Hip and Knee Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45266-6_14
Download citation
DOI: https://doi.org/10.1007/978-3-642-45266-6_14
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-45265-9
Online ISBN: 978-3-642-45266-6
eBook Packages: MedicineMedicine (R0)