Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA.
Arch Orthop Trauma Surg. 2022 Oct;142(10):2577-2583. doi: 10.1007/s00402-021-03891-3. Epub 2021 Apr 9.
Recalls of total hip arthroplasty (THA) implants, including metal-on-metal (MoM) THA and dual taper stems, due to increased risk of adverse local tissue reaction (ALTR), represent a challenge for both surgeons and patients. This study aims to analyze the revision surgery outcomes for ALTR in patients with recalled THA implants.
A total of 118 consecutive patients who underwent revision surgery due to ALTR with recalled THA were analyzed. Sub-group analysis was performed for recalled MoM THAs, head-neck modular stems, and dual taper neck-stems.
At a mean follow-up of 6.6 years, the complication and reoperation rates of the recalled THAs were 32.2% and 25.4% respectively. The most common post-revision complication was dislocation (16%). Revision of modular taper corrosion THA and high-grade intraoperative tissue damage were risk factors associated with post-revision complications.
This study reports high complication and reoperation rates of recalled THAs at mid-term follow-up. The high revision surgery complication rates in both groups suggest the importance of a systematic evaluation of all THA patients with at-risk implants.
Level III, case control retrospective analysis.
由于金属对金属（MoM）全髋关节置换术（THA）和双锥度柄的不良局部组织反应（ALTR）风险增加，导致 THA 植入物召回，这对外科医生和患者都构成了挑战。本研究旨在分析因 THA 植入物召回而发生 ALTR 的患者行翻修手术的结果。
分析了 118 例因 ALTR 行翻修手术的连续患者，这些患者均因 THA 植入物召回。对召回的 MoM THR、头颈模块柄和双锥度颈柄进行了亚组分析。
在平均 6.6 年的随访中，召回 THA 的并发症和再次手术率分别为 32.2%和 25.4%。最常见的术后并发症是脱位（16%）。模块锥度腐蚀 THA 的翻修和术中组织损伤程度高是与术后并发症相关的危险因素。
本研究报告了中期随访时召回 THA 的高并发症和再手术率。两组高翻修手术并发症发生率表明，对所有有风险植入物的 THA 患者进行系统评估非常重要。
III 级，病例对照回顾性分析。
