Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.
Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, PO Box 1777, 70211, Kuopio, Finland.
Arch Orthop Trauma Surg. 2023 Jul;143(7):4437-4446. doi: 10.1007/s00402-022-04633-9. Epub 2022 Oct 5.
The aim of this retrospective study was to study the long-term survival and reasons for revisions of a single-type, large-diameter head (LDH) metal-on-metal (MoM) implant. A special study interest was to find the threshold level for revision in terms of adverse reaction to metal debris (ARMD).
In this cohort study, we retrospectively reviewed 234 patients (253 hips) who received 38 mm head size LDH MoM total hip arthroplasties (THAs) between 01 January 2004 and 31 December 2009 at our institution. Patient symptoms, conventional radiographs, magnetic resonance imaging (MRI) findings and whole blood metal ions were studied.
The median follow-up time was 11.5 years. The Kaplan-Meier cumulative survival estimate of the implant was 89.6% at 10 years and 82.9% at 14.6 years. Overall, 34/253 (13.4%) hips were revised during the follow-up period and of these; 19/34 (55.9%) were revised due to ARMD. The prevalence of ARMD was 12.4% (29/234 patients).
The survival of the implant was on a moderate level as the 10-year cumulative survival rate was 89.6%. The exact threshold level for ARMD revision cannot be determined due to multiple variables affecting factors in re-operation decision-making.
本回顾性研究旨在研究单一类型、大直径头（LDH）金属对金属（MoM）植入物的长期存活率和翻修原因。一项特殊的研究兴趣是确定与金属碎屑不良反应（ARMD）相关的翻修阈值水平。
在这项队列研究中，我们回顾性地分析了 2004 年 1 月 1 日至 2009 年 12 月 31 日期间在我们机构接受 38 毫米头大小 LDH MoM 全髋关节置换术（THA）的 234 名患者（253 髋）。研究了患者症状、常规 X 线片、磁共振成像（MRI）结果和全血金属离子。
中位随访时间为 11.5 年。植入物的 Kaplan-Meier 累积生存率在 10 年时为 89.6%，在 14.6 年时为 82.9%。在整个随访期间，共有 34/253（13.4%）髋需要翻修，其中 19/34（55.9%）因 ARMD 而翻修。ARMD 的患病率为 12.4%（29/234 例患者）。
由于影响再手术决策的多种因素，植入物的存活率处于中等水平，10 年累积生存率为 89.6%。由于影响再手术决策的多种因素，无法确定 ARMD 翻修的确切阈值水平。
