The Long-Term Survivorship and Cause of Failure of Metal-on-Metal Total Hip Arthroplasty
Background: Complications associated with metal-on-metal (MOM) prostheses, such as adverse reactions to metal debris (ARMDs), include pseudotumor (PT) formation, metallosis, and soft tissue necrosis. High short-term failure rates have been reported for various MOM total hip arthroplasties (THAs) due...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-02-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/14/2/161 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850080525984727040 |
|---|---|
| author | Hiroki Wakabayashi Masahiro Hasegawa Yohei Naito Shine Tone Akihiro Sudo |
| author_facet | Hiroki Wakabayashi Masahiro Hasegawa Yohei Naito Shine Tone Akihiro Sudo |
| author_sort | Hiroki Wakabayashi |
| collection | DOAJ |
| description | Background: Complications associated with metal-on-metal (MOM) prostheses, such as adverse reactions to metal debris (ARMDs), include pseudotumor (PT) formation, metallosis, and soft tissue necrosis. High short-term failure rates have been reported for various MOM total hip arthroplasties (THAs) due to ARMDs. ARMDs in MOM THAs can potentially lead to secondary failure modes, such as dislocation or infection. Objectives: This study aims to examine the cumulative incidence of revisions due to ARMDs and periprosthetic joint infection (PJI) in primary MOM total hip arthroplasty and to compare the outcomes of ARMD and PJI cases. Methods: Between 2006 and 2011, 247 primary MOM THAs were performed on 230 patients (39 men, 191 women) with a mean age of 64.1 years. The average follow-up duration was 10.5 years. Results: Thirty-eight hips were converted to metal-on-polyethylene articulation between 1.2 and 14.7 years postoperatively (mean: 7.2 years) due to pain, swelling, infection, and/or implant failure. Eight hips (3.2%) were complicated by infection, while 30 hips (12.1%) were diagnosed with ARMDs. Rheumatoid arthritis (RA) was significantly more prevalent in patients with PJI. Preoperative C-reactive protein (CRP) levels were significantly elevated in THAs diagnosed with PJI compared to ARMD cases. Additionally, the preoperative white blood cell (WBC) counts, neutrophil counts, and neutrophil-to-WBC ratios were significantly higher in THAs with PJI, while the lymphocyte-to-WBC ratios were significantly lower. Conclusion: The incidence of postoperative infection in MOM THA cases was 3.2%, with a notable occurrence of late-onset infections. Differentiating ARMDs from PJI in MOM THA cases remains crucial. |
| format | Article |
| id | doaj-art-40f38a040e6546f599591b207e5d1721 |
| institution | DOAJ |
| issn | 2079-6382 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj-art-40f38a040e6546f599591b207e5d17212025-08-20T02:44:55ZengMDPI AGAntibiotics2079-63822025-02-0114216110.3390/antibiotics14020161The Long-Term Survivorship and Cause of Failure of Metal-on-Metal Total Hip ArthroplastyHiroki Wakabayashi0Masahiro Hasegawa1Yohei Naito2Shine Tone3Akihiro Sudo4Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, JapanDepartment of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, JapanDepartment of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, JapanDepartment of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, JapanDepartment of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, JapanBackground: Complications associated with metal-on-metal (MOM) prostheses, such as adverse reactions to metal debris (ARMDs), include pseudotumor (PT) formation, metallosis, and soft tissue necrosis. High short-term failure rates have been reported for various MOM total hip arthroplasties (THAs) due to ARMDs. ARMDs in MOM THAs can potentially lead to secondary failure modes, such as dislocation or infection. Objectives: This study aims to examine the cumulative incidence of revisions due to ARMDs and periprosthetic joint infection (PJI) in primary MOM total hip arthroplasty and to compare the outcomes of ARMD and PJI cases. Methods: Between 2006 and 2011, 247 primary MOM THAs were performed on 230 patients (39 men, 191 women) with a mean age of 64.1 years. The average follow-up duration was 10.5 years. Results: Thirty-eight hips were converted to metal-on-polyethylene articulation between 1.2 and 14.7 years postoperatively (mean: 7.2 years) due to pain, swelling, infection, and/or implant failure. Eight hips (3.2%) were complicated by infection, while 30 hips (12.1%) were diagnosed with ARMDs. Rheumatoid arthritis (RA) was significantly more prevalent in patients with PJI. Preoperative C-reactive protein (CRP) levels were significantly elevated in THAs diagnosed with PJI compared to ARMD cases. Additionally, the preoperative white blood cell (WBC) counts, neutrophil counts, and neutrophil-to-WBC ratios were significantly higher in THAs with PJI, while the lymphocyte-to-WBC ratios were significantly lower. Conclusion: The incidence of postoperative infection in MOM THA cases was 3.2%, with a notable occurrence of late-onset infections. Differentiating ARMDs from PJI in MOM THA cases remains crucial.https://www.mdpi.com/2079-6382/14/2/161periprosthetic hip joint infectionirrigation and debridementantibiotic-impregnated calcium hydroxyapatite |
| spellingShingle | Hiroki Wakabayashi Masahiro Hasegawa Yohei Naito Shine Tone Akihiro Sudo The Long-Term Survivorship and Cause of Failure of Metal-on-Metal Total Hip Arthroplasty Antibiotics periprosthetic hip joint infection irrigation and debridement antibiotic-impregnated calcium hydroxyapatite |
| title | The Long-Term Survivorship and Cause of Failure of Metal-on-Metal Total Hip Arthroplasty |
| title_full | The Long-Term Survivorship and Cause of Failure of Metal-on-Metal Total Hip Arthroplasty |
| title_fullStr | The Long-Term Survivorship and Cause of Failure of Metal-on-Metal Total Hip Arthroplasty |
| title_full_unstemmed | The Long-Term Survivorship and Cause of Failure of Metal-on-Metal Total Hip Arthroplasty |
| title_short | The Long-Term Survivorship and Cause of Failure of Metal-on-Metal Total Hip Arthroplasty |
| title_sort | long term survivorship and cause of failure of metal on metal total hip arthroplasty |
| topic | periprosthetic hip joint infection irrigation and debridement antibiotic-impregnated calcium hydroxyapatite |
| url | https://www.mdpi.com/2079-6382/14/2/161 |
| work_keys_str_mv | AT hirokiwakabayashi thelongtermsurvivorshipandcauseoffailureofmetalonmetaltotalhiparthroplasty AT masahirohasegawa thelongtermsurvivorshipandcauseoffailureofmetalonmetaltotalhiparthroplasty AT yoheinaito thelongtermsurvivorshipandcauseoffailureofmetalonmetaltotalhiparthroplasty AT shinetone thelongtermsurvivorshipandcauseoffailureofmetalonmetaltotalhiparthroplasty AT akihirosudo thelongtermsurvivorshipandcauseoffailureofmetalonmetaltotalhiparthroplasty AT hirokiwakabayashi longtermsurvivorshipandcauseoffailureofmetalonmetaltotalhiparthroplasty AT masahirohasegawa longtermsurvivorshipandcauseoffailureofmetalonmetaltotalhiparthroplasty AT yoheinaito longtermsurvivorshipandcauseoffailureofmetalonmetaltotalhiparthroplasty AT shinetone longtermsurvivorshipandcauseoffailureofmetalonmetaltotalhiparthroplasty AT akihirosudo longtermsurvivorshipandcauseoffailureofmetalonmetaltotalhiparthroplasty |