Suscribirse

Same survival but higher rate of osteolysis for metal-on-metal Ultamet versus ceramic-on-ceramic in patients undergoing primary total hip arthroplasty after 8 years of follow-up - 23/11/18

Doi : 10.1016/j.otsr.2018.08.005 
Yoshitoshi Higuchi , Taisuke Seki, Yasuhiko Takegami, Daigo Komatsu, Daigo Morita, Naoki Ishiguro
 Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan 

Corresponding author.

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
Artículo gratuito.

Conéctese para beneficiarse!

Abstract

Background

To avoid wear-induced osteolysis, ceramic-on-ceramic (CoC) and metal-on-metal (MoM) bearings have been developed. At present, there are no direct material related clinical comparisons between cementless total hip arthroplasty with CoC and MoM at more than 5-year follow-up. The bearing that is more likely to prevent osteolysis is still controversial. Therefore, we performed a retrospective case control study evaluating CoC and MoM cementless THAs in order to:

– compare the longevity and complications for CoC and MoM THAs at 5–10 years postoperatively;

– compare the incidence of osteolysis between both type THAs;

– evaluate pseudotumors in MoM THAs.

Hypothesis

CoC THAs will have a lower rate of osteolysis, better longevity, and better clinical outcomes than MoM THAs.

Patients and methods

Ninety-six hips underwent CoC THAs, and 56 hips underwent MoM THA (Ultamet, Pinnacle, Depuy). Average patient age at the time of surgery was 57.1 years (range, 28 to 77 years).

Results

There were no differences with regard to the Harris hip score (89.5 and 90.3 for the CoC and MoM groups, respectively). Osteolysis (9 hips, 14.3%) among MoM THAs were significantly more frequently observed compared to CoC THAs (2 hips, 2.1%). Kaplan-Meier survival at 8 years with implant loosening or revision THA as the endpoint was 98.2% (95% CI: 87.8–99.8) for CoC, and 98.6% (95% CI: 90.2–99.8) for MoM (p=0.684). There was one audible squeaking (1.0%) and no ceramic fracture among CoC THAs. Five (8.9%) hips showed pseudotumors among MoM THAs.

Discussion

CoC THAs had a low incidence of osteolysis. No significant difference was seen in the 8-year survival rate between implants, when using implant loosening and revision THA as endpoints. These data indicate that CoC THAs have excellent clinical and radiological outcomes, compared with MoM THAs. Ultamet MoM had a higher rate of osteolysis compared to other MoM bearings; the cup modularity (without polyethylene) and the use of 36mm heads as well as the process of production (after 2006) may play a significant role in the higher rate of osteolysis.

Level of evidence

III, Case control study, case control retrospective design.

El texto completo de este artículo está disponible en PDF.

Keywords : Ceramic-on-ceramic total hip arthroplasty, Metal-on-metal total hip arthroplasty, Osteolysis


Esquema


© 2018  Elsevier Masson SAS. Reservados todos los derechos.
Añadir a mi biblioteca Eliminar de mi biblioteca Imprimir
Exportación

    Exportación citas

  • Fichero

  • Contenido

Vol 104 - N° 8

P. 1155-1161 - décembre 2018 Regresar al número
Artículo precedente Artículo precedente
  • Does hip center location affect the recovery of abductor moment after total hip arthroplasty?
  • Jun-ichi Fukushi, Ichiro Kawano, Goro Motomura, Satoshi Hamai, Ken-ichi Kawaguchi, Yasuharu Nakashima
| Artículo siguiente Artículo siguiente
  • Total hip arthroplasty after failed transtrochanteric rotational osteotomy for osteonecrosis of the femoral head: A systematic review and meta-analysis
  • Tomonori Shigemura, Yohei Yamamoto, Yasuaki Murata, Takashi Sato, Ryuto Tsuchiya, Norichika Mizuki, Yasunori Toki, Yuichi Wada

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.

Mi cuenta


Declaración CNIL

EM-CONSULTE.COM se declara a la CNIL, la declaración N º 1286925.

En virtud de la Ley N º 78-17 del 6 de enero de 1978, relativa a las computadoras, archivos y libertades, usted tiene el derecho de oposición (art.26 de la ley), el acceso (art.34 a 38 Ley), y correcta (artículo 36 de la ley) los datos que le conciernen. Por lo tanto, usted puede pedir que se corrija, complementado, clarificado, actualizado o suprimido información sobre usted que son inexactos, incompletos, engañosos, obsoletos o cuya recogida o de conservación o uso está prohibido.
La información personal sobre los visitantes de nuestro sitio, incluyendo su identidad, son confidenciales.
El jefe del sitio en el honor se compromete a respetar la confidencialidad de los requisitos legales aplicables en Francia y no de revelar dicha información a terceros.


Todo el contenido en este sitio: Copyright © 2024 Elsevier, sus licenciantes y colaboradores. Se reservan todos los derechos, incluidos los de minería de texto y datos, entrenamiento de IA y tecnologías similares. Para todo el contenido de acceso abierto, se aplican los términos de licencia de Creative Commons.