Table 7: Metal-on-Metal Hip Resurfacing Arthroplasty: Clinical Outcomes of Case Series*.
| Study | Revision/Conversion Rate | Femoral Neck Fracture | Avascular Necrosis | Osteolysis | Heterotopic Bone | Other Complications |
|---|---|---|---|---|---|---|
| Number (%) | Number (%) | Number (%) | Number (%) | Number (%) | Number (%) | |
| Reasons | Reasons | Reasons | ||||
| De Smet 2005 (36) | 3 (1.2) 1 femoral neck fracture at 3 weeks 1 avascular necrosis at 2 years 1 low grade infection at 2 years |
1 at 3 weeks (0.4) | 1 (0.4) | 2 (0.8) (Seen in revision cases) | 4 (1.6) | 1 deep venous thrombosis 1 pulmonary embolism 1 infection 2 (0.8) sciatic nerve palsy 1 dislocation |
| Back et al. 2005 (37) | 1 (0.4) at 18 month revised to THR Loose acetabular component |
1 (2.2) at 6 weeks 4 stress fractures |
0 | 0 | 59.56% of the hips (3 underwent excision of the heterotopic bone at a mean of 1 year after surgery) | Notched femoral neck: 5 Nerve palsy: 5 Vascular injury: 3 Superficial infection: 11 Urinary tract infection: 9 Deep venous thrombosis: 11 Pulmonary embolism: 2 Sinus tachycardia: 5 Hypotension: 14 Pressure sores: 4 |
| Treacy et al. 2005 (38) | 3 (2.3) within 2 years 2 Loosening due to deep infection 1 Subcapital fracture due to deep infection |
1 (0.7) Deep infection | 1 (0.7) at 9 months Local emboli | 0 (0) | 30 (28) | |
| Lilikakis et al. 2005 (39) | 2 (3) 1 for aseptic loosening at 15 months 1 for infection |
0 | 0 | 0 | 1 | Intraoperative notching: 16 (the hips with notching had significantly higher degrees of valgus placement [13.4 vs. 9.9, P.08]) Displacement of the cup: 1 Pulmonary embolism: 1 Superficial wound infection: 1 Wound hematoma: 1 |
| Amstutzet al. 2005 (34) | 12 (3.4) were converted to THR 7 for loosening of femoral component 3 for femoral neck fracture 1 for recurrent subluxations 1 for a late hematogenous infection (at 36 months) |
3 (0.85) 2 within the first 6 weeks 1 at 20 months |
0 | 0 | 106 26 (7) All were men |
Dislocation: 3 (0.75) 4 hips required reoperation (1 for cup exchange because of component mismatch 2 hips in 1 patient required removal of heterotopic bone 1 hip with trochanteric bursitis required wire removal |
| Daniel et al. 2004 (35) | 1 (0.3) was revised to THR with a ceramic-on-polyethylene implant after 8 months Avascular necrosis |
0 | 0 | 0 | 0 | 1 pulmonary embolism |
| Beaule et al. 2004 (40) | 3 (3.6) were converted to THR at a mean of 27 (2–50) months 1 for component loosening at 29 months 1 femoral neck fracture at 2 months 1 for subluxation at 50 months |
1 (1.2) | 0 | (2.1) | NR | 1 subluxation 1 patient had a socket exchange because of component size mismatch during index surgery. 1 patient required surgery for trochanteric bursitis and developed trochanteric nonunion |
| Beaule et al. 2004 (41) | 14/42 (35.9) hip were revised at an average 52.4 months (9.7-95.5) (11 to THR and 3 to MOM arthroplasty) Aseptic loosening (9 due to loosening of a cemented acetabular socket, 1 was cementless acetabular socket, 3 were femoral failures, 1 due to a late hematogenous sepsis) |
1 (2.6) | 0 | 1 (2.6) | NR | NR |
*
NR indicates not reported; THR, total hip replacement.