Minimum ten-year results of a 28-mm metal-on-metal bearing in cementless total hip arthroplasty in patients fifty years of age and younger

• DOI: 10.1007/s00264-013-2228-3
• Publication Date: 2013-12-19T03:55:22Z
• Authors: Moritz M. Innmann; Tobias Gotterbarm; Jan Philippe Kretzer; Christian Merle; Volker Ewerbeck; Stefan Weiss; Peter R. Aldinger; Marcus R. Streit
• Keywords: Adult; Male; Time Factors; Arthroplasty, Replacement, Hip; Age Factors; Middle Aged; Prosthesis Design; 3. Good health; Young Adult; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Metal-on-Metal Joint Prostheses; Humans; Female; Hip Prosthesis; Retrospective Studies

Concerns have been raised in relation to metal-on-metal (MoM) articulations with catastrophic soft-tissue reactions due to metal debris. We reviewed how small head MoM articulations perform in primary uncemented total hip arthroplasty (THA) in young patients at a minimum of ten years.We retrospectively evaluated the clinical and radiographic results of the first 100 consecutive primary cementless THAs using the 28-mm Metasul MoM articulation in 91 patients younger than 50 years of age at the time of surgery.After 13 years, survival for the endpoint revision due to any reason was 90.9 % and 98.9 % for revision due to aseptic implant loosening. The cumulative incidence of MoM related revisions was 1.2 %. Small proximal femoral osteolysis was found in 18 % of hips. No acetabular osteolysis or loosening was detected. Two hips showed signs of femoral neck impingement with severe damage to the neck.Early in the second decade, MoM-associated complications were rare using the 28-mm Metasul articulation, and aseptic loosening was not a major mode of failure in this cohort of young patients.Therapeutic Level IV.