{"title":"Blood Metal Ion Levels After Hip Resurfacing: A Comparison of 2 Different Implants","authors":"","doi":"10.1016/j.artd.2024.101555","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>While hip resurfacing arthroplasty has been shown to be an effective prosthetic solution for end-stage osteoarthritis, prior studies have also reported an increasing concern regarding blood metal ion levels following the use of metal-on-metal articulations. The purpose of this study was to compare early and midterm blood metal ion levels to functional outcomes and implant survivorship for patients treated with the Birmingham Hip Resurfacing (BHR) implant system and the ReCap Magnum.</div></div><div><h3>Methods</h3><div>A retrospective review identified 104 patients who underwent 134 hip resurfacing arthroplasties using BHR (n = 67) and ReCap (n = 67) at a single institution between 2006 and 2018. ReCap and BHR patients were matched 1:1 by sex, femoral head and acetabular cup sizes, age, and year of surgery. The primary outcome of interest was cobalt (Co) and chromium (Cr) ion levels.</div></div><div><h3>Results</h3><div>The ReCap cohort had lower median metal ion levels compared to the BHR cohort at 1-2 y (Co: 1.5 vs 1.9 parts per billion [ppb], <em>P</em> = .018; Cr: 1.3 vs 2.8 ppb, <em>P</em> = .008) and 3-5 y (Co: 1.1 vs 1.9 ppb, <em>P</em> = .001; Cr: 1.2 vs 2.2 ppb, <em>P</em> = .003) after surgery. Correlation analysis showed no significant associations between Co and Cr ion levels and pre- and postoperative patient-reported outcomes. Indications for revision differed between groups. Three BHR hips were revised due to adverse reactions to metal debris, whereas 2 ReCap hips required revisions: one for instability and another for periprosthetic fracture.</div></div><div><h3>Conclusions</h3><div>BHR patients had higher metal ion levels than ReCap patients at 1-2 and 3-5 y after surgery, though these metal levels are still low and in line with prior studies. Indications for revision differed between patients treated with BHR and ReCap. Surgeons should be aware of these outcomes when counseling patients regarding these metal-on-metal articulations.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroplasty Today","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352344124002401","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
While hip resurfacing arthroplasty has been shown to be an effective prosthetic solution for end-stage osteoarthritis, prior studies have also reported an increasing concern regarding blood metal ion levels following the use of metal-on-metal articulations. The purpose of this study was to compare early and midterm blood metal ion levels to functional outcomes and implant survivorship for patients treated with the Birmingham Hip Resurfacing (BHR) implant system and the ReCap Magnum.
Methods
A retrospective review identified 104 patients who underwent 134 hip resurfacing arthroplasties using BHR (n = 67) and ReCap (n = 67) at a single institution between 2006 and 2018. ReCap and BHR patients were matched 1:1 by sex, femoral head and acetabular cup sizes, age, and year of surgery. The primary outcome of interest was cobalt (Co) and chromium (Cr) ion levels.
Results
The ReCap cohort had lower median metal ion levels compared to the BHR cohort at 1-2 y (Co: 1.5 vs 1.9 parts per billion [ppb], P = .018; Cr: 1.3 vs 2.8 ppb, P = .008) and 3-5 y (Co: 1.1 vs 1.9 ppb, P = .001; Cr: 1.2 vs 2.2 ppb, P = .003) after surgery. Correlation analysis showed no significant associations between Co and Cr ion levels and pre- and postoperative patient-reported outcomes. Indications for revision differed between groups. Three BHR hips were revised due to adverse reactions to metal debris, whereas 2 ReCap hips required revisions: one for instability and another for periprosthetic fracture.
Conclusions
BHR patients had higher metal ion levels than ReCap patients at 1-2 and 3-5 y after surgery, though these metal levels are still low and in line with prior studies. Indications for revision differed between patients treated with BHR and ReCap. Surgeons should be aware of these outcomes when counseling patients regarding these metal-on-metal articulations.
期刊介绍:
Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.