Isolated acetabular cup revision in Metal-on-Metal total hip arthroplasty: a low-complication strategy feasible in only half of cases.

IF 2 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2025-04-21 DOI:10.1007/s00264-025-06534-z

Cristobal Duda, Pierre-Alban Bouché, Morgan Gauthier, Amanda Gonzalez, Matthieu Zingg, Didier Hannouche

{"title":"Isolated acetabular cup revision in Metal-on-Metal total hip arthroplasty: a low-complication strategy feasible in only half of cases.","authors":"Cristobal Duda, Pierre-Alban Bouché, Morgan Gauthier, Amanda Gonzalez, Matthieu Zingg, Didier Hannouche","doi":"10.1007/s00264-025-06534-z","DOIUrl":null,"url":null,"abstract":"Purpose: There is still a debate regarding the removal of the femoral stem due to the risk of trunnion. To answer this question, we conducted a study to compare long terms outcomes of isolated acetabular to total revision of MoM THA using an institutional arthroplasty registry.Methods: From 1996 to 2019, 150 patients (12.5%) of the 1202 revision THAs (rTHA) recorded in Geneva Arthroplasty Registry (GAR) underwent a revision of a MoM THA. After matching the two groups,126 patients were finally included: 63 in each group. The mean age was 64.4 (SD 11.6) years, 48.4% (61/126) were women with a mean BMI of 27.2 (SD 5.5) Kg/m2.Results: The overall survival rate was 88.1% [79.9-97.2%] at ten years. 10-year survival rate was 93.5% [86.2-100.0%] after isolated acetabular rTHA and 79.5% [61.7-100.0%] after total rTHA (p = 0.16). Regarding Hip Harris score and Merle d'Aubigne score, no difference at last follow-up was observed between the two groups (respectively: p = 0.39; p = 0.33). Regarding the chrome, cobalt, and nickel level reduction, no difference was observed between the two groups (respectively, p = 0.38, 0.81 and 0.97).Conclusion: No difference was observed between isolated acetabular and total revision of MoM THAs regarding survival rate and ions levels at long term. It seems advisable to perform an isolated acetabular revision of a MoM THA when it is indicated.Levels of evidence: Level III, case control studies.","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00264-025-06534-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: There is still a debate regarding the removal of the femoral stem due to the risk of trunnion. To answer this question, we conducted a study to compare long terms outcomes of isolated acetabular to total revision of MoM THA using an institutional arthroplasty registry.

Methods: From 1996 to 2019, 150 patients (12.5%) of the 1202 revision THAs (rTHA) recorded in Geneva Arthroplasty Registry (GAR) underwent a revision of a MoM THA. After matching the two groups,126 patients were finally included: 63 in each group. The mean age was 64.4 (SD 11.6) years, 48.4% (61/126) were women with a mean BMI of 27.2 (SD 5.5) Kg/m2.

Results: The overall survival rate was 88.1% [79.9-97.2%] at ten years. 10-year survival rate was 93.5% [86.2-100.0%] after isolated acetabular rTHA and 79.5% [61.7-100.0%] after total rTHA (p = 0.16). Regarding Hip Harris score and Merle d'Aubigne score, no difference at last follow-up was observed between the two groups (respectively: p = 0.39; p = 0.33). Regarding the chrome, cobalt, and nickel level reduction, no difference was observed between the two groups (respectively, p = 0.38, 0.81 and 0.97).

Conclusion: No difference was observed between isolated acetabular and total revision of MoM THAs regarding survival rate and ions levels at long term. It seems advisable to perform an isolated acetabular revision of a MoM THA when it is indicated.

Levels of evidence: Level III, case control studies.

查看原文本刊更多论文

金属对金属全髋关节置换术中孤立髋臼杯翻修：只有一半病例可行的低并发症策略。

目的：由于耳轴的风险，对股骨干的切除仍有争议。为了回答这个问题，我们进行了一项研究，通过机构关节置换术登记，比较了孤立髋臼和全翻修MoM THA的长期结果。方法：从1996年到2019年，日内瓦关节置换术登记处（GAR）记录的1202例翻修THA （rTHA）中，150例患者（12.5%）接受了MoM THA翻修。两组匹配后，最终纳入126例患者，每组63例。平均年龄为64.4岁（SD 11.6），女性48.4%(61/126)，平均BMI为27.2 (SD 5.5) Kg/m2。结果：10年总生存率为88.1%[79.9 ~ 97.2%]。单纯髋臼rTHA术后10年生存率为93.5%[86.2-100.0%]，全髋臼rTHA术后10年生存率为79.5% [61.7-100.0%]（p = 0.16）。在髋关节Harris评分和Merle d'Aubigne评分方面，两组末次随访无差异(p = 0.39；p = 0.33)。关于铬、钴和镍水平的降低，两组之间无差异（p分别为0.38、0.81和0.97）。结论：分离的髋臼与全翻修的MoM tha在生存率和长期离子水平上无显著差异。当有需要时，建议对MoM THA进行孤立髋臼翻修。证据等级：III级，病例对照研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.