Abstract
Introduction
High early failure rates have been reported with certain metal-metal surface arthroplasties and good results have been reported with others. This is a minimum 10-year review of the first 1000 consecutive resurfacings including all ages and diagnoses from one centre.
Methods
The first 1000 surface arthroplasties (892 patients) were followed-up with postal questionnaires. Of these the first 402 hips (350 patients) were also invited for a clinico-radiological review. 54 patients (63 hips) died 6.7 years (0.7–12.6) later due to unrelated causes. Mean follow-up is 12.2 years (range 10.8–13.7). Radiographs were assessed independently by a senior musculoskeletal radiologist.
Results
There were 33 revisions at a mean of 7 years (0–11.6) following operation, 15 femoral failures (0.6%), 6 infections (1.5%) and 12 wear-related failures (1.2%) including 7 pseudotumours (0.7%). With revision for any reason as the end-point Kaplan-Meier survival analysis showed 97.5% survival at 10 years and 96.5% at 13 years. Single zone socket lucencies were found in 2.7% and 5.7% on the femoral side and two zone lucencies in 2.1% on the acetabular side only. No 3-zone lucencies or component migration were seen.
Discussion and Conclusion
Our study shows that the performance of modern metal-on-metal resurfacing arthroplasty continues to be good at 10 year follow-up. Even though the incidence of radiographic adverse features, wear-related failures and pseudotumours is low at this stage it continues to raise concern about long-term implications.
