Abstract
Background
Revision surgery for a failed metal on metal (MoM) hip arthroplasty is often unpredictable and challenging due to associated massive soft tissue and bony lesions. We present the analysis and early outcomes of revision surgery in failed MoM hip arthroplasties at our institution.
Methods
We have retrospectively analysed the findings and outcomes of revision surgery in 61 failed MoM hip arthroplasties performed between 2009 and 2014. These patients were identified in the special MoM hip surveillance pathway. All these patients underwent clinical assessment and relevant investigations. Intra-operative and histopathological findings were analysed.
Results
There were 24 male and 37 female patients with an average age 63.67 yrs. Of the 61 patients, 39 were revised for pseudocysts, 10 for painful hip with raised metal ion levels and the remaining cases for aseptic loosening, malposition and periprosthetic fracture. Average follow up was 12 months. Pre-op and Post-op Oxford hip scores were recorded. One death and one intra-operative periprosthetic fracture was observed. There were no dislocations but one post-op infection was observed.
Conclusions
A dedicated MoM pathway helps to identify early failures. A thorough knowledge of failure mechanisms combined with appropriate early and effective surgical intervention may help achieve good clinical outcomes.
