Metal-on-metal total hip replacements (MoM THRs) are frequently revised. However, there is a paucity of data on clinical outcomes following revision surgery in this cohort. We report on outcomes from the largest consecutive series of revisions from MoM THRs and consider pre-revision factors which were prognostic for functional outcome. A single-centre consecutive series of revisions from MoM THRs performed during 2006–2015 was identified through a prospectively maintained, purpose-built joint registry. The cohort was subsequently divided by the presence or absence of symptoms prior to revision. The primary outcome was functional outcome (Oxford Hip Score (OHS)). Secondary outcomes were complication data, pre- and post-revision serum metal ions and modified Oxford classification of pre-revision magnetic resonance imaging (MRI). In addition, the study data along with demographic data was interrogated for prognostic factors informing on post-revision functional outcome.Aims
Materials and Methods
The prevalence of adverse reactions to metal debris around metal-on-metal (MOM) hip replacements has been reported to range from 7 to 69%. Little has been published on MRI scans with conventional total hip bearing surfaces. This study aimed to establish the prevalence of soft tissue lesions associated with metal-on-polyethylene (MOP) and ceramic-on-ceramic (COC) bearings, compared to MOM prostheses. All Metal Artefact Reduction Sequence (MARS) MRI scans for MOM THRs performed at our unit from January 2009 to present were reviewed, identifying those with contralateral primary MOP or COC THRs included on the scan. These were compared to a previously analysed cohort of 281 MOM THRs. Scans were classified using the Modified Oxford Classification as ‘Normal’, ‘Trochanteric Fluid’, ‘Effusions’ or Adverse Reactions to Debris.Introduction
Patients/Materials & Methods
Large head total hip arthroplasty (THA) reduces dislocation rates and provides a theooretically larger range of motion. We hypothesised that this would translate into greater improvement in functional scores when compared to 28mm metal-on-polyethylene THA at 5 years. We believe ours to be the first in vivo comparison study. A multi-surgeon case-control study in a District General Hospital. The study group consisted of 427 patients with 452 hips, the 38mm uncemented metal-on-metal articulation THA (M2A/Bi-metric, Biomet UK). The control group consisted of 438 age and sex-matched patients with 460 28mm metal-on-polyethylene articulation THA (Exeter/Exeter or Exeter/Duraloc - Stryker UK. All patients were assessed in a physiotherapist led Joint Review Service as part of their standard follow up, with functional scoring using Oxford Hip (scored 0–48) and WOMAC scores (0–100).Introduction
Methods
To examine the short term patient assessed functional results of the Journey BCS ¯(Smith & Nephew) and Triathlon ¯(Stryker Orthopaedics, Mahwah, NJ) total knee replacements when compared to the Scorpio ¯(Stryker) total knee replacement using a multi-surgeon case control design in a single centre. From September 2006 to August 2008 a total of 135 Journey and 97 Triathlon total knee replacements (TKR) were performed. 105 patients with Journey and 90 patients with Triathlon implants were available for follow-up at a minimum of 1 year, with an average of 2 years. Age and sex matched controls were obtained from our pool of patients who had had Scorpio TKR's. The same surgeons using the same approach operated on patients in both groups. All implants were posterior stabilised and all underwent patella resurfacing. All patients were seen pre-operatively and followed up post operatively in a physiotherapist led joint review clinic to assess range of motion (ROM) as well as function using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS) and the High Activity Arthroplasty Score (HAAS - used post operatively only).OBJECTIVE
METHODS
