Modular dual-mobility (DM) articulations are increasingly used during total hip arthroplasty (THA). However, concerns remain regarding the metal liner modularity. This study aims to correlate metal artifact reduction sequence (MARS)-MRI abnormalities with serum metal ion levels in patients with DM articulations. A total of 45 patients (50 hips) with a modular DM articulation were included with mean follow-up of 3.7 years (SD 1.2). Enrolled patients with an asymptomatic, primary THA and DM articulation with over two years’ follow-up underwent MARS-MRI. Each patient had serum cobalt, chromium, and titanium levels drawn. Patient satisfaction, Oxford Hip Score, and Forgotten Joint Score-12 (FJS-12) were collected. Each MARS-MRI was independently reviewed by fellowship-trained musculoskeletal radiologists blinded to serum ion levels.Aims
Methods
Total hip replacement (THR) and total knee replacement (TKR) are the most successful operations in orthopaedics. In the US, there is a marked difference between black patients and white patients in the utilization of joint replacement therapy. An attempt has been made to study total joint replacement comparing Maoris’ and Caucasians in Gisborne. Prospective study, 100 consecutive total joint replacements for osteoarthritis performed by a single surgeon [VSP] from Feb 2007 to July 2008 attending Gisborne Public Hospital. These cases have been studied independently by [RM, EW, VP]. T hose with arthritis other than osteoarthritis, a fracture neck of femur or secondaries or revision joint replacements or those who refused to give informed consent were excluded. Medical notes were carefully scrutinised: surgeons pre-op notes, anaesthetic assessment, pre-operative and post operative information, early post operative complication. Outcome assessment is obtained at 6 months in 50% of patients:
fifty-five percent were females; 40% Maori; 60% had THR and 40% TKR Patients with medical co-morbidities were stratified by anaesthetist Complications: one deep infection; one superficial infection, two stitch abscess; Hematoma two; one stiffness required manipulation. Complication did not appear to correlate with ethnic differences or ASA grading. No dislocation. No patient had or waiting for revision, No nerve damage. Womac scoring: all patients had excellent to good results [short follow up]. Because of high co morbidity, Maori were more likely than white patients to expect longer hospital course With anaesthetic stratification, complications can be minimised despite high ASA grade. There is no increase complication in Maori population
