11-Year outcomes in patients with metal-on-metal ASR hip arthroplasty

Christian Bitar; Ivan Moberg; Ferid Krupic; Per Wretenberg; Volker Otten; Sead Crnalic

doi:10.1016/j.jor.2022.05.015

11-Year outcomes in patients with metal-on-metal ASR hip arthroplasty

J Orthop. 2022 May 25:32:98-103. doi: 10.1016/j.jor.2022.05.015. eCollection 2022 Jul-Aug.

Authors

Christian Bitar^{1

2}, Ivan Moberg³, Ferid Krupic⁴, Per Wretenberg^{1

5}, Volker Otten³, Sead Crnalic³

Affiliations

¹ Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
² Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden.
³ Department of Surgical and Perioperative Sciences (Orthopaedics), Umeå University, Umeå, Sweden.
⁴ Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁵ Department of Orthopaedics, School of Medical Sciences, Örebro University and Örebro University Hospital, Örebro, Sweden.

Abstract

Background: We analysed the long-term revision rate, clinical outcomes and metal ion concentrations in blood over time in patients who had undergone metal-on-metal Articular Surface Replacement (ASR) hip arthroplasty.

Methods: A total of 38 patients (43 hips) were included: 24 patients (28 hips) underwent large-head total hip arthroplasty (XL THA), and 14 patients (15 hips) underwent hip resurfacing arthroplasty (HRA). The median follow-up time was 11 (range 7-12) years.

Results: None of 15 HRA implants were revised. Nine of 28 XL THA implants (32%) in 8 patients were revised. The Co ion levels significantly increased in the XL THA group (p=0.009) over a median time period of 84 (25-97) months.

Conclusion: The levels of Co ions in blood were higher in the patients who had undergone XL THA and increased significantly over time.