This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the exam for this article:
 Adult Hip Reconstruction Test 4: Bearing Surfaces/Alternatives to Conventio...
Right arrow [Supplementary Material]
Right arrow [Video Supplement]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Amstutz, H. C.
Right arrow Articles by Gruen, T. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Amstutz, H. C.
Right arrow Articles by Gruen, T. A.
Related Collections
Right arrow Adult Hip
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?
The Journal of Bone and Joint Surgery (American) 86:28-39 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

Metal-on-Metal Hybrid Surface Arthroplasty: Two to Six-Year Follow-up Study

Harlan C. Amstutz, MD1, Paul E. Beaulé, MD, FRCSC1, Frederick J. Dorey, PhD1, Michel J. Le Duff, MA1, Pat A. Campbell, PhD1 and Thomas A. Gruen, MS1

1 Joint Replacement Institute, Orthopaedic Hospital, 2400 South Flower Street, Los Angeles, CA 90007. E-mail address for H.C. Amstutz: jortega{at}laoh.ucla.edu

Investigation performed at the Joint Replacement Institute at Orthopaedic Hospital, Los Angeles, California

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from the Los Angeles Orthopaedic Hospital Foundation and the William G. McGowan Charitable Fund, Inc. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Wright Medical Technology, Inc.). Also, a commercial entity (Wright Medical Technology, Inc.) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our subscription department, at 781-449-9780, to order the CD-ROM).

A video supplement to this article is available from the Video Jour- nal of Orthopaedics. A video clip is available at the JBJS web site, www.jbjs.org. The Video Journal of Orthopaedics can be contacted at (805) 962-3410, web site: www.vjortho.com.

Background: Following the reintroduction of metal-on-metal articulating surfaces for total hip arthroplasty in Europe in 1988, we developed a surface arthroplasty prosthetic system using a metal-on-metal articulation. The present study describes the clinical and radiographic results of the first 400 hips treated with metal-on-metal hybrid surface arthroplasties at an average follow-up of three and a half years.

Methods: Between November 1996 and November 2000, 400 metal-on-metal hybrid surface arthroplasties were performed in 355 patients. All femoral head components were cemented, but only fifty-nine of the short metaphyseal stems were cemented. The patients had an average age of forty-eight years, 73% were men, and 66% had a diagnosis of osteoarthritis. Clinical and radiographic follow-up were performed at three months postoperatively and yearly thereafter.

Results: The majority of the patients returned to a high level of activity, including sports, and 54% had activity scores of >7 on the University of California at Los Angeles activity assessment system. Kaplan-Meier survivorship curves demonstrated that the rate of survival of the components at four years was 94.4%. For patients with a surface arthroplasty risk index score of >3, the rate of survival of the components at four years was 89% compared with a rate of 97% for those with a score of ≤3. The patients with a higher risk index were 4.2 times more likely to undergo revision to a total hip replacement at four years. Twelve hips (3%) had a revision to a total hip replacement. Seven of the twelve hips were revised because of loosening of the femoral component, and three were revised because of a femoral neck fracture. Substantial radiolucencies were seen around sixteen uncemented metaphyseal femoral stems. No femoral radiolucencies were observed among the hips in which the metaphyseal stem was cemented. The most important risk factors for femoral component loosening and substantial stem radiolucencies were large femoral head cysts (p = 0.029), patient height (p = 0.032), female gender (p = 0.005), and smaller component size in male patients (p = 0.005).

Conclusions: The preliminary experience with this hybrid metal-on-metal bearing is encouraging. Optimal femoral bone preparation and component fixation are critical to improving durability. The metal-on-metal hybrid surface arthroplasty is easily revised to a standard femoral component if necessary.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
A. Shimmin, P. E. Beaule, and P. Campbell
Metal-on-Metal Hip Resurfacing Arthroplasty
J. Bone Joint Surg. Am., March 1, 2008; 90(3): 637 - 654.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
M. J. Le Duff, H. C. Amstutz, and F. J. Dorey
Metal-on-Metal Hip Resurfacing for Obese Patients
J. Bone Joint Surg. Am., December 1, 2007; 89(12): 2705 - 2711.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
H. C. Amstutz, J. T. Antoniades, and M. J. Le Duff
Results of Metal-on-Metal Hybrid Hip Resurfacing for Crowe Type-I and II Developmental Dysplasia
J. Bone Joint Surg. Am., February 1, 2007; 89(2): 339 - 346.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
P. E. Beaule, P. Campbell, Z. Lu, K. Leunig-Ganz, M. Beck, M. Leunig, and R. Ganz
Vascularity of the Arthritic Femoral Head and Hip Resurfacing
J. Bone Joint Surg. Am., December 1, 2006; 88(suppl_4): 85 - 96.
[Full Text] [PDF]

Home page
 JBJSHome page
N. Forrest, A. Welch, A.D. Murray, L. Schweiger, J. Hutchison, and G.P. Ashcroft
Femoral Head Viability After Birmingham Resurfacing Hip Arthroplasty: Assessment with Use of [18F] Fluoride Positron Emission Tomography
J. Bone Joint Surg. Am., November 1, 2006; 88(suppl_3): 84 - 89.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
M. A. Mont, T. M. Seyler, D. R. Marker, G. A. Marulanda, and R. E. Delanois
Use of Metal-on-Metal Total Hip Resurfacing for the Treatment of Osteonecrosis of the Femoral Head
J. Bone Joint Surg. Am., November 1, 2006; 88(suppl_3): 90 - 97.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
M. P. Revell, C. W. McBryde, S. Bhatnagar, P. B. Pynsent, and R. B.C. Treacy
Metal-on-Metal Hip Resurfacing in Osteonecrosis of the Femoral Head
J. Bone Joint Surg. Am., November 1, 2006; 88(suppl_3): 98 - 103.
[Abstract] [Full Text] [PDF]

Home page
 J Am Acad Orthop SurgHome page
M. A. Mont, P. S. Ragland, G. Etienne, T. M. Seyler, and T. P. Schmalzried
Hip Resurfacing Arthroplasty
J. Am. Acad. Ortho. Surg., August 1, 2006; 14(8): 454 - 463.
[Abstract] [Full Text] [PDF]

Home page
 J Bone Joint Surg BrHome page
T. C. B. Pollard, R. P. Baker, S. J. Eastaugh-Waring, and G. C. Bannister
Treatment of the young active patient with osteoarthritis of the hip: A FIVE- TO SEVEN-YEAR COMPARISON OF HYBRID TOTAL HIP ARTHROPLASTY AND METAL-ON-METAL RESURFACING
J Bone Joint Surg Br, May 1, 2006; 88-B(5): 592 - 600.
[Abstract] [Full Text] [PDF]

Home page
 J Bone Joint Surg BrHome page
P. E. Beaule, P. A. Campbell, R. Hoke, and F. Dorey
Notching of the femoral neck during resurfacing arthroplasty of the hip: A VASCULAR STUDY
J Bone Joint Surg Br, January 1, 2006; 88-B(1): 35 - 39.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
M. H. Huo and N. F. Gilbert
What's New in Hip Arthroplasty
J. Bone Joint Surg. Am., September 1, 2005; 87(9): 2133 - 2146.
[Full Text] [PDF]

Home page
 J Bone Joint Surg BrHome page
P. E. Beaule, M. Krismer, P. Mayrhofer, S. Wanner, M. Le Duff, M. Mattesich, B. Stoeckl, H. C. Amstutz, and R. Biedermann
EBRA-FCA for measurement of migration of the femoral component in surface arthroplasty of the hip
J Bone Joint Surg Br, May 1, 2005; 87-B(5): 741 - 744.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
M. K. Sayana, R. A. Brand, J. D. Heckman, and J. Scott
The Least Publishable Unit * R.A. Brand, J.D. Heckman, and J. Scott reply:
J. Bone Joint Surg. Am., March 1, 2005; 87(3): 679 - 680.
[Full Text]

Home page
 J Bone Joint Surg BrHome page
D. L. Back, R. Dalziel, D. Young, and A. Shimmin
Early results of primary Birmingham hip resurfacings: AN INDEPENDENT PROSPECTIVE STUDY OF THE FIRST 230 HIPS
J Bone Joint Surg Br, March 1, 2005; 87-B(3): 324 - 329.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
H. C. Amstutz, P. A. Campbell, and M. J. L. Duff
Fracture of the Neck of the Femur After Surface Arthroplasty of the Hip
J. Bone Joint Surg. Am., September 1, 2004; 86(9): 1874 - 1877.
[Abstract] [Full Text] [PDF]