The effectiveness of blood metal ions in identifying bilateral metal-on-metal total hip arthroplasty patients at risk of adverse reactions to metal debris.

We investigated whether blood metal ions could effectively identify bilateral metal-on-metal total hip arthroplasty (THA) patients at risk of adverse reactions to metal debris (ARMD). Whole blood metal ions were sampled in 50 patients with bilateral 36mm Corail-Pinnacle THAs. Patients were divided into ARMD (n=10) and non-ARMD groups (n=40), with optimal ion thresholds for identifying ARMD determined using receiver operating characteristic analysis.

The Effectiveness of Blood Metal Ions in Identifying Patients with Unilateral Birmingham Hip Resurfacing and Corail-Pinnacle Metal-on-Metal Hip Implants at Risk of Adverse Reactions to Metal Debris.

Background: We investigated whether blood metal ions could effectively identify patients with metal-on-metal hip implants with two common designs (Birmingham Hip Resurfacing [BHR] and Corail-Pinnacle) who were at risk of adverse reactions to metal debris.

Methods: This single-center, prospective study involved 598 patients with unilateral hip implants (309 patients with the BHR implant and 289 patients with the Corail-Pinnacle implant) undergoing whole blood metal ion sampling at a mean time of 6.9 years.

Predicting high blood metal ion concentrations following hip resurfacing.

Purpose: To determine whether gender, femoral head size, acetabular inclination, and time since surgery predicted high blood metal ion concentrations following Birmingham Hip Resurfacing (BHR).

Methods: BHR patients with unilateral bearings at one specialist centre with blood cobalt and chromium concentrations measured up to May 2013 were included. This comprised a mixed (at-risk) group including symptomatic patients and asymptomatic individuals with specific clinical and/or radiological findings.

The future role of metal-on-metal hip resurfacing.

Purpose: The purpose of this review was to assess the ten to 15-year outcomes of metal-on-metal hip resurfacing (MoM HR) when performed at designing and independent centres, and make recommendations for the future use of MoM HR.

Methods: Studies reporting ten to 15-year outcomes for modern MoM HR devices from both designing and independent centres were reviewed. Outcomes from these studies were assessed to allow the formulation of recommendations for the future use of MoM HR.

Influence of implant design on blood metal ion concentrations in metal-on-metal total hip replacement patients.

Purpose: Most factors considered to affect blood metal ions following metal-on-metal hip replacement are based on hip resurfacing patients. The study aims were to determine which factors affect blood metal ion concentrations following metal-on-metal total hip replacement (MoM THR).

Methods: All unilateral MoM THR patients at one centre with whole-blood cobalt (Co) and chromium (Cr) concentrations measured up to May 2013 were included.

Survival and functional outcome of the Birmingham Hip Resurfacing system in patients aged 65 and older at up to ten years of follow-up.

Purpose: Limited evidence exists regarding the outcomes of hip resurfacing in elderly patients. The primary study aims were to determine the survival and functional outcome following Birmingham Hip Resurfacing (BHR) in patients ≥65 years at up to ten years of follow-up. Secondary aims were to explore factors affecting survival and functional outcome.

Impact of active patient follow-up on worst-case implant survival analysis.

Background: Patients lost to follow-up pose problems when performing implant survival analysis. We are unaware of any report detailing how implant survival is affected by the sequential capture of patients.


Aims: To assess the logistics of long-term follow-up of patients undergoing Birmingham Hip Resurfacing (BHR), and to determine what impact this had on implant survival with time.

A review of hip resurfacings revised for unexplained pain.

Background: Adverse reaction to metal debris (ARMD) has come to prominence as a mode of failure for metal-on-metal hip resurfacings. These patients frequently present with unexplained groin pain.

Aims: 1) To review all metal-on-metal hip resurfacings revised for unexplained pain seeking evidence for ARMD; 2) To determine the clinical outcome following revision arthroplasty.

A comparison of subsidence of Exeter standard and long stems.

The survivorship of the polished, double taper Exeter stem is related to subsidence within the cement mantle. Long Exeter stems have altered geometry which may influence subsidence characteristics. Using digitised x-rays and appropriate computer software we measured the subsidence of 35 standard and 40 long stem Exeter implants.

The influence of head size and sex on the outcome of Birmingham hip resurfacing.

Background: Hip resurfacing has gained popularity for the treatment of young and active patients who have arthritis. Recent literature has demonstrated an increased rate of revision among female patients as compared with male patients who have undergone hip resurfacing. The aim of the present study was to identify any differences in survival or functional outcome between male and female patients with osteoarthritis who were managed with metal-on-metal hip resurfacing.

The influence of surgical approach on outcome in Birmingham hip resurfacing.

Unlabelled: Various approaches have been described for metal-on-metal hip resurfacing. We compared the posterolateral and direct lateral approaches for complications, pain, function, and implant survival in the short and medium term for two surgeons in a consecutive series of 790 patients (909 hips; July 1997 to July 2004) followed until July 2007. The direct lateral approach group included 135 resurfacing procedures and the posterolateral group included 774 procedures.

Metal-on-metal hip resurfacing in osteonecrosis of the femoral head.

Background: The treatment of end-stage osteonecrosis of the femoral head remains a challenge to the orthopaedic surgeon. Historically, total hip arthroplasty for this condition has been associated with poor rates of survival and function when compared with total hip arthroplasty for the treatment of osteoarthritis. The purpose of this study was to determine the medium-term clinical and radiographic results of metal-on-metal hip resurfacing arthroplasty in patients with end-stage osteonecrosis of the femoral head.