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Clinical and radiographic outcomes of 139 hips with articular surface replacement total hip arthroplasty*. | LitMetric

Clinical and radiographic outcomes of 139 hips with articular surface replacement total hip arthroplasty*.

Isr Med Assoc J

Department of Orthopedics, Tel Aviv Sourasky Medical Center, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.

Published: September 2013

AI Article Synopsis

  • - The ASR total hip arthroplasty was recalled due to high failure rates, but a study evaluated 139 patients who underwent the surgery from 2007 to 2010 to assess outcomes and revision rates.
  • - After an average follow-up of 42 months, the study found a low revision rate of 2%, significant pain relief, and improved functional outcomes, with overall satisfaction reported at 7.86.
  • - However, patients with high blood ion levels and inflammatory issues showed poorer outcomes, indicating potential need for future revisions, despite generally favorable results for the ASR implant.

Article Abstract

Background: The articular surface replacement (ASR) total hip arthroplasty (THA) was recently recalled from the market due to high failure rates. This modality was used frequently by surgeons at our medical center.

Objectives: To assess the clinical and radiographic outcomes in patients following the surgery and determine the revision rate in our cohort.

Methods: Between 2007 and 2010 139 hips were operated on and evaluated in our clinic. All patients underwent a clinical interview, function and pain evaluation, as well as physical examination and radiographic evaluation. When necessary, patients were sent for further tests, such as measuring cobalt-chromium levels and magnetic resonance hip imaging.

Results: With an average follow-up of 42 months the revision rate was 2% (3/139). Patients reported alleviation of pain (from 8.8 to 1.7 on the Visual Analog Scale, P < 0.001), good functional outcomes on the Harris Hip Score, and improved quality of life. Overall satisfaction was 7.86 on the reversed VAS. For patients who required further tests, clinical and radiographic outcomes were significantly poorer than for the rest of the cohort. Average blood ion levels were high above the normal (cobalt 31.39 ppb, chromium 13.32 ppb), and the rate of inflammatory collection compatible with pseudotumors on MRI was 57%.

Discussion: While our study favors the use of the ASR implant both clinically and radiographically, some patients with abnormal ion levels and inflammatory collections on MRI might require revision in the future.

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