Mid-Term Review of ADEPT Metal-On-Metal Hip Prosthesis. Functional, Radiological and Metal Ion Analysis

DOI: 10.4236/ojo.2014.42007   PDF   HTML     4,521 Downloads   6,348 Views  

Abstract

Background: There is much interest regarding metal-on-metal implants in medical and general media. Much of this has been regarding failure of specific implant systems and metal ion toxicity. We present our early mid-term experience of the ADEPT metal-on-metal system which has both modular and non-modular hip options. Methods: Functional assessment, blood metal ion quantification, and radiographic analysis were performed for the modular and non-modular ADEPT variants. Fifty implants were implanted with a mean follow up time of 28 months. Unpaired t-tests were used to compare modular and resurfacing groups, standardised hip scores were used to compare function to conventional total hip arthroplasty. Results: Metal ion levels were significantly higher in modular prostheses compared to resurfacing implants, but not at “harmful” levels (as determined by a previous metal-on-metal implant recall). Functional outcomes were excellent and revision rates were lower than expected. Conclusions: At our institution we have good outcomes with the ADEPT hip prosthesis. Though patient selection and implant position are crucial, poor performance of metal-on-metal hip replacements is implant specific.

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J. Plant, G. Prosser, B. Burston, S. Edmondston and P. Yates, "Mid-Term Review of ADEPT Metal-On-Metal Hip Prosthesis. Functional, Radiological and Metal Ion Analysis," Open Journal of Orthopedics, Vol. 4 No. 2, 2014, pp. 38-43. doi: 10.4236/ojo.2014.42007.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] P. Wiles, “The Surgery of the Osteoarthritic Hip,” British Journal of Surgery, Vol. 45, No. 193, 1938, pp. 488-497.
http://dx.doi.org/10.1002/bjs.18004519315
[2] J. M. Cuckler, “The Rationale for Metal-On-Metal Total Hip Arthroplasty,” Clinical Orthopaedics and Related Research, Vol. 441, 2005, pp. 132-136.
[3] M. T. Clarke, P. Lee and R. N. Villar, “Dislocation after Total Hip Replacement in Relation to Metal-On-Metal Bearing Surfaces,” The Journal of Bone & Joint Surgery. British Volume, Vol. 85, No. 5, 2003, pp. 650-654.
[4] I. C. Clarke and M. T. Manley, “Implant Wear Symposium 2007 Engineering Work Group. How Do Alternative Bearing Surfaces Influence Wear Behavior?” Journal of the American Academy of Orthopaedic Surgeons, Vol. 16, Suppl. 1, 2008, pp. S86-S93.
[5] N. M. Bernthal and P. C. Celestre, “Disappointing Short-Term Results with the DePuy ASR XL Metal-On-Metal Total Hip Arthroplasty,” The Journal of Arthroplasty, Vol. 27, No. 4, 2012, pp. 539-544.
http://dx.doi.org/10.1016/j.arth.2011.08.022
[6] W. T. Long and M. Dastane, “Failure of the Durom Metasul Acetabular Component,” Clinical Orthopaedics and Related Research, Vol. 468, No. 2, 2010, pp. 400-405.
http://dx.doi.org/10.1007/s11999-009-1071-8
[7] K. A. Kindsfater, C. J. Sychterz Terefenko and T. A. Gruen, “Minimum 5-Year Results of Modular Metal-On-Metal Total Hip Arthroplasty,” The Journal of Arthroplasty, Vol. 27, No. 4, 2012, pp. 545-550.
http://dx.doi.org/10.1016/j.arth.2011.07.002
[8] A. J. Smith, P. Dieppe, K. Vernon, M. Porter and A. W. Blom, “On Behalf of the National Joint Registry of England and Wales. Failure Rates of Stemmed Metal-On-Metal Hip Replacements: Analysis of Data from the National Joint Registry of England and Wales,” Lancet, Vol. 380, No. 9855, 2012, pp. 1759-1766.
http://dx.doi.org/10.1016/S0140-6736(12)60989-1
[9] The Adept Resurfacing System, 2013.
http://www.matortho.com/medical-professionals/adept-resurfacing.aspx
[10] J.-P. Vidalain, “Twenty-Year Results of the Cementless Corail Stem,” International Orthopaedics (SICOT), Vol. 35, No. 2, 2011, pp. 189-194.
http://dx.doi.org/10.1007/s00264-010-1117-2
[11] D. W. Murray, R. Fitzpatrick, K. Rogers, H. Pandit, D. J. Beard and A. J. Carr, “The Use of the Oxford Hip and Knee Scores,” The Journal of Bone & Joint Surgery. British Volume, Vol. 89-B, No. 8, 2007, pp. 1010-1014.
http://dx.doi.org/10.1302/0301-620X.89B8.19424
[12] N. Bellamy, W. W. Buchanan, C. H. Goldsmith, J. Campbell and L. W. Stitt, “Validation Study of WOMAC: A Health Status Instrument for Measuring Clinically Important Patient Relevant Outcomes to Antirheumatic Drug Therapy in Patients with Osteoarthritis of the Hip or Knee,” The Journal of Rheumatology, Vol. 15, No. 12, 1988, pp. 1833-1840.
[13] H. Amstutz, B. Thomas, R. Jinnah, et al., “Treatment of Primary Osteoarthritis of the Hip. A Comparison of Total Joint and Surface Replacement Arthroplasty,” The Journal of Bone & Joint Surgery, Vol. 66, 1984, p. 228
[14] A. Nilsdotter and A. Bremander, “Measures of Hip Function and Symptoms: Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), Oxford Hip Score (OHS), Lequesne Index of Severity for Osteoarthritis of the Hip (LISOH), and American Academy of Orthopedic Surgeons,” Arthritis Care & Research, Vol. 63, 2011, pp. S200-S207.
[15] T. A. Gruen, G. M. McNeice and H. C. Amstutz, “‘Modes of failure’” of Cemented Stem-Type Femoral Components: A Radiographic Analysis of Loosening,” Clinical Orthopaedics and Related Research, 1979, pp. 17-27.
[16] R. C. Johnston, R. H. Fitzgerald Jr., W. H. Harris, et al., “Clinical and Radiological Evaluation of total Hip Replacement,” The Journal of Bone & Joint Surgery. American Volume, Vol. 72-A, 1990, pp. 161-168.
[17] R. T. Steffen, H. P. Pandit, J. Palan, D. J. Beard, R. Gundle and P. McLardy-Smith, “The Five-Year Results of the Birmingham Hip Resurfacing Arthroplasty: An Independent Series,” The Journal of Bone & Joint Surgery. British Volume, Vol. 90-B, No. 4, 2008, pp. 436-41.
http://dx.doi.org/10.1302/0301-620X.90B4.19648
[18] J. G. DeLee and J. Charnley, “Radiological Demarcation of Cemented Sockets in Total Hip Replacement,” Clinical Orthopaedics and Related Research, 1976, pp. 20-32.
[19] C. A. Engh, J. D. Bobyn and A. H. Glassman, “Porous-Coated Hip Replacement,” The Journal of Bone & Joint Surgery. British Volume, Vol. 69-B, 1987, pp. 45-55.
[20] A. F. Brooker, J. W. Bowerman, R. A. Robinson, L. H. Riley, “Ectopic Ossification following Total Hip Replacement. Incidence and a Method of Classification,” The Journal of Bone & Joint Surgery. American Volume, Vol. 55, 1973, pp. 1629-1632.
[21] Australian Orthopaedic Association National Joint Replacement Registry 2012.
https://aoanjrr.dmac.adelaide.edu.au/documents/10180/60142/Annual%20Report%202012?version=1.3&t=1361226543157
[22] N. M. Desy, S. G. Bergeron, A. Petit, O. L. Huk and J. Antoniou, “Surgical Variables Influence Metal Ion Levels after Hip Resurfacing,” Clinical Orthopaedics and Related Research, Vol. 469, No. 6, 2011, pp. 1635-1641.
http://dx.doi.org/10.1007/s11999-010-1636-6
[23] K. J. Bozic, J. Browne, C. J. Dangles, P. A. Manner, A. J. Yates and K. L. Weber, “Modern Metal-On-Metal Hip Implants,” The Journal of the American Academy of Orthopaedic Surgeons, Vol. 20, No. 6, 2012, pp. 402-406.
http://dx.doi.org/10.5435/JAAOS-20-06-402
[24] R. K. Hallows, C. E. Pelt, J. A. Erickson and C. L. Peters, “Serum Metal ion Concentration: Comparison between Small and Large Head Metal-On-Metal Total Hip Arthroplasty,” The Journal of Arthroplasty, Vol. 26, No. 8, 2011, 1176-1181.
http://dx.doi.org/10.1016/j.arth.2010.11.004

  
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