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Acta Orthopaedica Volume 90, 2019 - Issue 6
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Articles

Has the threshold for revision surgery for adverse reactions to metal debris changed in metal-on-metal hip arthroplasty patients? A cohort study of 239 patients using an adapted risk-stratification algorithm

Gulraj S MatharuNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Nuffield Orthopaedic Centre, Oxford;; ;Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol;; ;The Royal Orthopaedic Hospital, Birmingham;; Correspondence[email protected]
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Fiona BerrymanThe Royal Orthopaedic Hospital, Birmingham;;
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David J DunlopThe Royal Orthopaedic Hospital, Birmingham;;
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Andrew JudgeNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Nuffield Orthopaedic Centre, Oxford;; ;Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol;;
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David W MurrayNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Nuffield Orthopaedic Centre, Oxford;;
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Hemant G PanditNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Nuffield Orthopaedic Centre, Oxford;; ;Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital and University of Leeds, Leeds, UK
Pages 530-536 | Published online: 09 Sep 2019

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  • Matharu G S, Pynsent P B, Sumathi V P, Mittal S, Buckley C D, Dunlop D J, Revell P A, Revell M P. Predictors of time to revision and clinical outcomes following revision of metal-on-metal hip replacements for adverse reaction to metal debris. Bone Joint J 2014; 96-B (12): 1600–9.
  • Matharu G S, Berryman F, Brash L, Pynsent P B, Dunlop D J, Treacy R B. Can blood metal ion levels be used to identify patients with bilateral Birmingham Hip Resurfacings who are at risk of adverse reactions to metal debris? Bone Joint J 2016a; 98-B (11): 1455–62.
  • Matharu G S, Berryman F, Brash L, Pynsent P B, Treacy R B, Dunlop D J. 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. J Bone Joint Surg Am 2016b; 98 (8): 617–26.
  • Matharu G S, Judge A, Murray D W, Pandit H G. Prevalence of and risk factors for hip resurfacing revision: a cohort study into the second decade after the operation. J Bone Joint Surg Am 2016c; 98 (17): 1444–52.
  • Matharu G S, Berryman F, Judge A, Reito A, McConnell J, Lainiala O, Young S, Eskelinen A, Pandit H G, Murray D W. Blood metal ion thresholds to identify patients with metal-on-metal hip implants at risk of adverse reactions to metal debris: an external multicenter validation study of Birmingham Hip Resurfacing and Corail-Pinnacle implants. J Bone Joint Surg Am 2017a; 99 (18): 1532–39.
  • Matharu G S, Nandra R S, Berryman F, Judge A, Pynsent P B, Dunlop D J. Risk factors for failure of the 36 mm metal-on-metal Pinnacle total hip arthroplasty system: a retrospective single-centre cohort study. Bone Joint J 2017b; 99-B (5): 592–600.
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  • Matharu G S, Judge A, Pandit H G, Murray D W. Follow-up for patients with metal-on-metal hip replacements: are the new MHRA recommendations justified? BMJ 2018c; 360: k566.
  • Matharu G S, Berryman F, Dunlop D J, Revell M P, Judge A, Murray D W, Pandit H G. No threshold exists for recommending revision surgery in metal-on-metal hip arthroplasty patients with adverse reactions to metal debris: a retrospective cohort study of 346 revisions. J Arthroplasty 2019; 34 (7): 1483–1491.
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  • MHRA. Medicines & Healthcare products Regulatory Agency (MHRA). Medical Device Alert: all metal-on-metal (MoM) hip replacements. MDA/2012/036; 2012. http://www.mhra.gov.uk/.
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  • Van Der Straeten C, Grammatopoulos G, Gill H S, Calistri A, Campbell P, De Smet K A. The 2012 Otto Aufranc Award: The interpretation of metal ion levels in unilateral and bilateral hip resurfacing. Clin Orthop Relat Res 2013; 471 (2): 377–85.

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