Repeated metal ion measurements and long-term outcome of Durom/MMC total hip arthroplasty

Authors

  • Sakari Pietiläinen Department of Orthopaedics and Traumatology, Turku University Hospital; University of Turku
  • Erno Smedberg University of Turku https://orcid.org/0000-0002-0484-8602
  • Inari Laaksonen Department of Orthopaedics and Traumatology, Turku University Hospital; University of Turku https://orcid.org/0000-0001-6272-4010
  • Mikko S Venäläinen Turku Bioscience Centre, University of Turku and Åbo Akademi University; Division of Medical Imaging, Department of Medical Physics, Turku University Hospital, Turku https://orcid.org/0000-0003-1777-4259
  • Petteri Lankinen Department of Orthopaedics and Traumatology, Turku University Hospital; University of Turku; Department of Administration, Satakunta Central Hospital, Pori, Finland
  • Keijo T Mäkelä Department of Orthopaedics and Traumatology, Turku University Hospital; University of Turku

DOI:

https://doi.org/10.2340/17453674.2022.1444

Keywords:

ARMD, Arthroplasty, Durom THA, Metal-on-Metal Joint Prostheses, pseudotumor

Abstract

Background and purpose — Data regarding long-term behavior of metal ion levels in metal-on-metal total hip arthroplasty (MoM THA) patients is scarce. Therefore, we assessed whether there is any change in whole blood (WB) chromium (Cr), and cobalt (Co) ion measurements in Durom and MMC MoM THA patients over time. The secondary aim was to report the clinical outcomes using these devices in a single district.

Patients and methods — Durom and MMC cups were used in 249 MoM THAs from 2005 to 2011 in our district. Median follow-up time was 12 years for Durom THA (interquartile range [IQR] = 3) and 9 years for MMC THA (IQR = 1). A random coefficient model was used to compare individual differences in repeated WB Cr and Co ion measurements. The Kaplan–Meier estimator was used to analyze implant survival with any reason for revision as the endpoint.

Results — Geometric means of Cr in Durom THA and MMC THA patients decreased from 2.2 ppb (geometric standard deviation [SD] = 1.9) to 1.5 ppb (geometric SD = 2.5, p< 0.001) and from 1.8 ppb (geometric SD = 1.8) to 1.1 ppb (geometric SD = 2.8, p = 0.01) respectively. The geometric means of Co values remained unchanged. The 10-year survival of Durom THA was 82%, and that of MMC THA 89% for any revision reason as endpoint.

Interpretation — WB Cr levels decreased over time, and Co levels remained unchanged at long-term follow-up. Despite this we recommend continuing the follow-up of these devices due to relatively low implant survival. 

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Published

2022-01-19

How to Cite

Pietiläinen, S., Smedberg, E., Laaksonen, I., Venäläinen, M. S., Lankinen, P., & Mäkelä, K. T. (2022). Repeated metal ion measurements and long-term outcome of Durom/MMC total hip arthroplasty. Acta Orthopaedica, 93, 241–248. https://doi.org/10.2340/17453674.2022.1444

Issue

Section

Non-randomized clinical study

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