Median 10-year whole blood metal ion levels and clinical outcome of ReCap-M2a-Magnum metal-on-metal total hip arthroplasty

Authors

  • Sakari Pietiläinen Department of Orthopaedics and Traumatology, Turku University Hospital; University of Turku; Department of Orthopaedics and Traumatology, Vaasa Central Hospital
  • Axel Linnovaara Department of Orthopaedics and Traumatology, Vaasa Central Hospital
  • Mikko S Venäläinen Turku Bioscience Centre, University of Turku and Åbo Akademi University; Turku University Hospital, Division of Medical Imaging, Department of Medical Physics, Turku https://orcid.org/0000-0003-1777-4259
  • Heikki Mäntymäki Department of Orthopaedics, Tampere University Hospital, Tampere
  • Inari Laaksonen Department of Orthopaedics and Traumatology, Turku University Hospital; University of Turku https://orcid.org/0000-0001-6272-4010
  • Petteri Lankinen Department of Orthopaedics and Traumatology, Turku University Hospital; University of Turku; Satasairaala Central Hospital, Satakunta Hospital District, Pori, Finland
  • Keijo T Mäkelä Department of Orthopaedics and Traumatology, Turku University Hospital; University of Turku

DOI:

https://doi.org/10.2340/17453674.2022.2510

Keywords:

Arthroplasty, chromium, cobalt, metal ion levels, metal-on-metal

Abstract

Background and purpose: We have previously reported that the whole blood (WB) chromium (Cr) and cobalt (Co) ion levels decrease in the short term after ReCap-M2a-Magnum large-diameter head (LDH) metal-on-metal (MoM) total hip arthroplasty (THA). This study reports long-term metal ion levels and clinical outcomes after ReCap-Magnum THA.
Patients and methods: ReCap-M2a-Magnum LDH THA was used in 1,450 patients in our hospital district from 2005 to 2012. Median follow-up time was 10 years. 991 patients had 2 or more metal ion measurements. The median measurement interval was 4 years. Individual metal ion change was assessed using logarithmic metal ion values in a random coefficient model. Kaplan–Meier survival estimates were calculated for revision surgery for any reason for revision, and separately for metal-related adverse events (metal
ions above safe upper limit [SUL], revision due to ARMD, or pseudotumor).
Results: Geometric mean of Cr decreased from 1.8 ppb (geometric standard deviation [GSD] 1.8) to 1.0 ppb (GSD 2.8, p < 0.001). The Co levels decreased from 1.7 ppb (GSD 2.4) to 1.4 ppb (GSD 2.8, p < 0.001). The hip-specific survival was 85% for revision due to any reason at 14 years and the hip-specific survival for any metal-related adverse event was 69% at 14 years.
Interpretation: WB Cr and Co levels continued to decrease in the long-term follow-up of ReCap-M2a-Magnum THA patients. The amount of metal-related adverse events was rather high, but revision surgery was seldom required. We suggest that after 10 years from the implantation a 5-year measurement interval may be sufficient for asymptomatic ReCap-M2a-Magnum patients.

Downloads

Download data is not yet available.

Published

2022-04-19

How to Cite

Pietiläinen, S., Linnovaara, A., Venäläinen, M. S., Mäntymäki, H., Laaksonen, I., Lankinen, P., & Mäkelä, K. T. (2022). Median 10-year whole blood metal ion levels and clinical outcome of ReCap-M2a-Magnum metal-on-metal total hip arthroplasty. Acta Orthopaedica, 93, 444–450. https://doi.org/10.2340/17453674.2022.2510

Issue

Section

Non-randomized clinical study

Most read articles by the same author(s)

1 2 3 > >>