Hip Resurfacing vs. Total Arthroplasty: New Data
Orthopedics This Week reports on HSS study findings published in Clinical Orthopaedics and Related Research by senior author Hollis G. Potter, MD, chairman, Department of Radiology and Imaging, lead author Matthew F. Koff PhD, scientist, co-author Edwin P. Su, MD, hip and knee surgeon, and colleagues.
The study found that patients with unilateral hip resurfacing arthroplasty had higher cobalt and chromium serum ion levels than those with unilateral ceramic on polyethylene bearings. Additionally, more patients who had a hip resurfacing arthroplasty developed adverse local tissue reactions (ALTR) or metallosis on MRI than did patients who got ceramic on polyethylene bearings.
Dr. Potter said, “While the majority of these high functioning individuals with HRA [hip resurfacing arthroplasty] had no adverse local tissue reaction, longitudinal yearly evaluation disclosed that more patients who received a HRA developed ALTR or metallosis on MRI than patients who had ceramic on polyethylene bearings (hazard ratio 4.8 (95% CI 1.2-18.4); p=0.02).”
Dr. Su explained, “This study highlights the value in using MRI to evaluate patients with metal-on-metal hip resurfacing. It demonstrates that metal levels or clinical performance do not always correlate with MRI findings of adverse local tissue reaction, and therefore all of this information is valuable in the evaluation of such a patient. Just as I would not recommend the sole use of metal ion levels in deciding management of a patient, similarly, I would not utilize MR information alone to make decisions. All of the information—clinical picture, metal ions, and MR information—should be used in concert in managing the patient with a metal-on-metal hip resurfacing."
Read the full article at Ryortho.com.