How Should We Follow-Up Asymptomatic Metal-on-Metal Hip Resurfacing Patients? A Prospective Longitudinal Cohort Study.
prospective_cohort · Level II
Where this comes from
- Record sourced from PubMed, PMID 26439179.
- Also identified by DOI 10.1016/j.arth.2015.08.007.
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Abstract
Current surveillance for metal-on-metal hip resurfacing (MoMHR) patients is not evidence based. This study established changes that occurred in 152 asymptomatic MoMHRs using repeat ultrasound and patient-reported outcomes. Factors associated with (1) ultrasound progression and (2) developing new pseudotumors were analyzed. Patients underwent repeat assessments 4.3 years later. Ultrasound progression was observed in 19% (n = 29), with 10% (n = 15) developing new pseudotumors. Key predictors of ultrasound progression included high blood cobalt (P = .00013) and chromium (P = .00065), and high initial ultrasound grade (P = .003) and volume (P = .036). No asymptomatic MoMHRs with initially normal metal ions (<2 μg/L) and normal ultrasounds (33% of cohort) developed new pseudotumors. This patient subgroup does not require repeat follow-up within 5 years.
Medical subject headings
- Arthroplasty, Replacement, Hip
- Granuloma, Plasma Cell
- Hip Prosthesis
- Prosthesis Design
Anatomy
- hip