Management Guidelines for Metal-on-metal Hip Resurfacing Arthroplasty: A Strategy on Followup.


Type
Article
Change log
Authors
Nakano, Naoki 
Volpin, Andrea 
Bartlett, Jonathan 
Abstract

Despite the initial promise of metal-on-metal (MoM) implants as the ideal bearing surface for hip replacements and resurfacings, high short term failure rates due to an adverse reaction to metal debris (ARMD) have led to a dramatic reduction in the number of MoM implants used in the modern era. With over one million patients worldwide having undergone hip operations utilizing a MoM bearing surface, the long term outcomes for such patients remains unknown, and there is much debate as to the most effective management of these patients. Although several regulatory bodies have released guidelines on the management of patients with MoM hips, these recommendations remain open to interpretation, and the most effective management for these patients remains unclear. The aim of this review is to compare the current guidelines for managing patients with MoM hips and also to discuss established ARMD risk factors, evidence regarding the optimum management for patients with MoM hips, and the indications for revision surgery. Furthermore, although specialized laboratory tests and imaging can be used to facilitate clinical decision making, over-reliance on any single tool should be avoided in the decision making process, and surgeons should carefully consider all findings when determining the most appropriate course of action.

Description
Keywords
Adverse reaction to metal debris, Replacement, arthroplasty, follow up, guideline, hip, hip replacement, hip resurfacing, metal-on-metal, patient management, prosthesis, reoperation
Journal Title
Indian J Orthop
Conference Name
Journal ISSN
0019-5413
1998-3727
Volume Title
51
Publisher
Springer Science and Business Media LLC