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METAL-ON-METAL HIP RESURFACING: THE IMPORTANCE OF PATIENT SELECTION



Abstract

Introduction: Metal-on-metal (MOM) hip resurfacing is becoming a more accepted and available option to consider when treating increasingly younger and more active patients. Advantages include preservation of bone stock and a larger femoral head which increases range of motion without risk of dislocation. We report here the effects of gender on revision rates in patients receiving the Cormet 2000 MOM Hip Resurfacing System.

Methods: 1058 hips were implanted in a multicenter, prospective study. All patients received a cementless, press-fit Cobalt Chrome acetabular shell with plasma sprayed titanium and HA coating and cemented Cobalt Chrome femoral head. Patients were evaluated pre-operatively through 2 years using standardized questionnaires, physical examinations, and radiographic evaluations.

Results: There were 754 males (71%) and 304 (29%) females implanted with the device. Thirty-eight (3.6%) revisions were required; 19 females (6.3%) and 19 (2.5%) males. Males had risk factors significant for revision including increased age in 10-year increments and smaller implant size. Trending but not significant (p=0.08) was lower preoperative HHS.

Discussion and Conclusion: There was a difference in revision rates between males and females, likely due to a difference in bone mass and stability. Based on these findings, the optimal patient seemed to be a larger, younger, more active male. This population has previously been identified to be at most risk after THA and utilization of a resurfacing device may be a good alternative. In addition, future studies designed to optimally select females for MOM hip resurfacing may reduce the revision rate in that population.

Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland