Abstract
Introduction
The aim of this study is to report the results of Revision hip arthroplasty using large diameter, metal on metal bearing implants- minimum 2 year follow up.
Methods
A single centre retrospective study was performed of 22 consecutive patients who underwent acetabular revision surgery using metal on metal bearing implants between 2004 and 2007. Birmingham hip resurfacing (BHR) cup was used in all patients - monoblock, uncemented, without additional screws in 16 cases and cemented within reinforcement or reconstruction ring in 6 cases.
Femoral revisions were carried out as necessary.
Results
There were 16 men and 6 women with a mean age of 71 years (51-83). Revision surgery was performed for aseptic loosening in 10, infected primary hip arthroplasty in 8, infected Hemiarthroplasty in 1 and Peri-prosthetic fracture with loosening in 3 patients. A 2-stage revision was performed for all infected hips.
One patient died and the remaining 21 patients had clinical and radiological assessment at a mean 35 months (24-60). The mean Harris hip score was 75 (23-98) with 50% good to excellent results.
Only 1 patient had further revision to a proximal femoral replacement and constrained cup in 2 stages for recurrent infection at 24 months.
There were 2 recurrent infections (both revised for septic loosening) and 1 non-union of trochanteric osteotomy.
There were no dislocations in the group. No radiological loosening of implants or metal ion complications have been seen at last follow up.
Conclusions
We believe this is the first reported series on the use of large diameter metal on metal bearing surfaces for revision hip arthroplasty. Our series shows satisfactory short to medium term results in this complex group of patients with no component loosenings, despite monoblock cups and no dislocations.
