How should we follow-up asymptomatic metal-on-metal hip resurfacing patients? A prospective longitudinal cohort study

Adrian K. Low; Gulraj S. Matharu; Simon J. Ostlere; David W. Murray; Hemant G. Pandit

doi:10.1016/j.arth.2015.08.007

How should we follow-up asymptomatic metal-on-metal hip resurfacing patients? A prospective longitudinal cohort study

Adrian K. Low
, Gulraj S. Matharu^*
, Simon J. Ostlere
, David W. Murray
, Hemant G. Pandit

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

26 Citations (Scopus)

16 Downloads (Pure)

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.

Original language	English
Pages (from-to)	146-151
Number of pages	6
Journal	Journal of Arthroplasty
Volume	31
Issue number	1
DOIs	https://doi.org/10.1016/j.arth.2015.08.007
Publication status	Published - Jan 2016
Externally published	Yes

Bibliographical note

Copyright the Author(s) 2016. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

Asymptomatic
Blood metal ions
Follow-up
Hip resurfacing
Metal-on-metal
Ultrasound

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10.1016/j.arth.2015.08.007

Publisher version (open access)Final published version, 240 KBLicence: CC BY-NC-ND

Cite this

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title = "How should we follow-up asymptomatic metal-on-metal hip resurfacing patients? A prospective longitudinal cohort study",

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.",

keywords = "Asymptomatic, Blood metal ions, Follow-up, Hip resurfacing, Metal-on-metal, Ultrasound",

author = "Low, \{Adrian K.\} and Matharu, \{Gulraj S.\} and Ostlere, \{Simon J.\} and Murray, \{David W.\} and Pandit, \{Hemant G.\}",

note = "Copyright the Author(s) 2016. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher. ",

year = "2016",

month = jan,

doi = "10.1016/j.arth.2015.08.007",

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T1 - How should we follow-up asymptomatic metal-on-metal hip resurfacing patients? A prospective longitudinal cohort study

AU - Low, Adrian K.

AU - Matharu, Gulraj S.

AU - Ostlere, Simon J.

AU - Murray, David W.

AU - Pandit, Hemant G.

N1 - Copyright the Author(s) 2016. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2016/1

Y1 - 2016/1

N2 - 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.

AB - 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.

KW - Asymptomatic

KW - Blood metal ions

KW - Follow-up

KW - Hip resurfacing

KW - Metal-on-metal

KW - Ultrasound

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SN - 0883-5403

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JO - Journal of Arthroplasty

JF - Journal of Arthroplasty

IS - 1

ER -

How should we follow-up asymptomatic metal-on-metal hip resurfacing patients? A prospective longitudinal cohort study

Abstract

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Keywords

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