MoM total hip replacements in Europe: a NORE report

Bart G Pijls, Jennifer M T A Meessen, Keith Tucker, Susanna Stea, Liza Steenbergen, Anne Marie Fenstad, Keijo Mäkelä, Ioan Cristian Stoica, Maxim Goncharov, Søren Overgaard, Jorge Arias de la Torre, Anne Lübbeke, Ola Rolfson, Rob G H H Nelissen, Bart G Pijls, Jennifer M T A Meessen, Keith Tucker, Susanna Stea, Liza Steenbergen, Anne Marie Fenstad, Keijo Mäkelä, Ioan Cristian Stoica, Maxim Goncharov, Søren Overgaard, Jorge Arias de la Torre, Anne Lübbeke, Ola Rolfson, Rob G H H Nelissen

Abstract

The purpose of this paper is to determine the prevalence of metal-on-metal (MoM) total hip replacement (THR) in European registries, to assess the incidence of revision surgery and to describe the national follow-up guidelines for patients with MoM THR including resurfacings.Eleven registries of the Network of Orthopaedic Registries of Europe (NORE) participated totalling 54 434 resurfacings and 58 498 large stemmed MoM THRs.The resurfacings and stemmed large head MoM had higher pooled revision rates at five years than the standard total hip arthroplasties (THA): 6.0%, 95% confidence interval (CI) 5.3 to 6.8 for resurfacings; 6.9%, 95% CI 4.4 to 9.4 for stemmed large head MoM; and 3.0%, 95% CI 2.5 to 3.6 for conventional THA.The resurfacings and stemmed large head MoM had higher pooled revision rates at ten years than the standard THAs: 12.1%, 95% CI 11.0 to 13.3 for resurfacings; 15.5%, 95% CI 9.0 to 22 for stemmed large head MoM; and 5.1%, 95% CI 3.8 to 6.4 for conventional THA.Although every national registry reports slightly different protocols for follow-up, these mostly consist of annual assessments of cobalt and chromium levels in blood and MRI (MARS) imaging. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180078.

Keywords: joint registry; metal-on-metal total hip replacement.

Conflict of interest statement

ICMJE Conflict of interest statement: ALW reports that the Division of Orthopaedics and Trauma Surgery at Geneva University Hospitals receives institutional financial support for the Geneva Arthroplasty Registry from the “Fondation pour la recherche ostéoarticulaire”, outside the submitted work. OR reports payment for lectures from ZimmerBiomet, outside the submitted work. SO reports grants from Biomet Denmark and Biomet Inc, grants from DePuy and Protesekompagniet, grants from Zimmer, other from Eli Lilly Denmark, other from MSD, other from Sanofi-Aventis Denmark A/S, other from Mundipharma International Ltd, outside the submitted work. All other authors have nothing to declare.

Figures

Fig. 1
Fig. 1
Meta-analyses depicting the pooled revision rates for resurfacings, stemmed large head metal-on-metal (MoM) and standard total hip arthroplasty (THA) at five- and ten-years follow-up.

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