Long-term outcomes of uncemented or cemented arthroplasty revision following metal-on-metal total hip arthroplasty failure: A retrospective observational study with a mean follow-up of 7 years
Abstract Background: A high rate of metal-on-metal total hip arthroplasty (MoM-THA) has been well-known. The aim of this study was to compare the long-term outcomes of patients who had undergone uncemented or cemented THA(UTHA or CTHA) following initial MoM-THA failure.Methods: Data from 234 patients (234 hips) who were treated with UTHA or CTHA following initial MoM-THA failure during 2007 - 2018 were retrospectively compared. Follow-up occurred 3 months, 6 months, 1 year, 2 years, and then every 1 year after conversion. The mean follow-up was 84.15 months (67 - 101 months). The primary endpoint was the Harris Hip Scores (HHS); secondary endpoint was the incidence of major orthopaedic complications.Results: The HHS demonstrated statistically greater differences in Group CTHA than in Group UTHA 12 months after conversion. From the 12th month after conversion to the final follow-up, CTHA yielded superior functional outcomes than UTHA. Between-group noteworthy differences were observed regarding the rates of re-revision, aseptic loosening, and periprosthetic fracture (10.3% for UTHA vs 2.5% for CTHA, p = 0.015; 16.3% for UTHA vs 5.9% for CTHA, p = 0.011; and 12.0% for UTHA vs 4.2% for CTHA, p = 0.045, respectively). Conclusion: In the setting of revision following initial MoM-THA failure, we found definite evidence of the superiority of CTHA over UTHA in regard to improving functional outcomes and decreasing the incidence of major orthopaedic complications.