Author/Editor		Milošev, Ingrid; Trebše, Rihard; Kovač, Simon; Coer, Andrej; Pišot, Venčeslav
Title		Survivorship and retrieval analysis of Sikomet metal-on-metal total hip replacements at a mean of seven years
Type		članek
Source		J Bone Joint Surg Am
Vol. and No.		Letnik 88
Publication year		2006
Volume		str. 1173-82
Language		eng
Abstract		Background: Second-generation metal-on-metal total hip replacements were introduced in the early 1990s with the aim of eliminating polyethylene wear and the resulting complications of osteolysis and aseptic loosening. The goal of the present study was to evaluate the intermediate-term results in a series of patients who were managed with one of these implants. Methods: Between 1994 and 2002, we performed 640 total hip replacements in 591 patients with use of a Bicon-Plus cementless threaded cup with a polyethylene liner housing a metal inlay made of Sikomet low-carbon cobalt-chromiummolybdenum alloy that articulates with a Sikomet metal femoral head. Clinical and radiographic evaluation was performed retrospectively at a mean of 7.1 years postoperatively. Histologic analysis was performed on specimens retrieved from seventeen hips that were revised, and wear measurements were made for six hips that were revised. Results: Thirty-four hips (thirty-four patients) were revised because of infection (six hips), aseptic loosening (twentythree hips), pain without loosening (two hips), or other reasons (three hips). The survival rate of the prosthesis as a whole at ten years, with revision for any reason as the end point, was 0.91 (95% confidence interval, 0.88 to 0.95). The survival rate of the cup was 0.94 (95% confidence interval, 0.90 to 0.97), and that of the stem was 0.96 (95% confidence interval, 0.94 to 0.98). Linear or expansile osteolysis, or both, was observed on the radiographs of sixteen (64%) of the twenty-five hips that were revised because of aseptic loosening and/or pain. Histological analysis of pericapsular tissue was performed for seventeen of the twenty-five hips that were revised because of aseptic loosening and/or pain. (Abstract truncated at 2000 characters)
Descriptors		HIP PROSTHESIS POLYETHYLENES CHROMIUM ALLOYS COBALT MOLYBDENUM OSTEOLYSIS HIP JOINT WEIGHT-BEARING OSTEOARTHRITIS, HIP PROSTHESIS FAILURE TIME FACTORS REOPERATION MICROSCOPY, ELECTRON, SCANNING