This preprint is under consideration at Journal of Orthopaedic Surgery and Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
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Research Article
FIRAT OZAN
Kayseri City Hospital: Kayseri Sehir Egitim ve Arastirma Hastanesi
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2417-8343
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: To evaluate the clinical features and results of the revision total hip arthroplasties (THA) in patients with catastrophic failures and metallosis.
Methods: Fifteen hips of 14 patients with catastrophic failure and metallosis in hip arthroplasties were evaluated. They were followed for at least 4.2 years after the revision THA. Clinical evaluation was performed using Harris hip score. Osteolysis, loosening or presence of metallosis was evaluated with standard radiographs. Metallosis was evaluated intraoperatively according to the metallosis severity classification.
Results: The mean time from failure until revision surgery was 9.4 years. It was observed that in the primary THA, metal-on-ceramic (MoC), ceramic-on-ceramic (CoC) and metal-on-conventional polyethylene (MoCPE) bearings were used in 1, 3 and 11 hips, respectively. Grade III metallosis was observed in all patients during revision surgeries. The mean Harris hip score increased from 55 points before revision THA to 75 points at the final follow-up. In revision arthroplasty, MoCPE and CoC bearings were used in 13 and 2 hips, respectively. The femoral stem was replaced in 5 hips. All acetabular cups, except that of one hip, were revised.
Conclusions: Revisions of THAs with catastrophic failures and metallosis are quite challenging. Routine follow-up of arthroplasty patients is beneficial to examine for osteolysis, loosening, and asymmetric wear.
Keywords
Catastrophic failure, Metallosis, Wear, Bearing surface, Total hip arthoplasty
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CURRENT STATUS: Under Review
Version (no preprint)
Posted 14 May, 2021
Reviewer #1 agreed
On 12 May, 2021
Review #1 received
Received 12 May, 2021
Editor assigned
On 11 May, 2021
Reviewers invited
Invitations sent on 11 May, 2021
Submission checks complete
On 11 May, 2021
Editor invited
On 11 May, 2021
This version was not preprinted
Version 1
Posted 16 Apr, 2021
No community comments so far
Editorial decision: Minor revision
On 01 May, 2021
Reviewer #1 agreed
On 29 Apr, 2021
Review #1 received
Received 29 Apr, 2021
Reviews received
Received 29 Apr, 2021
Editor assigned
On 14 Apr, 2021
Reviewers invited
Invitations sent on 14 Apr, 2021
Submission checks complete
On 14 Apr, 2021
Editor invited
On 14 Apr, 2021
First submitted
On 13 Apr, 2021
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This preprint is under consideration at Journal of Orthopaedic Surgery and Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
FIRAT OZAN
Kayseri City Hospital: Kayseri Sehir Egitim ve Arastirma Hastanesi
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2417-8343
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version (no preprint)
Posted 14 May, 2021
Reviewer #1 agreed
On 12 May, 2021
Review #1 received
Received 12 May, 2021
Editor assigned
On 11 May, 2021
Reviewers invited
Invitations sent on 11 May, 2021
Submission checks complete
On 11 May, 2021
Editor invited
On 11 May, 2021
This version was not preprinted
Version 1
Posted 16 Apr, 2021
No community comments so far
Editorial decision: Minor revision
On 01 May, 2021
Reviewer #1 agreed
On 29 Apr, 2021
Review #1 received
Received 29 Apr, 2021
Reviews received
Received 29 Apr, 2021
Editor assigned
On 14 Apr, 2021
Reviewers invited
Invitations sent on 14 Apr, 2021
Submission checks complete
On 14 Apr, 2021
Editor invited
On 14 Apr, 2021
First submitted
On 13 Apr, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: To evaluate the clinical features and results of the revision total hip arthroplasties (THA) in patients with catastrophic failures and metallosis.
Methods: Fifteen hips of 14 patients with catastrophic failure and metallosis in hip arthroplasties were evaluated. They were followed for at least 4.2 years after the revision THA. Clinical evaluation was performed using Harris hip score. Osteolysis, loosening or presence of metallosis was evaluated with standard radiographs. Metallosis was evaluated intraoperatively according to the metallosis severity classification.
Results: The mean time from failure until revision surgery was 9.4 years. It was observed that in the primary THA, metal-on-ceramic (MoC), ceramic-on-ceramic (CoC) and metal-on-conventional polyethylene (MoCPE) bearings were used in 1, 3 and 11 hips, respectively. Grade III metallosis was observed in all patients during revision surgeries. The mean Harris hip score increased from 55 points before revision THA to 75 points at the final follow-up. In revision arthroplasty, MoCPE and CoC bearings were used in 13 and 2 hips, respectively. The femoral stem was replaced in 5 hips. All acetabular cups, except that of one hip, were revised.
Conclusions: Revisions of THAs with catastrophic failures and metallosis are quite challenging. Routine follow-up of arthroplasty patients is beneficial to examine for osteolysis, loosening, and asymmetric wear.
Figure 1
Figure 2
Figure 3
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