How to Manage Metallosis: A Retrospective Cohort Analysis after Revision Hip Surgery
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Data Collection
2.2. Characteristics of Revision Prosthesis
2.3. Functional Evaluation
2.4. Statistical Analysis
3. Results
3.1. Demographic Data
3.2. Complications and Implant Survivorship
3.3. Functional Evaluation
3.4. Serum Data
3.5. Microbiological Data
3.6. Imaging Data
4. Discussion
4.1. Aim of the Study
4.2. What Is Known in the Literature
4.3. Comparison between Literature and Our Data
4.4. Limitation of the Study and Future Perspectives
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Number of Patients | 43 |
Age (y) | 67.1 (range of 30–86) |
Gender (F/M) | 30/13 |
Side (L/R) | 24/19 |
Revision (months) | 35.3 ± 8.4 |
Height (cm) | 157.8 ± 5.7 |
Weight (kg) | 84.6 ± 15.4 |
BMI (kg/m2) | 23.6 (range of 18–35) |
Mean interval from initial THA surgery to revision (months) | 30.8 ± 14.5 (range of 10–60) |
Mean follow-up period after revision surgery (months) | 40.2 ± 19.4 (range of 20–75) |
WOMAC at admission for revision surgery (mean ± standard deviation)
| 54.6 ± 19.6 51.2 ± 17.4 |
HHS at admission for revision surgery (mean ± standard deviation)
| 36.5 ± 5.4 41.4 ± 3.6 |
WOMAC at one year follow-up (mean ± standard deviation)
| 11.2 ± 16.4 10.2 ± 14.8 |
HHS at one year follow-up (mean ± standard deviation)
| 75.4 ± 5.5 78.7 ± 6.4 |
Asymptomatic | Typical Symptomatic | Atypical Symptomatic | p-Value | |
---|---|---|---|---|
17 | 16 | 10 | ||
Cobalt [μg/L] | 3.2 (0–7.4) | 4.3 (0.2–11.7) | 5.3 (0.2–14.8) | 0.45 |
Chromium [μg/L] | 1.4 (0–7.0) | 1.6 (0.2–8.2) | 1.6 (0.4–4.3) | 0.96 |
ESR [mm/h] | 15.5 (2–45) | 14.7 (1–61) | 13.4 (1–61) | 0.67 |
CRP [mg/dL] | 2.0 (0.5–16.6) | 2.1 (0.1–6.1) | 2.2 (0.1–7.2) | 0.89 |
Age | Sex | Time from Initial Surgery to Revision | ARMD | Microbiology |
---|---|---|---|---|
55 | Female | 35 months | Metallosis | S. epidermidis |
72 | Female | 31 months | Metallosis | E. faecalis |
64 | Male | 34 months | Metallosis | K. pneumoniae |
Asymptomatic | Typical Symptomatic | Atypical Symptomatic | p-Value | ||
---|---|---|---|---|---|
Number of patients | 30 | 5 (17%) | 15 (50%) | 10 (33%) | |
MARS/MRI | Muscle changes | 1 (3%) | 8 (26%) | 5 (17%) | 0.001 |
Fluid accumulations | 2 (6%) | 4 (13%) | 4 (13%) | 0.001 | |
Mass | 1 (3%) | 2 (6%) | 0 | 0.2 |
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Bruschetta, A.; Palco, M.; Fenga, D.; Giuca, G.; Holzer, L.A.; Alito, A.; Cacciola, G.; De Meo, F.; Cavaliere, P. How to Manage Metallosis: A Retrospective Cohort Analysis after Revision Hip Surgery. J. Clin. Med. 2023, 12, 4809. https://doi.org/10.3390/jcm12144809
Bruschetta A, Palco M, Fenga D, Giuca G, Holzer LA, Alito A, Cacciola G, De Meo F, Cavaliere P. How to Manage Metallosis: A Retrospective Cohort Analysis after Revision Hip Surgery. Journal of Clinical Medicine. 2023; 12(14):4809. https://doi.org/10.3390/jcm12144809
Chicago/Turabian StyleBruschetta, Antongiulio, Michelangelo Palco, Domenico Fenga, Gabriele Giuca, Lukas A. Holzer, Angelo Alito, Giorgio Cacciola, Federico De Meo, and Pietro Cavaliere. 2023. "How to Manage Metallosis: A Retrospective Cohort Analysis after Revision Hip Surgery" Journal of Clinical Medicine 12, no. 14: 4809. https://doi.org/10.3390/jcm12144809