Ahmed Bakr
North Manchester General Hospital, UK
Title: Metal on metal hip arthroplasty outcome ten years study
Biography:
Ahmed Bakr has his expertise evaluation in Orthopaedics and Trauma Surgery. He was graduated from ASU Cairo, Egypt and completed Rotatory Foundation year in ASU Hospitals. Currently, he is working as Senior House Officer of General Surgery at North Manchester General Hospital. His research interest includes Metal Total Hip Replacements.
Abstract:
Background: Patients with metal on metal hip replacements are currently reviewed according to the Medicines and Healthcare Products Regulatory Agency (MHRA) guidelines. Certain implants such as ASR system have been found to have higher revision rates than others. We present the results of multiple brands of metal on metal hip replacement implants used at our institution since 2001.
Methods: We retrospectively reviewed all the records of patients who had metal on metal hip replacements at North Manchester General Hospital. Their metal ions level (cobalt and chromium) and MRI scans were also looked at.
Results: There were 215 patients. Majority were males (162 patients). 50 patients had resurfacing implants. Most implants used were Zimmer Durom Hip systems (85 patients). Other brands included Smith & Nephew BHR, Biomet Recap Magnum and DePuy ASR hip systems. 45 patients (21%) have had revision surgery due to reasons such as raised metal ions level, positive MRI scans or clinical symptoms. The revision rate in each brand or system was comparable to each other. We have now stopped doing metal on metal hip replacement surgery. The last surgery was in 2011.
Conclusion: The revision rate is high (21%) in patients with metal on metal hip replacements done at our institution. The lack of significant difference in revision rates between brands of implants implies metal on metal bearings as a common denominator in causing metallosis.
Implications: Regardless of brands or hip systems, metal on metal hip replacements have higher revision rates than other types of hip replacements at our institution.