A Comparison of Hip Muscle Mass, Muscle Power, and Clinical Outcomes with Long-Term Follow-Up in Patients with Metal-on-Metal Hip Arthroplasty Compared to Metal-on-Polyethylene Hip Arthroplasty
Source abstract
Abstract
(1) Background: Metal-on-metal (MoM) total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) was presumed to provide superior functional outcomes compared to metal-on-polyethylene (MoP) THA. (2) Methods: We compared muscle mass, power, step test asymmetry, and patient-reported outcomes between MoM THA/HRA and MoP THA. A total of 51 MoM THA/HRAs and 23 MoP THAs participated in the cross-sectional study at a mean of 6.5 (2.4–12.5) years postoperatively. Muscle mass was measured by Dual energy X-ray Absorption (DXA) scans and muscle power in a Leg Extensor Power Rig. Step test asymmetry was obtained with an Inertial Measurement Unit (IMU). The patients completed the Harris Hip Score (HHS) and the Copenhagen Hip and Groin Outcome Score (HAGOS). (3) Results: The MoM THA/HRA group had a greater inter-limb difference in hip muscle mass compared to the MoP THA group (p = 0.02). Other inter-limb differences in muscle mass and power were similar (p > 0.05). Muscle mass of the thigh and calf area and muscle power in both legs were higher in MoM THA/HRA compared to MoP THA (p < 0.009). Step test time asymmetry when ascending was lower in MoM THA/HRA compared to MoP THA (p = 0.03). HHS and HAGOS scores were similar between groups (p > 0.05). (4) Conclusion: Overall, we could not verify the hypothesis that MoM THA/HRA contributes to superior functional outcomes compared to MoP THA.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Orthopaedic implants and arthroplasty · Total Knee Arthroplasty Outcomes · Orthopedic Infections and Treatments
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Blv. 99, 8200 Aarhus, Denmark
Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus, Denmark
Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
Funding
Bevica Fonden, Aase and Ejnar Danielsen’s Foundation and Zimmer Biomet
References (61)
Show source-provided references
1. Assessment of outcomes after hip arthroplasty10.1177/112070000901900101 ↗
2. Health status after hip or knee arthroplasty10.1136/ard.62.8.700 ↗
3. Health related quality of life outcomes after total hip and knee arthroplasties in a community based population
4. Polyethylene wear rate and osteolysis: Critical threshold versus continuous dose-response relationship10.1016/j.orthres.2004.11.005 ↗
5. A literature review of the association between wear rate and osteolysis in total hip arthroplasty10.1054/arth.2002.33664 ↗
6. Total hip arthroplasty for congenital dysplasia or dislocation of the hip. Survivorship analysis and long-term results10.2106/00004623-199709000-00009 ↗
7. Comparison of the risk of revision in cementless total hip arthroplasty with ceramic-on-ceramic and metal-on-polyethylene bearings: Data on 11,096 patients from the Danish Hip Arthroplasty Registry10.3109/17453674.2015.1012975 ↗
8. Large versus small femoral heads in metal-on-metal total hip arthroplasty10.1016/j.arth.2004.09.006 ↗
9. Metal-on-Metal Hip Arthroplasty: A Review of Adverse Reactions and Patient Management10.3390/jfb6030486 ↗
10. Metal-on-metal total hip arthroplasty: Is there still a role in 2016?10.1007/s12178-016-9323-1 ↗
11. Increased mortality in metal-on-metal versus non-metal-on-metal primary total hip arthroplasty at 10 years and longer follow-up: A systematic review and meta-analysis
12. Head size in primary total hip arthroplasty10.1302/2058-5241.3.170061 ↗
13. Holappa, E., Kettunen, J., Miettinen, H., Kröger, H., and Miettinen, S. (2022). Long-term survival analysis of cementless large-diameter head metal-on-metal total hip arthroplasty. Arch. Orthop. Trauma Surg., Online ahead of print.10.1007/s00402-022-04633-9 ↗
14. 11-Year outcomes in patients with metal-on-metal ASR hip arthroplasty10.1016/j.jor.2022.05.015 ↗
15. Metal on metal hip resurfacing arthroplasty: Where are we now?10.1016/j.jor.2020.12.036 ↗
16. Recovery in mechanical muscle strength following resurfacing vs standard total hip arthroplasty—A randomised clinical trial10.1016/j.joca.2011.06.011 ↗
17. The John Charnley Award: The functional outcome of hip resurfacing and large-head THA is the same: A randomized, double-blind study10.1007/s11999-009-0938-z ↗
18. Gait analysis of patients with resurfacing hip arthroplasty compared with hip osteoarthritis and standard total hip arthroplasty 23110.1016/j.arth.2006.03.010 ↗
19. Gait patterns after total hip arthroplasty and surface replacement arthroplasty10.1016/j.apmr.2008.08.215 ↗
20. Postural balance during quiet standing in patients with total hip arthroplasty and surface replacement arthroplasty10.1016/j.clinbiomech.2007.10.011 ↗
21. Resurfacing hip arthroplasty better preserves a normal gait pattern at increasing walking speeds compared to total hip arthroplasty10.1080/17453674.2019.1594096 ↗
22. Block-step asymmetry 5 years after large-head metal-on-metal total hip arthroplasty is related to lower muscle mass and leg power on the implant side10.1016/j.clinbiomech.2014.03.007 ↗
23. World Medical Association (2013). Declaration of Helsinki Ethical Principles for Medical Research Involving Human Subjects. JAMA, 310, 2191–2194.10.1001/jama.2013.281053 ↗
24. Modeling leg sections by bioelectrical impedance analysis, dual-energy X-ray absorptiometry, and anthropometry: Assessing segmental muscle volume using magnetic resonance imaging as a reference 2510.1111/j.1749-6632.2000.tb06471.x ↗
25. Assessment of limb muscle and adipose tissue by dual-energy X-ray absorptiometry using magnetic resonance imaging for comparison 2810.1038/sj.ijo.0801070 ↗
26. Agreement and reliability of functional performance and muscle power in patients with advanced osteoarthritis of the hip or knee 210.1097/PHM.0b013e3182465ed0 ↗
27. A study of the inter-rater reliability of a test battery for use in patients after total hip replacement10.1177/0269215514534088 ↗
28. Validation of an inertial measurement unit to determine countermovement jump height
29. Measuring orientation of human body segments using miniature gyroscopes and accelerometers10.1007/BF02345966 ↗
30. Assessment of spatio-temporal gait parameters from trunk accelerations during human walking10.1016/S0966-6362(02)00190-X ↗
31. Inertial sensor motion analysis of gait, sit-stand transfers and step-up transfers: Differentiating knee patients from healthy controls 210.1088/0967-3334/33/11/1947 ↗
32. Recovery of gait after short-stay total hip arthroplasty10.1016/j.apmr.2006.11.026 ↗
33. Acceleration-based gait test for healthy subjects: Reliability and reference data10.1016/j.gaitpost.2009.04.008 ↗
34. Acceleration-based motion analysis as a tool for rehabilitation: Exploration in simulated functional knee limited walking conditions10.1097/PHM.0b013e31820b151a ↗
35. The efficacy of early initiated, supervised, progressive resistance training compared to unsupervised, home-based exercise after unicompartmental knee arthroplasty: A single-blinded randomized controlled trial10.1177/0269215516640035 ↗
36. Pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis: A cross-sectional study10.1007/s00402-015-2276-9 ↗
37. Traumatic Arthritis of the Hip after Dislocation and Acetabular Fractures: Treatment by Mold Arthroplasty: An End-Result Study Using a New Method of Result Evaluation10.2106/00004623-196951040-00012 ↗
38. The Copenhagen Hip and Groin Outcome Score (HAGOS): Development and validation according to the COSMIN checklist10.1136/bjsm.2010.080937 ↗
39. Measures of hip function and symptoms: Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), Oxford Hip Score (OHS), Lequesne Index of Severity for Osteoarthritis of the Hip (LISOH), and American Academy of Orthopedic Surgeons (AAOS) Hip and Knee Questionnaire10.1002/acr.20549 ↗
40. Altman, D.G. (2009). Practical Statistics for Medical Research, Chapman & Hall.
41. Muscle weakness in hip osteoarthritis: A systematic review10.1002/acr.21806 ↗
42. Strength, power and related functional ability of healthy people aged 65–89 years 1210.1093/ageing/23.5.371 ↗
43. Lower extremity muscle function after strength or power training in older adults10.1123/japa.17.4.416 ↗
44. Pseudotumours associated with metal-on-metal hip resurfacings10.1302/0301-620X.90B7.20213 ↗
45. Muscle atrophy and metal-on-metal hip implants: A serial MRI study of 74 hips10.3109/17453674.2015.1006981 ↗
46. MRI investigations in patients with problems due to metal-on-metal implants
47. MRI findings in painful metal-on-metal hip arthroplasty10.2214/AJR.11.8203 ↗
48. MRI of early symptomatic metal-on-metal total hip arthroplasty: A retrospective review of radiological findings in 20 hips10.1016/j.crad.2007.07.012 ↗
49. Persisting muscle atrophy two years after replacement of the hip10.1302/0301-620X.91B5.21477 ↗
50. Do gait adaptations during stair climbing result in changes in implant forces in subjects with total hip replacements compared to normal subjects?10.1016/j.clinbiomech.2008.02.006 ↗
51. Do different types of bearings and noise from total hip arthroplasty influence hip-related pain, function, and quality of life postoperatively?: A cross-sectional study from the Danish Hip Arthroplasty Registry10.1080/17453674.2016.1225649 ↗
52. Measuring Physical Capacity10.1177/0898264316635566 ↗
53. Associations between preoperative functional status and functional outcomes of total joint replacement in the Dominican Republic10.1093/rheumatology/ket180 ↗
54. Preoperative Patient Functional Status Is an Independent Predictor of Outcomes After Primary Total Hip Arthroplasty10.3928/01477447-20190321-01 ↗
55. Pitfalls in the measurement of muscle mass: A need for a reference standard10.1002/jcsm.12268 ↗
56. Assessment of hip abductors by MRI after total hip arthroplasty and effect of fatty atrophy on functional outcome10.1016/j.aott.2017.10.005 ↗
57. Could the tendon degeneration and the fatty infiltration of the gluteus medius affect clinical outcome in total hip arthroplasty?10.1007/s00264-019-04468-x ↗
58. MARS MRI assessment of fatty degeneration of the gluteal muscles in patients with THA: Reliability and accuracy of commonly used classification systems10.1007/s00256-020-03611-9 ↗
59. Surgical approach in primary total hip arthroplasty: Anatomy, technique and clinical outcomes10.1503/cjs.007214 ↗
60. Muscular strength after total hip arthroplasty. A prospective comparison of 3 surgical approaches10.3109/17453674.2015.1068032 ↗
61. Which approach for total hip arthroplasty: Anterolateral or posterior?10.1007/s11999-008-0560-5 ↗