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Ali E, Neufeld ME, Howard LC, Masri BA, Greidanus NV, Garbuz DS. Clinical Outcomes and Risk Factors for Re-Revision Due to Trunnion Corrosion in Primary Metal-on-Polyethylene Total Hip Arthroplasty. J Arthroplasty 2024; 39:S404-S409. [PMID: 38336304 DOI: 10.1016/j.arth.2024.01.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND There is a paucity of literature regarding the mid-term (greater than 2 years) outcomes of revision for adverse local tissue reaction to metal debris due to corrosion at the head-neck junction (trunnionosis) in metal-on-polyethylene total hip arthroplasty (THA), and risk factors for re-revision remain largely unknown. We aimed to report the re-revision-free survival and functional outcomes for this patient population and to identify risk factors for re-revision. METHODS A total of 80 hips (79 patients) with a metal-on-polyethylene THA who had undergone revision for trunnionosis at our institution were included. The mean study follow-up from index trunnionosis revision was 4.6 years (range, 2.0 to 9.4). Kaplan-Meier survival analysis was performed with all-cause re-revision as the end point, and multivariate logistic regression was used to identify risk factors for re-revision. RESULTS We saw that twenty-one hips (26%) underwent re-revision at a mean of 8.0 months (range, 0.03 to 36.3) after the index trunnionosis revision, most commonly for instability and infection. The two- and five-year all-cause re-revision-free survival rates were 75.0 and 73.2%, respectively. The mean Oxford Hip Score was 33.7 (range, 11 to 48); 76% were satisfied, and 24% were dissatisfied with their hip. Multivariate analysis identified not undergoing a cup revision (odds ratio: 4.5; 95% confidence interval: 1.03 to 19.7) and time from primary THA to the index trunnionosis revision (odds ratio: 0.77; 95% confidence interval: 0.62 to 0.97) as risk factors for undergoing re-revision. CONCLUSIONS The risk of early re-revision for these patients is high (26%), mostly due to infection and instability, and functional outcomes are fair. Not performing a cup revision appears to be a risk factor for re-revision, as is the shorter time from primary THA to trunnionosis revision. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Erden Ali
- Faculty of Medicine-Orthopaedics, The University of British Columbia, Diamond Health Care Centre, Vancouver, Canada
| | - Michael E Neufeld
- Faculty of Medicine-Orthopaedics, The University of British Columbia, Diamond Health Care Centre, Vancouver, Canada
| | - Lisa C Howard
- Faculty of Medicine-Orthopaedics, The University of British Columbia, Diamond Health Care Centre, Vancouver, Canada
| | - Bassam A Masri
- Faculty of Medicine-Orthopaedics, The University of British Columbia, Diamond Health Care Centre, Vancouver, Canada
| | - Nelson V Greidanus
- Faculty of Medicine-Orthopaedics, The University of British Columbia, Diamond Health Care Centre, Vancouver, Canada
| | - Donald S Garbuz
- Faculty of Medicine-Orthopaedics, The University of British Columbia, Diamond Health Care Centre, Vancouver, Canada
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Jurewicz A, Dziedziejko V, Rać M, Białecka M, Safranow K, Kurzawski M, Malinowski D, Bosiacki M, Leźnicka K, Bohatyrewicz A, Białecka M, Droździk M, Machoy-Mokrzyńska A. Level of Disability after Total Hip Replacement in Patients with Some COMT Gene Polymorphism. J Clin Med 2023; 12:7652. [PMID: 38137720 PMCID: PMC10743937 DOI: 10.3390/jcm12247652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The COMT gene encodes the enzyme catechol-O-methyltransferase, which is a key modulator of dopaminergic and adrenergic neurotransmission. Hip osteoarthritis is accompanied by reduced mobility and some level of disability. In our study, we analyzed the association between some COMT gene polymorphisms and reduced mobility in patients after total hip replacement (THR). METHODS The operative procedures were performed on 195 patients with symptomatic and radiologically advanced hip osteoarthritis. In the postoperative follow-up, we assessed hip function with the Harris Hip Score (HHS) and the degree of disability with the Oswestry Disability Index (ODI). These procedures were repeated three times at defined intervals (one week, six weeks, and six months) after the total hip replacement. Genomic DNA was extracted from peripheral blood. SNPs in the COMT genes rs4680:A>G, rs6269:A>G, rs4633:C>T, and rs4818:C>G were genotyped. RESULTS Our findings suggest an association between COMT gene variability and the level of disability measured by the Oswestry Disability Index (ODI) in patients after total hip replacement (THR). CONCLUSIONS A higher number of COMT G alleles (rs4818) is an independent factor in a significant reduction in disability degree at both one week and six months after total hip replacement (THR), regardless of age or gender.
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Affiliation(s)
- Alina Jurewicz
- Department of Specialistic Nursing, Pomeranian Medical University, Żołnierska St. 48, 71-210 Szczecin, Poland;
| | - Violetta Dziedziejko
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (V.D.); (K.S.)
| | - Monika Rać
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (V.D.); (K.S.)
| | - Marta Białecka
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (V.D.); (K.S.)
| | - Mateusz Kurzawski
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
| | - Damian Malinowski
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
| | - Mateusz Bosiacki
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Żołnierska St. 54, 71-210 Szczecin, Poland;
| | - Katarzyna Leźnicka
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, K. Górskiego St. 1, 80-336 Gdansk, Poland;
| | - Andrzej Bohatyrewicz
- Department of Orthopedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, Unii Lubelskiej St. 1, 71-252 Szczecin, Poland;
| | - Monika Białecka
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
| | - Marek Droździk
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
| | - Anna Machoy-Mokrzyńska
- Department of Pharmacology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (M.B.); (M.K.); (D.M.); (M.D.)
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