ArthroplastyHip - Arthroplasty
Metal-on-Metal Hip Arthroplasty Failure
Arthroplasty
Intermediate
6 min
High Yield
loosening
6:00
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Metal-on-Metal Hip Arthroplasty Failure
Clinical Scenario
Patient with MoM hip presenting for surveillance or with symptoms
Questions & Model Answers
Q
How do you stratify patients for surveillance?
Q
What investigations for suspected MoM failure?
Q
What are the risk factors for MoM disease?
Q
What are the systemic effects of metal poisoning?
Q
What are the surgical options for revision of a failed MoM hip arthroplasty?
Q
What is the prognosis and what monitoring is required post-revision?
Key Learning Points
- Metal ion threshold is 7ppb
- Cup abduction >50° is a major risk factor
- MARS MRI is the imaging of choice
- Pseudotumour may be sterile or infected
- Metal toxicity affects multiple organ systems