Metal-on-metal total hip resurfacing arthroplasty: an evidence-based analysis
Record ID 32006000950
English
Authors' objectives:
The Ontario Health Technology Advisory Committee asked the Medical Advisory Secretariat to conduct a health technology assessment of metal-on-metal (MOM) total hip resurfacing arthroplasty.
Authors' recommendations:
Metal-on-metal (MOM) hip resurfacing arthroplasty has been shown to be an effective arthroplasty procedure as tested in younger patients.
However, evidence for effectiveness is based only on 7 case series with short duration of follow-up (2.8-3.5 years). There are no randomized controlled trials (RCTs) or other well-controlled studies that compare MOM hip resurfacing with total hip replacement (THR).
Revision rates reported in the MOM studies using implants currently licensed in Canada (hybrid systems, uncemented acetabular, and cemented femoral) range from 0.3% to 3.6% for a mean follow-up ranging from 2.8 to 3.5 years.
Fracture of femoral neck is not very common; it occurs in 0.4% to 2.2% of cases (as observed in a short follow-up period).
All the studies that measured health outcomes have reported improvement in Harris Hip and SF-12 scores; 1 study reported significant reduction in pain and improvement in function, and 2 studies reported significant improvement in SF-12 scores. One study reported significant improvement in University of California Los Angeles Hip scores.
Concerns remain on the potential adverse effects of metal ions. Longer-term follow-up data will help to resolve the inconsistency of findings on adverse effects, including toxicity and carcinogenicity.
Authors' methods:
Systematic review
Details
Project Status:
Completed
Year Published:
2006
URL for published report:
http://www.health.gov.on.ca/english/providers/program/mas/tech/reviews/pdf/rev_mom_020106.pdf
URL for additional information:
http://www.hqontario.ca/en/mas/mas_ohtas_tech_mom_020106.html
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Costs and Cost Analysis
- Hip Prosthesis
- Metals
- Arthroplasty, Replacement, Hip
Contact
Organisation Name:
Medical Advisory Secretariat
Contact Address:
Medical Advisory Secretariat, 20 Dundas Street West, 10th Floor, Toronto, ON M5G 2N6 CANADA. Tel: 416-314-1092l; Fax: 416-325-2364;
Contact Name:
MASinfo.moh@ontario.ca
Contact Email:
MASinfo.moh@ontario.ca
Copyright:
Medical Advisory Secretariat, Ontario Ministry of Health and Long-Term Care
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.