Abstract:

OBJECTIVE: To compare the clinical safety and long-term effect between import and domestic metal-to-metal hip prosthesis in hip replacement.
METHODS: A computer-based online search was performed for related articles published between January 1969 and December 2009, with key words “hip replacement, bulk metal hip” in English. Articles related with biomaterials and tissue-engineered vessels were included. Repetitive studies or Meta analysis were excluded. A total of 14 articles were discussed. A total of 63 patients (71 hips) undergoing bulk metal total hip replacement in Department of Joint Surgery, Fourth Hospital of Guangxi Medical University were divided into two groups. Group A was treated with the fourth generation bulk metal hip prosthesis (A.K.), and group B was treated with the fourth generation bulk metal hip prosthesis (Depuy, USA). Harris scores for hip joint, range of motion, X-ray radiolucent zone, leg length discrepancy and complications during 1 year follow up were compared.
RESULTS: Artificial hip joint was divided into 4 types according to femoral and acetabular materials: metal-polyethylene, ceramics-polyethylene, ceramics-ceramics, metal-metal. And the metal-metal prosthesis included bulk metal hip and metal surface replacement. Clinical results showed that group A was followed up for 15-28 months and group B for 13-26 months. At 1 year following replacement, Harris scores were 89 (range 65-98) in group A, and 92 (71-99) in group B (P > 0.05). Range of motion was 37° in group B and 35° in group A (P > 0.05). Keg length discrepancy was 5.1 mm (2-1 1 mm) in group B and 6.8 mm (5- 14 mm) in group A (P > 0.05). X-ray radiolucent zone (≤1 mm) was observed in two groups (4 cases in group A and 1 in group B). In addition, 1 case of group B developed dislocation.
CONCLUSION: Import and domestic bulk metal hip prostheses are safe and effective in treating hip joint diseases and exhibit similar short-term effect.