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A new study on patient outcomes after metal-on-metal hip replacement revision surgery has been selected as part of a prestigious 'Game Changers' session at the American Academy of Orthopaedic Surgeons (AAOS) annual meeting.

The biggest study in the world of its kind, researchers specifically investigated outcomes after revision surgery performed for abnormal reactions to metal. The Program Committee for the conference, this year taking place in San Diego, selects work which they feel will change clinical practice within the next two to three years.

Approximately 1.5 million patients worldwide have metal-on-metal hip replacements for painful arthritis. Abnormal reactions to metal can develop which may cause surrounding tissue damage. Many patients with these reactions require further operations, known as revision surgery. Little is currently known about outcomes for patients following these further operations, though initial observations showed patients experienced poor results. This is concerning as most patients who received this type of hip replacement are young and active. Therefore poor results would have a significant impact on a patient's quality of life.

Researchers based at the University of Oxford (Mr Gulraj Matharu, Associate Professor Andrew Judge, Professor Hemant Pandit, and Professor David Murray), have performed a retrospective observational study using National Joint Registry data on 2,535 metal-on-metal hip replacement patients undergoing revision surgery performed for abnormal reactions to metal (also known as adverse reactions to metal debris).

The study identified a number of factors that the surgeon can modify during revision surgery, which could potentially improve the outcomes for patients further. This is important as surgeons have currently received very little guidance about how best to treat these patients. This study also showed that the outcomes following this type of revision surgery have substantially improved, and are now similar to the outcomes in patients with other types of hip replacement undergoing revision surgery.

Funded by Arthritis Research UK and the Orthopaedics Trust, the research aimed to answer the following key questions:

  • What are the expected outcomes for patients following revision surgery for abnormal reactions to metal?
  • Which factors predict which patients do better or worse after revision surgery?

Over 900 studies have been selected for presentation at the prestigious AAOS conference. This research study was one of only six academic papers selected to be presented during the AAOS' 'Game Changers' session, taking place on the afternoon of Friday 17 March 2017.

The findings will be fully published in the Bone and Joint Journal later this year.