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INTRODUCTION: We assessed changes in metal-on-metal hip arthroplasties (MoMHAs) after repeat ultrasound examination. METHODS: This retrospective, single-centre cohort study involved all patients undergoing two ultrasound examinations of the same MoMHA. Between 2010 and 2014, 96 ultrasound examinations were performed in 48 MoMHAs (mean time between scans = 1.1 years). A radiologist assigned each scan to one of four grades and measured volumes of any solid/cystic masses. Changes in grade and lesion volume between scans were analysed. RESULTS: Change in grade between scans was significant (p=0.012); 27% (n=13) of MoMHAs increased in grade, 67% (n=32) had no grade change, and 6% (n=3) decreased in grade. The mean increase in lesion volume was 24.2cm(3) by the second scan, and was significant (p=0.023). Evidence of progression in findings was observed in 54% (26/48) of MoMHAs. Of patients with normal scans initially, 44% (8/18) developed abnormalities. No factors (including blood metal ion concentrations and cup position) were associated significantly with progression of ultrasound findings. CONCLUSIONS: Repeat ultrasound in MoMHA patients demonstrated that findings frequently progress in the short-term. Therefore, regular surveillance of MoMHA patients is important, with ultrasound representing an effective investigation for identifying the development and progression of lesions.

Original publication




Journal article


Ann r coll surg engl

Publication Date





143 - 149


Adverse reaction to metal debris, follow-up, hip arthroplasty, metal-on-metal, ultrasound, Adult, Aged, Aged, 80 and over, Arthroplasty, Replacement, Hip, Equipment Failure Analysis, Female, Hip, Hip Prosthesis, Humans, Male, Metal-on-Metal Joint Prostheses, Middle Aged, Postoperative Complications, Prosthesis Failure, Retrospective Studies, Ultrasonography