期刊
JOURNAL OF ARTHROPLASTY
卷 30, 期 8, 页码 1317-1323出版社
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2015.03.009
关键词
metal-on-metal; hip resurfacing; total hip arthroplasty; follow-up; finance; guidelines
类别
资金
- Royal College of Surgeons of England
- Arthritis Research Trust
Over one-million patients worldwide have received metal-on-metal (MoM) hip arthroplasties with a significant proportion requiring revision surgery in the short-term for adverse reaction to metal debris (ARMD). Worldwide authorities have subsequently issued follow-up guidance for MoM hip patients. This article compares follow-up guidelines for MoM hips published by five worldwide authorities, analyses these protocols in relation to published evidence, and assesses the financial implications of these guidelines. A number of major differences exist between authorities regarding patient follow-up, with vast cost differences between protocols (84 pound to 988 pound/patient/year for stemmed MoM hips and 0 pound to 988 pound/patient/year for hip resurfacing). Current worldwide guidance is neither evidence-based nor financially sustainable with most protocols lacking the sensitivity to detect asymptomatic ARMD lesions. (C) 2015 Elsevier Inc. All rights reserved.
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