In a recent presentation, one surgeon outlined his indications for follow-up and revision of metal-on-metal total hip replacements.
Thomas P. Schmalzried, MD, presented his experience at the International Congress for Joint Reconstruction San Diego 2012 meeting, which was held in collaboration with Orthopedics Today.
According to Schmalzried, revision should be considered in patients who display poor clinical results, such as pain or mechanical symptoms. Pseudotumor or other soft tissue involvement, such as edema and necrosis, are also a sign that revision should be performed within 3 months. Osteolysis and high metal ion levels should also bring revision into consideration.
Schmalzried stressed he still observes asymptomatic patients with “clean” MRIs, regardless of their metal ion levels.