Skip to main content

01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Femoral diameter and stem type are independent risk factors for ARMD in the Large-headed ASR THR group

BMC Musculoskeletal Disorders > Ausgabe 1/2015
Aleksi Reito, Petra Elo, Timo Puolakka, Jorma Pajamäki, Antti Eskelinen
Wichtige Hinweise

Competing interests

None of the authors hold any stocks or shares in an organization that may in any way gain or lose financially from the publication of this manuscript. None of the authors hold or are currently applying for any patents relating to the content of the manuscript. TP has received a grant from Smith-Nephew, personal fee from Stryker and non-financial support from DePuy (not related to this manuscript), Biomet, Zimmer and Stryker. JP has received a personal fee from Zimmer, Biomet and DePuy (not related to this manuscript). AE has received a personal fee from DePuy (not related to this manuscript) and Stryker. AR and PE have no competing interests to declare.

Authors’ contributions

AR collected the data, analysed the data and drafted the manuscript. PE analysed the data and commented on the draft manuscript. TP and JP commented on the draft manuscript. AE designed the study and commented on the draft manuscript. All authors read and approved the final manuscript.



Adverse soft-tissue reaction to metal debris (ARMD) continues to be major source of concern in metal-on-metal (MoM) hip replacements. In our earlier study we were able to establish several risk factors for ARMD in patients who had received a small-diameter (<50 mm) Articular Surface Replacement (ASR, DePuy, Warsaw, IN, USA). The aims of the present study were to analyze whether these previously established risk factors also apply to patients who have received a large-headed (>50 mm) ASR™ XL THR.


Large-headed ASR total hip replacements were used in 225 operations (196 patients) at our institution. 176 patients (203 hips) attended a screening programme, consisting of a clinical evaluation, whole blood cobalt and chromium measurements, and cross-sectional imaging.


Revision surgery was performed on 84 hips (37%) in 75 patients. ARMD was diagnosed in the majority (n = 73 [87%]) of these revisions. Cumulative 8-year survivorship was 52%. The previously established risk factors for ARMD were not applicable. Interestingly, increasing femoral diameter and stem type were identified as independent risk factors for ARMD but reduced cup coverage had no significant association with ARMD.


Stem type and increasing femoral size as independent risk factors for ARMD in the cohort of ASR XL THR patients, support the importance of taper failure in the development of ARMD. The present results suggest that the degree of taper failure may be variable and dependent on the taper design.
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2015

BMC Musculoskeletal Disorders 1/2015 Zur Ausgabe

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.