Trial Outcomes & Findings for Metal on Metal Versus Ceramic on Metal Hip Replacement (NCT NCT00208494)

NCT ID: NCT00208494

Last Updated: 2013-08-14

Results Overview

The composite success/failure of the implant was made up of radiographic, clinical and revision data. Radiographic success was determined by femoral subsidence =/\< 2mm, acetabular migration =/\< 2mm, cup inclination =/\< 4°, no acetabular or femoral osteolysis, and acetabular and femoral lucencies less than 50% of visible porous coating. Clinical success was determined by a Harris Hip score equal to or greater than 80. A hip (patient) was considered to be a composite success at study endpoint if it was a radiographic and clinical success and no revision of any component had taken place.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

392 participants

Primary outcome timeframe

At 24 months

Results posted on

2013-08-14

Participant Flow

Eleven sites enrolled 392 subjects who were then randomized into two groups. The investigational group, Ceramic-on-Metal (COM) and the control group, Metal-on-Metal (MOM). Two subjects were intraoperatively excluded, resulting in 194 subjects COM subjects and 196 MOM subjects.

Participant milestones

Participant milestones
Measure
Ceramic-on-Metal (COM) Total Hip Implant
The COM modular total hip prosthesis has a ceramic femoral head articulating with a metal alloy acetabular bearing insert.
Metal-on-Metal (MOM) Total Hip Implant
The MOM modular total hip prosthesis has a metal femoral head articulating with a metal alloy acetabular bearing insert.
Overall Study
STARTED
194
196
Overall Study
COMPLETED
164
162
Overall Study
NOT COMPLETED
30
34

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Metal on Metal Versus Ceramic on Metal Hip Replacement

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Ceramic-on-Metal (COM) Total Hip Implant
n=194 Participants
The COM modular total hip prosthesis has a ceramic femoral head articulating with a metal alloy acetabular bearing insert.
Metal-on-Metal (MOM) Total Hip Implant
n=196 Participants
The MOM modular total hip prosthesis has a metal femoral head articulating with a metal alloy acetabular bearing insert.
Total
n=390 Participants
Total of all reporting groups
Age Continuous
Age
58.9 Years
STANDARD_DEVIATION 10.1 • n=5 Participants
59.1 Years
STANDARD_DEVIATION 9.5 • n=7 Participants
59 Years
STANDARD_DEVIATION 9.78 • n=5 Participants
Sex: Female, Male
Female
83 Participants
n=5 Participants
91 Participants
n=7 Participants
174 Participants
n=5 Participants
Sex: Female, Male
Male
111 Participants
n=5 Participants
105 Participants
n=7 Participants
216 Participants
n=5 Participants
Region of Enrollment
United States
194 participants
n=5 Participants
196 participants
n=7 Participants
390 participants
n=5 Participants

PRIMARY outcome

Timeframe: At 24 months

Population: Out of the 390 subjects, 84 subjects were removed from the analysis for the following reasons: 2 deaths (1 in each arm); 3 protocol violations (2 COM, 1 MOM); 28 bilateral (12 COM, 16 MOM); 39 subjects had no 24-month Harris Hip score (22 COM, 17 MOM); and 12 subjects had no 24-month x-ray (4 COM, 8 MOM).

The composite success/failure of the implant was made up of radiographic, clinical and revision data. Radiographic success was determined by femoral subsidence =/\< 2mm, acetabular migration =/\< 2mm, cup inclination =/\< 4°, no acetabular or femoral osteolysis, and acetabular and femoral lucencies less than 50% of visible porous coating. Clinical success was determined by a Harris Hip score equal to or greater than 80. A hip (patient) was considered to be a composite success at study endpoint if it was a radiographic and clinical success and no revision of any component had taken place.

Outcome measures

Outcome measures
Measure
Ceramic-on-Metal (COM) Total Hip Implant
n=154 Participants
The COM modular total hip prosthesis has a ceramic femoral head articulating with a metal alloy acetabular bearing insert.
Metal-on-Metal (MOM) Total Hip Implant
n=152 Participants
The MOM modular total hip prosthesis has a metal femoral head articulating with a metal alloy acetabular bearing insert.
Composite Success/Failure
142 Participants
141 Participants

Adverse Events

Ceramic-on-Metal (COM) Total Hip Implant

Serious events: 40 serious events
Other events: 137 other events
Deaths: 0 deaths

Metal-on-Metal (MOM) Total Hip Implant

Serious events: 48 serious events
Other events: 125 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Ceramic-on-Metal (COM) Total Hip Implant
n=194 participants at risk
The COM modular total hip prosthesis has a ceramic femoral head articulating with a metal alloy acetabular bearing insert.
Metal-on-Metal (MOM) Total Hip Implant
n=196 participants at risk
The MOM modular total hip prosthesis has a metal femoral head articulating with a metal alloy acetabular bearing insert.
Musculoskeletal and connective tissue disorders
Bone Fracture
1.0%
2/194 • Number of events 2
0.51%
1/196 • Number of events 1
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Cancer
1.5%
3/194 • Number of events 3
1.0%
2/196 • Number of events 2
Cardiac disorders
Cardiovascular
2.6%
5/194 • Number of events 5
2.0%
4/196 • Number of events 4
Nervous system disorders
Central Nervous System
1.5%
3/194 • Number of events 3
1.0%
2/196 • Number of events 2
General disorders
Constitutional Symptom
0.00%
0/194
0.51%
1/196 • Number of events 1
Skin and subcutaneous tissue disorders
Dermatological
0.00%
0/194
0.51%
1/196 • Number of events 1
Musculoskeletal and connective tissue disorders
Dislocation
1.0%
2/194 • Number of events 2
1.0%
2/196 • Number of events 2
Gastrointestinal disorders
Gastrointestinal
2.6%
5/194 • Number of events 5
1.0%
2/196 • Number of events 2
Renal and urinary disorders
Genitourinary
1.5%
3/194 • Number of events 3
0.51%
1/196 • Number of events 1
Blood and lymphatic system disorders
Hematological
0.52%
1/194 • Number of events 1
1.0%
2/196 • Number of events 2
Blood and lymphatic system disorders
Hematoma requiring drainage
0.52%
1/194 • Number of events 1
0.51%
1/196 • Number of events 1
Musculoskeletal and connective tissue disorders
Musculoskeletal
10.8%
21/194 • Number of events 21
11.7%
23/196 • Number of events 23
Surgical and medical procedures
Operative Adverse Event (fracture of femur
1.5%
3/194 • Number of events 3
4.1%
8/196 • Number of events 8
Surgical and medical procedures
Operative Adverse Event (other complication
0.00%
0/194
1.0%
2/196 • Number of events 2
Surgical and medical procedures
Operative Adverse Event (seating acetabular prosthesis)
0.00%
0/194
1.0%
2/196 • Number of events 3
Nervous system disorders
Peripheral nervous system
0.00%
0/194
0.51%
1/196 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Respiratory system
1.0%
2/194 • Number of events 2
0.51%
1/196 • Number of events 1
Infections and infestations
Deep Infection
0.52%
1/194 • Number of events 1
0.00%
0/196

Other adverse events

Other adverse events
Measure
Ceramic-on-Metal (COM) Total Hip Implant
n=194 participants at risk
The COM modular total hip prosthesis has a ceramic femoral head articulating with a metal alloy acetabular bearing insert.
Metal-on-Metal (MOM) Total Hip Implant
n=196 participants at risk
The MOM modular total hip prosthesis has a metal femoral head articulating with a metal alloy acetabular bearing insert.
Musculoskeletal and connective tissue disorders
Trochanteric Bursitis
7.7%
15/194 • Number of events 15
5.1%
10/196 • Number of events 10
Nervous system disorders
Central Nervous System
7.2%
14/194 • Number of events 14
7.1%
14/196 • Number of events 14
Renal and urinary disorders
Genitourinary
7.7%
15/194 • Number of events 15
9.7%
19/196 • Number of events 19
Respiratory, thoracic and mediastinal disorders
Respiratory system
8.2%
16/194 • Number of events 16
9.7%
19/196 • Number of events 19
Skin and subcutaneous tissue disorders
Dermatological
16.0%
31/194 • Number of events 31
12.2%
24/196 • Number of events 24
Blood and lymphatic system disorders
Hematological
7.2%
14/194 • Number of events 14
8.7%
17/196 • Number of events 17
Cardiac disorders
Cardiovascular
12.9%
25/194 • Number of events 25
10.2%
20/196 • Number of events 20
Gastrointestinal disorders
Gastrointestinal
9.8%
19/194 • Number of events 19
9.7%
19/196 • Number of events 19
General disorders
Constitutional symptom
10.8%
21/194 • Number of events 21
8.7%
17/196 • Number of events 17
Injury, poisoning and procedural complications
Wound problem
6.2%
12/194 • Number of events 12
5.6%
11/196 • Number of events 11
Musculoskeletal and connective tissue disorders
Musculoskeletal
54.6%
106/194 • Number of events 106
46.4%
91/196 • Number of events 91

Additional Information

Jennifer Hoag, MS, Project Leader, Clinical Research

DePuy Orthopaedics, Inc.

Phone: 574-372-7399

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60