Durom hip resurfacing at 15 years
Bibliographic record
Abstract
Aims A range of metal-on-metal hip resurfacing (MoM-HR) implants have shown good functional outcomes, but some have been associated with adverse reactions to metal debris (ARMD) and early failure, requiring regular follow-up and monitoring of the blood metal ion levels. The aim of this study was to report the minimum 15-year survival of the Durom hip resurfacing system (Zimmer Biomet, USA), the functional outcome, and factors which were predictive of failure. Methods A consecutive series of patients undergoing Durom MoM-HR at a single centre between January 2000 and December 2008 were included. Demographic variables, the size of the implant, radiological parameters, and the most recent blood metal ion levels were collected. The primary outcome measure was failure; secondary outcome measures included the Oxford Hip Score (OHS). Multivariable logistic regression was used to predict failure and identify the factors most strongly associated with failure. Results A total of 695 hips in 597 patients, 61.2% of whom were male, were included. The mean age of the patients was 51.5 years (SD 8.7). Survival at a mean follow-up of 15.2 years (SD 1.9) was 86.6% (602 of 695 hips). Implant survival was significantly increased in males (92.2% (95% CI 89.7 to 94.8) vs 77.8% (95% CI 72.8 to 82.7); p < 0.001) and with femoral components sized ≥ 50 mm (91.7% (95% CI 88.7 to 94.7) vs 82.3% (95% CI 78.4 to 86.2); p < 0.001). Failure was mostly due to aseptic loosening (42 hips; 6%) and ARMD (27 hips; 3.9%). The mean postoperative OHS was 31.9 (SD 13.5) for patients requiring revision and 41.8 (SD 9.2) for those not requiring revision (p < 0.001). Predictive factors of failure in the regression model included sex, the angle of inclination and migration of the acetabular component, the postoperative OHS and the blood chromium ion levels (Pseudo-R2 0.279). Standardized regression coefficients were greatest for migration of the acetabular component (0.855) and OHS (-0.606). Conclusion This study presents the longest reported follow-up for the Durom MoM-HR, with excellent survival and functional outcomes at 15 years’ follow-up in males and with ≥ 50 mm femoral components. Most failures were due to aseptic loosening. Migration of the acetabular component and symptomatology (OHS) were the factors which most strongly predicted failure. Cite this article: Bone Joint J 2025;107-B(6 Supple B):55–61.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".