{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:04:37Z","timestamp":1760130277504},"reference-count":32,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"2","license":[{"start":{"date-parts":[[2016,2,1]],"date-time":"2016-02-01T00:00:00Z","timestamp":1454284800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p> There are many guidelines that help direct the management of patients with metal-on-metal (MOM) hip arthroplasties. We have undertaken a study to compare the management of patients with MOM hip arthroplasties in different countries. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Six international tertiary referral orthopaedic centres were invited to participate by organising a multi-disciplinary team (MDT) meeting, consisting of two or more revision hip arthroplasty surgeons and a musculoskeletal radiologist. A full clinical dataset including history, blood tests and imaging for ten patients was sent to each unit, for discussion and treatment planning. Differences in the interpretation of findings, management decisions and rationale for decisions were compared using quantitative and qualitative methods. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Overall agreement between the orthopaedic centres and the recommended treatment plans for the ten patients with MOM hip implants was moderate (kappa = 0.6). Full agreement was seen in a third of cases, however split decisions were also seen in a third of cases. Units differed in their interpretation of the significance of the investigation findings and put varying emphasis on serial changes, in the presence of symptoms. <\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p> In conclusion, the management of raised or rising blood metal ions, cystic pseudotumours and peri-acetabular osteolysis led to inconsistency in the agreement between centres. Coordinated international guidance and MDT panel discussions are recommended to improve consensus in decision making. Take home message: A lack of evidence and the subsequent variation in regulator guidance leads to differences in opinions, the clinical impact of which can be reduced through a multi-disciplinary team approach to managing patients with MOM hip implants. Cite this article: Bone Joint J 2016;98-B:179\u201386. <\/jats:p><\/jats:sec>","DOI":"10.1302\/0301-620x.98b2.36201","type":"journal-article","created":{"date-parts":[[2016,2,5]],"date-time":"2016-02-05T09:07:22Z","timestamp":1454663242000},"page":"179-186","update-policy":"http:\/\/dx.doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["International metal-on-metal multidisciplinary teams"],"prefix":"10.1302","volume":"98-B","author":[{"given":"R.","family":"Berber","sequence":"first","affiliation":[{"name":"Royal National Orthopaedic Hospital, Brockley\rHill, Stanmore Middlesex, HA7\r4LP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Skinner","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic Hospital, Brockley\rHill, Stanmore Middlesex, HA7\r4LP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Board","sequence":"additional","affiliation":[{"name":"Wrightington Hospital, Hall\rLane, Appley Bridge, Wrightington, Lancashire, WN6\r9EP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Kendoff","sequence":"additional","affiliation":[{"name":"ENDOKLINIK, HELIOS\rKlinikum Berlin-Buch, Schwanebecker Chaussee\r50, 13125, Berlin."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Eskelinen","sequence":"additional","affiliation":[{"name":"COXA Hospital for Joint Replacement, PL\r652, 33101 Tampere, Finland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y-M.","family":"Kwon","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Massachusetts\rGeneral Hospital, 55 Fruit Street, Boston, Massachusetts, 02114, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. E.","family":"Padgett","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, 535\rE 70th St, New York, NY\r10021, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Hart","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic Hospital, Brockley\rHill, Stanmore Middlesex, HA7\r4LP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"42","reference":[{"key":"r1","unstructured":"No authors listed. Medical Device Alert: All metal-on-metal (MoM) hip replacements 2012. https:\/\/www.gov.uk\/drug-device-alerts\/medical-device-alert-metal-on-metal-mom-hip-replacements-updated-advice-with-patient-follow-ups (date last accessed 23 September 2015)."},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.00160"},{"key":"r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2013.01.005"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00973"},{"key":"r5","unstructured":"No authors listed. 11th Annual Report 2014. National Joint Registry for England, Wales and Northern Ireland. http:\/\/www.njrcentre.org.uk\/ (date last accessed 23 September 2015)."},{"key":"r6","unstructured":"No authors listed. Annual Report 2014. Australian Orthopaedic Association National Joint Replacement Registry. https:\/\/aoanjrr.dmac.adelaide.edu.au\/ (date last accessed 23 September 2015)."},{"key":"r7","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.94B5.27073"},{"key":"r8","unstructured":"No authors listed. U.S Metal-on-Metal Hip Implants - Advice for Surgeons 2014. U.S. Food and Drug Administration. http:\/\/www.fda.gov\/ (date last accessed 23 September 2015)."},{"key":"r9","unstructured":"No authors listed. The safety of Metal-on-Metal joint replacements with a particular focus on hip implants. European Commision 2014. http:\/\/ec.europa.eu\/health\/scientific_committees\/emerging\/docs\/scenihr_o_042.pdf (date last accessed 23 September 2015)."},{"key":"r10","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdj102"},{"key":"r11","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000145875.60036.ed"},{"key":"r12","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"r13","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"r14","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B10.26249"},{"key":"r15","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.25.2000148"},{"key":"r16","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.00957"},{"key":"r17","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-015-4156-6"},{"key":"r18","first-page":"777","volume":"77","author":"Ebreo D","year":"2011","journal-title":"Acta Orthop Belg"},{"key":"r19","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.04.022"},{"key":"r20","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01447"},{"key":"r21","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01508"},{"key":"r22","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2010.05.030"},{"key":"r23","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2015.1006981"},{"key":"r24","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.95B8.31377"},{"key":"r25","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2014.05.006"},{"key":"r26","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-2944-4"},{"key":"r27","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.95B12.32248"},{"key":"r28","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.02.019"},{"key":"r29","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4636(199701)34:1<29::AID-JBM5>3.0.CO;2-P"},{"key":"r30","doi-asserted-by":"publisher","DOI":"10.1002\/jab.770060406"},{"key":"r31","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2011.06.007"},{"key":"r32","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-2979-6"}],"container-title":["The Bone &amp; Joint Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.98B2.36201","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/full-xml\/10.1302\/0301-620X.98B2.36201","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.98B2.36201","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T03:02:53Z","timestamp":1634612573000},"score":1,"resource":{"primary":{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/10.1302\/0301-620X.98B2.36201"}},"subtitle":["do we manage patients with metal-on-metal hip arthroplasty in the same way? An analysis from the International Specialist Centre Collaboration on MOM Hips (ISCCoMH)"],"short-title":[],"issued":{"date-parts":[[2016,2]]},"references-count":32,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1302\/0301-620X.98B2.36201"],"URL":"https:\/\/doi.org\/10.1302\/0301-620x.98b2.36201","relation":{},"ISSN":["2049-4394","2049-4408"],"issn-type":[{"value":"2049-4394","type":"print"},{"value":"2049-4408","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2]]},"assertion":[{"value":"2015-04-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-09-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-02-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}