{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:57:51Z","timestamp":1780502271001,"version":"3.54.1"},"reference-count":49,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: This study aimed to report the long-term outcomes of total hip arthroplasty (THA) using a Conserve Plus (Wright Medical, Japan) metal-on-metal (MoM) acetabular prosthesis with a modular neck stem. Methods: This study enrolled 50 patients (10 men and 40 women; mean age, 65.8 (39\u201387) years) who underwent primary THA using a Conserve Plus MoM acetabular prosthesis with a modular neck stem. The preoperative diagnosis in most patients was osteoarthritis. Clinical function of hip joint outcomes was investigated using the Japanese Orthopedic Association (JOA) hip score preoperatively and at the final follow-up. The perfect JOA hip score was 100, while the worst score was 0. Radiological analyses were evaluated during the final follow-up visit. Magnetic resonance imaging (MRI) images were evaluated to screen for pseudotumors in 43 hips postoperatively. Results: Six patients did not visit before their 10-year follow-up for unknown reasons. Therefore, 44 patients were evaluated at a mean of 11-years of follow-up (10\u201312 years). The mean (\u00b1SD) preoperative JOA hip score of 44.2 (\u00b115.5) improved significantly to 85.1 (\u00b112.9) postoperatively at the final follow-up (n = 36 hips, excluding eight revision cases). One patient underwent femoral fixation for a periprosthetic fracture due to trauma that occurred 4 years postoperatively. Spot welds were identified in 93.2% (41\/44 hips) of cases. Severe (third- and fourth-degree) stress shielding was identified in 40.9% (18\/44 hips) of cases. Twenty-two patients (51.2%) had pseudotumors attributable to MoM articulation based on MRI results, 2 to 10 years after arthroplasty. Three hips showed cup osteolysis (7%) and three showed trochanteric region osteolysis (7%). There were seven cup and\/or three stem revisions for aseptic loosening and\/or osteolysis at 4 months (with trauma) and 3.3 to 11 years (with pseudotumor) postoperatively. The Kaplan\u2013Meier survivorship for the THA construct in this group was constant at 93.0% and 75.9% at 10 and 12 years after arthroplasty, respectively. The rates of survivorship of revision and loss of follow-up at 10 and 12 years were 83.9% and 66.8%, respectively. Conclusions: In summary, we reported on the long-term treatment results of MoM THA, precautions based on our cohort\u2019s findings, and the measures taken to address these issues, such as revision replacement and its outcomes. Clinical scores revealed good outcomes during the mean 11-year follow-up period. However, the prevalence of pseudotumors (PTs) was 51.2%. Some cases required revisions even after the 10 years following surgery. This is because in MoM THA, PT occurrence increases over time, and as a result, there were cases in which revised THA was required even after 10 years.<\/jats:p>","DOI":"10.3390\/jcm13061525","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T04:19:02Z","timestamp":1709785142000},"page":"1525","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Long-Term Outcome of Metal-on-Metal Total Hip Arthroplasty with Modular Neck Stem"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0371-911X","authenticated-orcid":false,"given":"Hiroki","family":"Wakabayashi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7948-2003","authenticated-orcid":false,"given":"Masahiro","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohei","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shine","family":"Tone","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0474-4368","authenticated-orcid":false,"given":"Akihiro","family":"Sudo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1016\/S0140-6736(07)60457-7","article-title":"The operation of the century: Total hip replacement","volume":"370","author":"Learmonth","year":"2007","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"172","DOI":"10.5312\/wjo.v6.i2.172","article-title":"Biological response to prosthetic debris","volume":"6","author":"Bitar","year":"2015","journal-title":"World J. 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Arthroplasty."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/6\/1525\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:10:06Z","timestamp":1760105406000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/6\/1525"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,7]]},"references-count":49,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["jcm13061525"],"URL":"https:\/\/doi.org\/10.3390\/jcm13061525","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,7]]}}}