The effect of bearing type on the outcome of total hip arthroplasty:Analysis of 209,912 primary total hip arthroplasties registered in the Dutch Arthroplasty Register

Background and purpose Alternative bearing surfaces such as ceramics and highly crosslinked polyethylene (HXLPE) were developed in order to further improve implant performance of total hip arthroplasties (THAs). Whether these alternative bearing surfaces result in increased longevity is subject to debate.Patients and methods Using the Dutch Arthroplasty Register (LROI), we identified all patients with a primary, non-metal-on-metal THA implanted in the Netherlands in the period 2007-2016 (n = 209,912). Cumulative incidence of revision was calculated to determine differences in survivorship of T... Mehr ...

Verfasser: Peters, Rinne M.
Van Steenbergen, Liza N.
Stevens, Martin
Rijk, Paul C.
Bulstra, Sjoerd K.
Zijlstra, Wierd P.
Dokumenttyp: Artikel
Erscheinungsdatum: 2018
Reihe/Periodikum: Peters , R M , Van Steenbergen , L N , Stevens , M , Rijk , P C , Bulstra , S K & Zijlstra , W P 2018 , ' The effect of bearing type on the outcome of total hip arthroplasty : Analysis of 209,912 primary total hip arthroplasties registered in the Dutch Arthroplasty Register ' , Acta Orthopaedica , vol. 89 , no. 2 , pp. 163-169 . https://doi.org/10.1080/17453674.2017.1405669
Schlagwörter: NETWORK METAANALYSIS / COMPETING RISKS / POLYETHYLENE / REVISION / SURVIVORSHIP / REPLACEMENT / SURFACES
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29028798
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://hdl.handle.net/11370/c29ec7be-2eef-4a7c-9145-186c52df391e

Background and purpose Alternative bearing surfaces such as ceramics and highly crosslinked polyethylene (HXLPE) were developed in order to further improve implant performance of total hip arthroplasties (THAs). Whether these alternative bearing surfaces result in increased longevity is subject to debate.Patients and methods Using the Dutch Arthroplasty Register (LROI), we identified all patients with a primary, non-metal-on-metal THA implanted in the Netherlands in the period 2007-2016 (n = 209,912). Cumulative incidence of revision was calculated to determine differences in survivorship of THAs according to bearing type: metal-on-polyethylene (MoPE), metal-on-HXLPE (MoHXLPE), ceramic-on-polyethylene (CoPE), ceramic-on-HXLPE (CoHXLPE), ceramic-on-ceramic (CoC), and oxidized-zirconium-on-(HXL)polyethylene (Ox(HXL)PE). Multivariable Cox proportional hazard regression ratios (HRs) were used for comparisons.Results After adjustment for confounders, CoHXLPE, CoC, and Ox(HXL)PE resulted in a statistically significantly lower risk of revision compared with MoPE after 9 years follow-up (HR =0.8-0.9 respectively, compared with HR =1.0). For small (22-28mm) femoral head THAs, lower revision rates were found for CoPE and CoHXLPE (HR =0.9). In the 36mm femoral head subgroup, CoC-bearing THAs had a lower HR compared with MoHXLPE (HR =0.7 versus 1.0). Crude revision rates in young patients (<60 years) for CoHXLPE, CoC, and Ox(HXL)PE (HR =0.7) were lower than MoPE (HR =1.0). However, after adjustment for case mix and confounders these differences were not statistically significant.Interpretation We found a mid-term lower risk of revision for CoHXLPE, CoC, and Ox(HXL)PE bearings compared with traditional MoPE-bearing surfaces.