Association between fixation technique and revision risk in total hip arthroplasty patients younger than 55 years of age. Results from the Nordic Arthroplasty Register Association

A. B. Pedersen, F. Mehnert, L. I. Havelin, O. Furnes, P. Herberts, J. Karrholm, G. Garellick, K. Makela, A. Eskelinen, Søren Overgaard

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Objectives: To evaluate implant survival following primary total hip replacement (THR) in younger patients. To describe the diversity in use of cup-stem implant combinations. Design: 29,558 primary THRs osteoarthritis (OA) patients younger than 55 years of age performed from 1995 through 2011 were identified using the Nordic Arthroplasty Registry Association database. We estimated adjusted relative risk (aRR) of revision with 95% confidence interval (CI) using Cox regression. Results: In general, no difference was observed between uncemented and cemented implants in terms of risk of any revision. Hybrid implants were associated with higher risk of any revision (aRR = 1.3, CI: 1.1 -1.5). Uncemented implants led to a reduced risk of revision due to aseptic loosening (aRR = 0.5, CI: 0.5 -0.6), whereas the risk was similar for hybrid and cemented implants. Compared with cemented implants, both uncemented and hybrid implants led to elevated risk of revision due to other causes, as well as elevated risk of revision due to any reason within 2 years. 183 different uncemented cup-stem implant combinations were registered in Denmark, of these, 172 were used in less than 100 operations which is similar to Norway, Sweden and Finland. Conclusions: Uncemented implants perform better in relation to long-term risk of aseptic loosening, whereas both uncemented and hybrid rather than cemented implants in patients younger than 55 years had more short-term revisions because problems due to dislocation, periprosthetic fracture and infection has not yet been completely solved. The vast majority of cup-stem combinations were used in very few operations. (C) 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
TidsskriftOsteoarthritis and Cartilage
Udgave nummer5
Sider (fra-til)659-667
StatusUdgivet - 2014

Bibliografisk note

ISI Document Delivery No.: AI8XK Times Cited: 2 Cited Reference Count: 49 Pedersen, A. B. Mehnert, F. Havelin, L. I. Furnes, O. Herberts, P. Karrholm, J. Garellick, G. Makela, K. Eskelinen, A. Overgaard, S. Department of Clinical Epidemiology's Research Foundation No conflicts of interest. The study was supported by the Department of Clinical Epidemiology's Research Foundation. 2 ELSEVIER SCI LTD OXFORD OSTEOARTHR CARTILAGE