Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry

Aksel Paulsen, Alma B Pedersen, Søren P Johnsen, Anders Riis, Ulf Lucht, Søren Overgaard

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip Arthroplasty Registry (DHR), we identified patients less than 70 years old who had undergone uncemented primary THA during 1997-2005. 4,125 HA-coated and 7,737 non-HA-coated cups and 3,158 HA-coated and 4,749 non-HA-coated stems were available for analysis. The mean follow-up time was 3.4 years for cups and 3.2 years for stems. We estimated the relative risk (RR) of revision due to aseptic loosening or any cause, and adjusted for possible confounders (age, sex, fixation of opposite implant part, and diagnosis for primary THA) using multivariate Cox regression analysis. RESULTS: The adjusted RRs for revision of HA-coated cups and stems due to aseptic loosening were 0.89 (95%CI: 0.37-2.2) and 0.71 (95%CI: 0.27-1.9) with up to 9 years of follow-up, compared to non-HA-coated implants. When taking all causes of revision into consideration, the risk estimates were 0.85 (95%CI: 0.68-1.1) and 0.81 (95%CI: 0.61-1.1) for HA-coated cups and stems, respectively. INTERPRETATION: In this medium-term follow-up study, the use of HA-coated implants was not associated with any clearly reduced overall risk of revision compared to non-HA-coated implants.
Original languageEnglish
JournalActa Orthopaedica (Print Edition)
Volume78
Issue number5
Pages (from-to)622-628
Number of pages6
ISSN1745-3674
DOIs
Publication statusPublished - 1. Oct 2007

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Durapatite
Registries
Hip
Regression Analysis

Keywords

  • Adult
  • Age Factors
  • Arthroplasty, Replacement, Hip
  • Coated Materials, Biocompatible
  • Denmark
  • Female
  • Follow-Up Studies
  • Hip Prosthesis
  • Humans
  • Hydroxyapatites
  • Male
  • Middle Aged
  • Outcome Assessment (Health Care)
  • Prosthesis Design
  • Prosthesis Failure
  • Registries
  • Reoperation
  • Risk Factors

Cite this

@article{ef6e3f70cda511dc8674000ea68e967b,
title = "Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry",
abstract = "BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip Arthroplasty Registry (DHR), we identified patients less than 70 years old who had undergone uncemented primary THA during 1997-2005. 4,125 HA-coated and 7,737 non-HA-coated cups and 3,158 HA-coated and 4,749 non-HA-coated stems were available for analysis. The mean follow-up time was 3.4 years for cups and 3.2 years for stems. We estimated the relative risk (RR) of revision due to aseptic loosening or any cause, and adjusted for possible confounders (age, sex, fixation of opposite implant part, and diagnosis for primary THA) using multivariate Cox regression analysis. RESULTS: The adjusted RRs for revision of HA-coated cups and stems due to aseptic loosening were 0.89 (95{\%}CI: 0.37-2.2) and 0.71 (95{\%}CI: 0.27-1.9) with up to 9 years of follow-up, compared to non-HA-coated implants. When taking all causes of revision into consideration, the risk estimates were 0.85 (95{\%}CI: 0.68-1.1) and 0.81 (95{\%}CI: 0.61-1.1) for HA-coated cups and stems, respectively. INTERPRETATION: In this medium-term follow-up study, the use of HA-coated implants was not associated with any clearly reduced overall risk of revision compared to non-HA-coated implants.",
keywords = "Adult, Age Factors, Arthroplasty, Replacement, Hip, Coated Materials, Biocompatible, Denmark, Female, Follow-Up Studies, Hip Prosthesis, Humans, Hydroxyapatites, Male, Middle Aged, Outcome Assessment (Health Care), Prosthesis Design, Prosthesis Failure, Registries, Reoperation, Risk Factors",
author = "Aksel Paulsen and Pedersen, {Alma B} and Johnsen, {S{\o}ren P} and Anders Riis and Ulf Lucht and S{\o}ren Overgaard",
year = "2007",
month = "10",
day = "1",
doi = "10.1080/17453670710014310",
language = "English",
volume = "78",
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journal = "Acta Orthopaedica (Print Edition)",
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Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry. / Paulsen, Aksel; Pedersen, Alma B; Johnsen, Søren P; Riis, Anders; Lucht, Ulf; Overgaard, Søren.

In: Acta Orthopaedica (Print Edition), Vol. 78, No. 5, 01.10.2007, p. 622-628.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry

AU - Paulsen, Aksel

AU - Pedersen, Alma B

AU - Johnsen, Søren P

AU - Riis, Anders

AU - Lucht, Ulf

AU - Overgaard, Søren

PY - 2007/10/1

Y1 - 2007/10/1

N2 - BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip Arthroplasty Registry (DHR), we identified patients less than 70 years old who had undergone uncemented primary THA during 1997-2005. 4,125 HA-coated and 7,737 non-HA-coated cups and 3,158 HA-coated and 4,749 non-HA-coated stems were available for analysis. The mean follow-up time was 3.4 years for cups and 3.2 years for stems. We estimated the relative risk (RR) of revision due to aseptic loosening or any cause, and adjusted for possible confounders (age, sex, fixation of opposite implant part, and diagnosis for primary THA) using multivariate Cox regression analysis. RESULTS: The adjusted RRs for revision of HA-coated cups and stems due to aseptic loosening were 0.89 (95%CI: 0.37-2.2) and 0.71 (95%CI: 0.27-1.9) with up to 9 years of follow-up, compared to non-HA-coated implants. When taking all causes of revision into consideration, the risk estimates were 0.85 (95%CI: 0.68-1.1) and 0.81 (95%CI: 0.61-1.1) for HA-coated cups and stems, respectively. INTERPRETATION: In this medium-term follow-up study, the use of HA-coated implants was not associated with any clearly reduced overall risk of revision compared to non-HA-coated implants.

AB - BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip Arthroplasty Registry (DHR), we identified patients less than 70 years old who had undergone uncemented primary THA during 1997-2005. 4,125 HA-coated and 7,737 non-HA-coated cups and 3,158 HA-coated and 4,749 non-HA-coated stems were available for analysis. The mean follow-up time was 3.4 years for cups and 3.2 years for stems. We estimated the relative risk (RR) of revision due to aseptic loosening or any cause, and adjusted for possible confounders (age, sex, fixation of opposite implant part, and diagnosis for primary THA) using multivariate Cox regression analysis. RESULTS: The adjusted RRs for revision of HA-coated cups and stems due to aseptic loosening were 0.89 (95%CI: 0.37-2.2) and 0.71 (95%CI: 0.27-1.9) with up to 9 years of follow-up, compared to non-HA-coated implants. When taking all causes of revision into consideration, the risk estimates were 0.85 (95%CI: 0.68-1.1) and 0.81 (95%CI: 0.61-1.1) for HA-coated cups and stems, respectively. INTERPRETATION: In this medium-term follow-up study, the use of HA-coated implants was not associated with any clearly reduced overall risk of revision compared to non-HA-coated implants.

KW - Adult

KW - Age Factors

KW - Arthroplasty, Replacement, Hip

KW - Coated Materials, Biocompatible

KW - Denmark

KW - Female

KW - Follow-Up Studies

KW - Hip Prosthesis

KW - Humans

KW - Hydroxyapatites

KW - Male

KW - Middle Aged

KW - Outcome Assessment (Health Care)

KW - Prosthesis Design

KW - Prosthesis Failure

KW - Registries

KW - Reoperation

KW - Risk Factors

U2 - 10.1080/17453670710014310

DO - 10.1080/17453670710014310

M3 - Journal article

VL - 78

SP - 622

EP - 628

JO - Acta Orthopaedica (Print Edition)

JF - Acta Orthopaedica (Print Edition)

SN - 1745-3674

IS - 5

ER -