Does choice of bearings influence the survival of cement-less total hip arthroplasty in patients aged 20–55 years? Comparison of 21,594 patients reported to the Nordic Arthroplasty Register Association dataset 2005–2017

Rasmus Tyrsted Mikkelsen, Søren Overgaard, Alma B. Pedersen, Johan Kärrholm, Ola Rolfson, Anne Marie Fenstad, Ove Furnes, Geir Hallan, Keijo Mäkelä, Antti Eskelinen, Claus Varnum

Tutkimustuotos: ArtikkeliScientificvertaisarvioitu

3 Lataukset (Pure)

Abstrakti

Background and purpose — The bearings with the best survivorship for young patients with total hip arthroplasty (THA) should be identified. We compared hazard ratios (HR) of revision of primary stemmed cementless THAs with metal-on-metal (MoM), ceramic-on-ceramic (CoC), and ceramic-on-highly-crosslinked-polyethylene (CoXLP) with that of metal-on-highly-crosslinked-polyethylene (MoXLP) bearings in patients aged 20–55 years with primary osteoar-thritis or childhood hip disorders. Patients and methods — From the Nordic Arthroplasty Register Association dataset we included 1,813 MoM, 3,615 CoC, 5,947 CoXLP, and 10,219 MoXLP THA in patients operated on between 2005 and 2017 in a prospective cohort study. We used the Kaplan–Meier estimator for THA sur-vivorship and Cox regression to estimate HR of revision adjusted for confounders (including 95% confidence intervals [CI]). MoXLP was used as reference. HRs were calcu-lated during 3 intervals (0–2, 2–7, and 7–13 years) to meet the assumption of proportional hazards. Results — Median follow-up was 5 years for MoXLP, 10 years for MoM, 6 years for CoC, and 4 years for CoXLP. 13-year Kaplan–Meier survival estimates were 95% (CI 94–95) for MoXLP, 82% (CI 80–84) for MoM, 93% (CI 92–95) for CoC, and 93% (CI 92–94) for CoXLP bearings. MoM had higher 2–7 and 7–13 years’ adjusted HRs of revi-sion (3.6, CI 2.3–5.7 and 4.1, CI 1.7–10). MoXLP, CoC, and CoXLP had similar HRs in all 3 periods. The 7–13-year adjusted HRs of revision of CoC and CoXLP were statisti-cally non-significantly higher. Conclusion — In young patients, MoXLP for primary cementless THA had higher revision-free survival and lower HR for revision than MoM bearings. Longer follow-up is needed to compare MoXLP, CoC, and CoXLP.

AlkuperäiskieliEnglanti
Sivut266-273
Sivumäärä8
JulkaisuActa orthopaedica
Vuosikerta94
DOI - pysyväislinkit
TilaJulkaistu - 2023
OKM-julkaisutyyppiA1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä

Julkaisufoorumi-taso

  • Jufo-taso 1

!!ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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