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...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2018-03-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.1080/17453674.2017.1405669 |
| _version_ | 1828749362350522368 |
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| author | Rinne M Peters Liza N Van Steenbergen Martin Stevens Paul C Rijk Sjoerd K Bulstra Wierd P Zijlstra |
| author_facet | Rinne M Peters Liza N Van Steenbergen Martin Stevens Paul C Rijk Sjoerd K Bulstra Wierd P Zijlstra |
| author_sort | Rinne M Peters |
| collection | DOAJ |
| description | 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 (22–28 mm) femoral head THAs, lower revision rates were found for CoPE and CoHXLPE (HR =0.9). In the 36 mm 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. |
| first_indexed | 2024-12-10T20:20:42Z |
| format | Article |
| id | doaj.art-de1b99260f9341c785e1df91da288b7c |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-12-10T20:20:42Z |
| publishDate | 2018-03-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-de1b99260f9341c785e1df91da288b7c2022-12-22T01:35:03ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822018-03-0189216316910.1080/17453674.2017.14056691405669The effect of bearing type on the outcome of total hip arthroplasty: Analysis of 209,912 primary total hip arthroplasties registered in the Dutch Arthroplasty RegisterRinne M Peters0Liza N Van Steenbergen1Martin Stevens2Paul C Rijk3Sjoerd K Bulstra4Wierd P Zijlstra5Medical Center LeeuwardenDutch Arthroplasty Register (Landelijke Registratie Orthopedische Implantaten)University of Groningen, University Medical Center GroningenMedical Center LeeuwardenUniversity of Groningen, University Medical Center GroningenMedical Center LeeuwardenBackground 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 (22–28 mm) femoral head THAs, lower revision rates were found for CoPE and CoHXLPE (HR =0.9). In the 36 mm 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.http://dx.doi.org/10.1080/17453674.2017.1405669 |
| spellingShingle | Rinne M Peters Liza N Van Steenbergen Martin Stevens Paul C Rijk Sjoerd K Bulstra Wierd P Zijlstra 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 |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | http://dx.doi.org/10.1080/17453674.2017.1405669 |
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