Increased risk of revision of cementless stemmed total hip arthroplasty with metal-on-metal bearings: Data from the Nordic Arthroplasty Register Association
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Increased risk of revision of cementless stemmed total hip arthroplasty with metal-on-metal bearings : Data from the Nordic Arthroplasty Register Association. / Varnum, Claus; Pedersen, Alma; Mäkelä, Keijo; Eskelinen, Antti; Havelin, Leif I; Furnes, Ove; Kärrholm, Johan; Garellick, Göran; Overgaard, Søren.
In: Acta Orthopaedica (Print Edition), Vol. 86, No. 4, 01.08.2015, p. 491-497.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Increased risk of revision of cementless stemmed total hip arthroplasty with metal-on-metal bearings
T2 - Data from the Nordic Arthroplasty Register Association
AU - Varnum, Claus
AU - Pedersen, Alma
AU - Mäkelä, Keijo
AU - Eskelinen, Antti
AU - Havelin, Leif I
AU - Furnes, Ove
AU - Kärrholm, Johan
AU - Garellick, Göran
AU - Overgaard, Søren
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Background and purpose-Data from the national joint registries in Australia and England and Wales have revealed inferior medium-term survivorship for metal-on-metal (MoM) total hip arthroplasty (THA) than for metal-on-polyethylene (MoP) THA. Based on data from the Nordic Arthroplasty Register Association (NARA), we compared the revision risk of cementless stemmed THA with MoM and MoP bearings and we also compared MoM THA to each other.Patients and methods-We identified 32,678 patients who were operated from 2002 through 2010 with cementless stemmed THA with either MoM bearings (11,567 patients, 35%) or MoP bearings (21,111 patients, 65%). The patients were followed until revision, death, emigration, or the end of the study period (December 31, 2011), and median follow-up was 3.6 (interquartile range (IQR): 2.4-4.8) years for MoM bearings and 3.4 (IQR: 2.0-5.8) years for MoP bearings. Multivariable regression in the presence of competing risk of death was used to assess the relative risk (RR) of revision for any reason (with 95% confidence interval (CI)).Results-The cumulative incidence of revision at 8 years of follow-up was 7.0% (CI: 6.0-8.1) for MoM bearings and 5.1% (CI: 4.7-5.6) for MoP bearings. At 6 years of follow-up, the RR of revision for any reason was 1.5 (CI: 1.3-1.7) for MoM bearings compared to MoP bearings. The RR of revision for any reason was higher for the ASR (adjusted RR = 6.4, CI: 5.0-8.1), the Conserve Plus (adjusted RR = 1.7, CI: 1.1-2.5) and "other" acetabular components (adjusted RR = 2.4, CI: 1.5-3.9) than for MoP THA at 6 years of follow-up.Interpretation-At medium-term follow-up, the survivorship for cementless stemmed MoM THA was inferior to that for MoP THA, and metal-related problems may cause higher revision rates for MoM bearings with longer follow-up.
AB - Background and purpose-Data from the national joint registries in Australia and England and Wales have revealed inferior medium-term survivorship for metal-on-metal (MoM) total hip arthroplasty (THA) than for metal-on-polyethylene (MoP) THA. Based on data from the Nordic Arthroplasty Register Association (NARA), we compared the revision risk of cementless stemmed THA with MoM and MoP bearings and we also compared MoM THA to each other.Patients and methods-We identified 32,678 patients who were operated from 2002 through 2010 with cementless stemmed THA with either MoM bearings (11,567 patients, 35%) or MoP bearings (21,111 patients, 65%). The patients were followed until revision, death, emigration, or the end of the study period (December 31, 2011), and median follow-up was 3.6 (interquartile range (IQR): 2.4-4.8) years for MoM bearings and 3.4 (IQR: 2.0-5.8) years for MoP bearings. Multivariable regression in the presence of competing risk of death was used to assess the relative risk (RR) of revision for any reason (with 95% confidence interval (CI)).Results-The cumulative incidence of revision at 8 years of follow-up was 7.0% (CI: 6.0-8.1) for MoM bearings and 5.1% (CI: 4.7-5.6) for MoP bearings. At 6 years of follow-up, the RR of revision for any reason was 1.5 (CI: 1.3-1.7) for MoM bearings compared to MoP bearings. The RR of revision for any reason was higher for the ASR (adjusted RR = 6.4, CI: 5.0-8.1), the Conserve Plus (adjusted RR = 1.7, CI: 1.1-2.5) and "other" acetabular components (adjusted RR = 2.4, CI: 1.5-3.9) than for MoP THA at 6 years of follow-up.Interpretation-At medium-term follow-up, the survivorship for cementless stemmed MoM THA was inferior to that for MoP THA, and metal-related problems may cause higher revision rates for MoM bearings with longer follow-up.
U2 - 10.3109/17453674.2015.1023132
DO - 10.3109/17453674.2015.1023132
M3 - Journal article
C2 - 25715878
VL - 86
SP - 491
EP - 497
JO - Acta Orthopaedica
JF - Acta Orthopaedica
SN - 1745-3674
IS - 4
ER -
ID: 252057150