Does hydroxyapatite coating of uncemented cups improve long-term survival? An analysis of 28,605 primary total hip arthroplasty procedures from the Nordic Arthroplasty Register Association (NARA)
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Does hydroxyapatite coating of uncemented cups improve long-term survival? An analysis of 28,605 primary total hip arthroplasty procedures from the Nordic Arthroplasty Register Association (NARA). / Lazarinis, Stergios; Mäkelä, Keijo T; Eskelinen, Antti; Havelin, Leif; Hallan, Geir; Overgaard, Søren; Pedersen, Alma Becic; Kärrholm, Johan; Hailer, Nils P.
I: Osteoarthritis and Cartilage, Bind 25, Nr. 12, 12.2017, s. 1980-1987.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Does hydroxyapatite coating of uncemented cups improve long-term survival?
T2 - An analysis of 28,605 primary total hip arthroplasty procedures from the Nordic Arthroplasty Register Association (NARA)
AU - Lazarinis, Stergios
AU - Mäkelä, Keijo T
AU - Eskelinen, Antti
AU - Havelin, Leif
AU - Hallan, Geir
AU - Overgaard, Søren
AU - Pedersen, Alma Becic
AU - Kärrholm, Johan
AU - Hailer, Nils P
N1 - Copyright © 2017. Published by Elsevier Ltd.
PY - 2017/12
Y1 - 2017/12
N2 - Objective It is unclear whether hydroxyapatite (HA) coating of uncemented cups used in primary total hip arthroplasty (THA) improves bone ingrowth and reduces the risk of aseptic loosening. We therefore investigated survival of different uncemented cups that were available with or without HA coating. Method We investigated three different cup types used with or without HA coating registered in the Nordic Arthroplasty Register Association (NARA) database that were inserted due to osteoarthritis (n = 28,605). Cumulative survival rates and adjusted hazard ratios (HRs) for the risk of revision were calculated. Results Unadjusted 13-year survival for cup revision due to aseptic loosening was 97.9% (CI: 96.5–99.4) for uncoated and 97.8% (CI: 96.3–99.4) for HA-coated cups. Adjusted HRs were 0.66 (CI 0.42–1.04) for the presence of HA coating during the first 10 years and 0.87 (CI 0.14–5.38) from year 10–13, compared with uncoated cups. When considering the endpoint cup revision for any reason, unadjusted 13-year survival was similar for uncoated (92.5% [CI: 90.1–94.9]) and HA-coated (94.7% [CI: 93.2–96.3]) cups. The risk of revision of any component due to infection was higher in THA with HA-coated cups than in THA with uncoated cups (adjusted HR 1.4 [CI 1.1–1.9]). Conclusions HA-coated cups have a similar risk of aseptic loosening as uncoated cups, thus the use of HA coating seems to not confer any added value in terms of implant stability. The risk of infection seemed higher in THA with use of HA-coated cups, an observation that must be investigated further.
AB - Objective It is unclear whether hydroxyapatite (HA) coating of uncemented cups used in primary total hip arthroplasty (THA) improves bone ingrowth and reduces the risk of aseptic loosening. We therefore investigated survival of different uncemented cups that were available with or without HA coating. Method We investigated three different cup types used with or without HA coating registered in the Nordic Arthroplasty Register Association (NARA) database that were inserted due to osteoarthritis (n = 28,605). Cumulative survival rates and adjusted hazard ratios (HRs) for the risk of revision were calculated. Results Unadjusted 13-year survival for cup revision due to aseptic loosening was 97.9% (CI: 96.5–99.4) for uncoated and 97.8% (CI: 96.3–99.4) for HA-coated cups. Adjusted HRs were 0.66 (CI 0.42–1.04) for the presence of HA coating during the first 10 years and 0.87 (CI 0.14–5.38) from year 10–13, compared with uncoated cups. When considering the endpoint cup revision for any reason, unadjusted 13-year survival was similar for uncoated (92.5% [CI: 90.1–94.9]) and HA-coated (94.7% [CI: 93.2–96.3]) cups. The risk of revision of any component due to infection was higher in THA with HA-coated cups than in THA with uncoated cups (adjusted HR 1.4 [CI 1.1–1.9]). Conclusions HA-coated cups have a similar risk of aseptic loosening as uncoated cups, thus the use of HA coating seems to not confer any added value in terms of implant stability. The risk of infection seemed higher in THA with use of HA-coated cups, an observation that must be investigated further.
U2 - 10.1016/j.joca.2017.08.001
DO - 10.1016/j.joca.2017.08.001
M3 - Journal article
C2 - 28802851
VL - 25
SP - 1980
EP - 1987
JO - Osteoarthritis and Cartilage
JF - Osteoarthritis and Cartilage
SN - 1063-4584
IS - 12
ER -
ID: 252058885