Matharu, GS, Judge, A, Murray, DW et al. (1 more author) (2018) Trabecular metal acetabular components reduce the risk of revision following primary total hip arthroplasty: A propensity score matched study from the National Joint Registry for England and Wales. Journal of Arthroplasty, 33 (2). pp. 447-452. ISSN 0883-5403
Abstract
Background: Trabecular metal (TM)-coated acetabular components are increasingly used in both primary and revision total hip arthroplasty (THA). However, previous studies assessing TM acetabular components have been small single-center cohorts with most lacking a control group. We compared revision rates following primary THA between TM and non-TM-coated acetabular components.
Methods: A retrospective observational study was performed using National Joint Registry data, which included primary THAs with the same cementless acetabular component (either TM or non-TM coated). TM and non-TM implants were matched for multiple potential confounding factors using propensity scores. Outcomes following primary THA (revision for all-cause acetabular indications, aseptic acetabular loosening, and infection) were compared between matched groups using competing risk regression analysis.
Results: In 18,200 primary THAs (9100 TM and 9100 non-TM), the overall prevalence of acetabular revision, revision for aseptic acetabular loosening, and septic revision was 1.2%, 0.13%, and 0.59% respectively. Five-year revision rates for all-causes (1.0% vs 1.8%, sub-hazard ratio [SHR] 0.57, 95% confidence interval [CI] 0.43-0.76, P < .001), aseptic acetabular loosening (0.1% vs 0.2%, SHR 0.35, 95% CI 0.14-0.90, P = .029), and infection (0.5% vs 0.9%, SHR 0.51, 95% CI 0.34-0.76, P = .001) were all lower in TM compared with non-TM implants.
Conclusion: Following primary THA, TM-coated acetabular implants had a reduced risk of both aseptic and septic revision compared with non-TM implants. Although absolute differences in revision risk were small, they may be clinically significant if TM designs were implanted in more complex cases.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2017, Elsevier Inc. All rights reserved. This is an author produced version of a paper published in The Journal of Arthroplasty. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | primary total hip arthroplasty; revision surgery; trabecular metal; aseptic loosening; infection |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Orthopaedics (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 01 Sep 2017 13:47 |
Last Modified: | 05 Sep 2018 00:38 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.arth.2017.08.036 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:120724 |