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Hip resurfacing arthroplasty: short-term survivorship of 4,401 hips from the Finnish Arthroplasty Register.

Seppänen M, Mäkelä K, Virolainen P, Remes V, Pulkkinen P, Eskelinen A - Acta Orthop (2012)

Bottom Line: We found that HRA had comparable short-term survivorship to THA at a nationwide level.Low hospital procedure volume worsened the outcome of HRA.Female patients had twice the revision risk of male patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland.

ABSTRACT

Background and purpose: Population-based registry data from the Nordic Arthroplasty Register Association (NARA) and from the National Joint Register of England and Wales have revealed that the outcome after hip resurfacing arthroplasty (HRA) is inferior to that of conventional total hip arthroplasty (THA). We analyzed the short-term survival of 4,401 HRAs in the Finnish Arthroplasty Register.

Methods: We compared the revision risk of the 4,401 HRAs from the Register to that of 48,409 THAs performed during the same time period. The median follow-up time was 3.5 (0-9) years for HRAs and 3.9 (0-9) years for THAs.

Results: There was no statistically significant difference in revision risk between HRAs and THAs (RR = 0.93, 95% CI: 0.78-1.10). Female patients had about double the revision risk of male patients (RR = 2.0, CI: 1.4-2.7). Hospitals that had performed 100 or more HRA procedures had a lower revision risk than those with less than 100 HRAs (RR = 0.6, CI: 0.4-0.9). Articular Surface Replacement (ASR, DePuy) had inferior outcome with higher revision risk than the Birmingham Hip Resurfacing implant (BHR, Smith & Nephew), the reference implant (RR = 1.8, CI: 1.2-2.7).

Interpretation: We found that HRA had comparable short-term survivorship to THA at a nationwide level. Implant design had an influence on revision rates. ASR had higher revision risk. Low hospital procedure volume worsened the outcome of HRA. Female patients had twice the revision risk of male patients.

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Related in: MedlinePlus

Cox-adjusted survival curves for 6 HRA designs (1,856 BHR, 995 ASR, 657 ReCap, 469 Conserve Plus, 333 Durom, and 91 Corin) and 18,843 cemented THAs. The endpoint was defined as revision for any reason. Adjustment was made for age at surgery, sex, operated side, and diagnosis.
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Figure 2: Cox-adjusted survival curves for 6 HRA designs (1,856 BHR, 995 ASR, 657 ReCap, 469 Conserve Plus, 333 Durom, and 91 Corin) and 18,843 cemented THAs. The endpoint was defined as revision for any reason. Adjustment was made for age at surgery, sex, operated side, and diagnosis.

Mentions: The mean overall follow-up for HRA designs and THAs is presented in Table 4. In Figure 2, the Cox-adjusted survival of HRA designs is compared to that of the cemented THA. Female patients had about twice the revision risk of male patients (RR = 1.98, CI: 1.44–2.71; p < 0.001) (Table 6). In repeated analysis also including the femoral head diameter, gender still had a statistically significant influence on revision rate. However, the femoral head diameter did not influence the revision rate (Table 7). Hospitals that had performed 100 or more HRA procedures had a lower revision risk than those with less than 100 HRAs (RR = 0.61, CI: 0.41–0.88; p = 0.009) (Table 6).


Hip resurfacing arthroplasty: short-term survivorship of 4,401 hips from the Finnish Arthroplasty Register.

Seppänen M, Mäkelä K, Virolainen P, Remes V, Pulkkinen P, Eskelinen A - Acta Orthop (2012)

Cox-adjusted survival curves for 6 HRA designs (1,856 BHR, 995 ASR, 657 ReCap, 469 Conserve Plus, 333 Durom, and 91 Corin) and 18,843 cemented THAs. The endpoint was defined as revision for any reason. Adjustment was made for age at surgery, sex, operated side, and diagnosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369143&req=5

Figure 2: Cox-adjusted survival curves for 6 HRA designs (1,856 BHR, 995 ASR, 657 ReCap, 469 Conserve Plus, 333 Durom, and 91 Corin) and 18,843 cemented THAs. The endpoint was defined as revision for any reason. Adjustment was made for age at surgery, sex, operated side, and diagnosis.
Mentions: The mean overall follow-up for HRA designs and THAs is presented in Table 4. In Figure 2, the Cox-adjusted survival of HRA designs is compared to that of the cemented THA. Female patients had about twice the revision risk of male patients (RR = 1.98, CI: 1.44–2.71; p < 0.001) (Table 6). In repeated analysis also including the femoral head diameter, gender still had a statistically significant influence on revision rate. However, the femoral head diameter did not influence the revision rate (Table 7). Hospitals that had performed 100 or more HRA procedures had a lower revision risk than those with less than 100 HRAs (RR = 0.61, CI: 0.41–0.88; p = 0.009) (Table 6).

Bottom Line: We found that HRA had comparable short-term survivorship to THA at a nationwide level.Low hospital procedure volume worsened the outcome of HRA.Female patients had twice the revision risk of male patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland.

ABSTRACT

Background and purpose: Population-based registry data from the Nordic Arthroplasty Register Association (NARA) and from the National Joint Register of England and Wales have revealed that the outcome after hip resurfacing arthroplasty (HRA) is inferior to that of conventional total hip arthroplasty (THA). We analyzed the short-term survival of 4,401 HRAs in the Finnish Arthroplasty Register.

Methods: We compared the revision risk of the 4,401 HRAs from the Register to that of 48,409 THAs performed during the same time period. The median follow-up time was 3.5 (0-9) years for HRAs and 3.9 (0-9) years for THAs.

Results: There was no statistically significant difference in revision risk between HRAs and THAs (RR = 0.93, 95% CI: 0.78-1.10). Female patients had about double the revision risk of male patients (RR = 2.0, CI: 1.4-2.7). Hospitals that had performed 100 or more HRA procedures had a lower revision risk than those with less than 100 HRAs (RR = 0.6, CI: 0.4-0.9). Articular Surface Replacement (ASR, DePuy) had inferior outcome with higher revision risk than the Birmingham Hip Resurfacing implant (BHR, Smith & Nephew), the reference implant (RR = 1.8, CI: 1.2-2.7).

Interpretation: We found that HRA had comparable short-term survivorship to THA at a nationwide level. Implant design had an influence on revision rates. ASR had higher revision risk. Low hospital procedure volume worsened the outcome of HRA. Female patients had twice the revision risk of male patients.

Show MeSH
Related in: MedlinePlus