Tags

Type your tag names separated by a space and hit enter

18 years of results with cemented primary hip prostheses in the Norwegian Arthroplasty Register: concerns about some newer implants.
Acta Orthop 2009; 80(4):402-12AO

Abstract

BACKGROUND AND PURPOSE

Few studies have compared the long-term survival of cemented primary total hip arthroplasties (THAs), and several prostheses have been used without adequate knowledge of their endurance. We studied long-term outcome based on data in the Norwegian Arthroplasty Register.

PATIENTS AND METHODS

The 10 most used prosthesis brands in 62,305 primary Palacos or Simplex cemented THAs reported to the Register from 1987 through 2007 were included. Survival analyses with revision as endpoint (for any cause or for aseptic loosening) were performed using Kaplan-Meier and multiple Cox regression with time-dependent covariates. Revision rate ratios (RRs) were estimated for the follow-up intervals: 0-5, 6-10, and > 10 years.

RESULTS

5 prosthesis brands (cup/stem combinations) (Charnley, Exeter, Titan, Spectron/ITH, Link IP/Lubinus SP; n = 24,728) were investigated with 0-20 year follow-up (inserted 1987-1997). After 18 years, 11% (95% CI: 10.6-12.1) were revised for any cause and 8.4% (7.7-9.1) for aseptic loosening. Beyond 10 years of follow-up, the Charnley cup had a lower revision rate due to aseptic loosening than Exeter (RR = 1.8) and Spectron (RR = 2.4) cups. For stems, beyond 10 years we did not find statistically significant differences comparing Charnley with Titan, ITH, and SP stems, but the Exeter stem had better results (RR = 05). 10 prosthesis brands (9 cups in combination with 6 stems; n = 37,577) were investigated with 0-10 years of follow-up (inserted from 1998 through 2007). The Charnley cup had a lower revision rate due to aseptic loosening than all cups except the IP. Beyond 5 years follow-up, the Reflection All-Poly cup had a 14 times higher revision rate. For stems, beyond 5 years the Spectron-EF (RR = 6.1) and Titan (RR = 5.5) stems had higher revision rates due to aseptic loosening than Charnley. The analyses also showed a marked improvement in Charnley results between the periods 1987-1997 and 1998-2007.

INTERPRETATION

We observed clinically important differences between cemented prosthesis brands and identified inferior results for previously largely undocumented prostheses, including the commonly used prosthesis combination Reflection All-Poly/ Spectron-EF. The results were, however, satisfactory according to international standards.

Authors+Show Affiliations

The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway. birgitte.espehaug@helse-bergen.noNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19857178

Citation

Espehaug, Birgitte, et al. "18 Years of Results With Cemented Primary Hip Prostheses in the Norwegian Arthroplasty Register: Concerns About some Newer Implants." Acta Orthopaedica, vol. 80, no. 4, 2009, pp. 402-12.
Espehaug B, Furnes O, Engesaeter LB, et al. 18 years of results with cemented primary hip prostheses in the Norwegian Arthroplasty Register: concerns about some newer implants. Acta Orthop. 2009;80(4):402-12.
Espehaug, B., Furnes, O., Engesaeter, L. B., & Havelin, L. I. (2009). 18 years of results with cemented primary hip prostheses in the Norwegian Arthroplasty Register: concerns about some newer implants. Acta Orthopaedica, 80(4), pp. 402-12. doi:10.3109/17453670903161124.
Espehaug B, et al. 18 Years of Results With Cemented Primary Hip Prostheses in the Norwegian Arthroplasty Register: Concerns About some Newer Implants. Acta Orthop. 2009;80(4):402-12. PubMed PMID: 19857178.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 18 years of results with cemented primary hip prostheses in the Norwegian Arthroplasty Register: concerns about some newer implants. AU - Espehaug,Birgitte, AU - Furnes,Ove, AU - Engesaeter,Lars B, AU - Havelin,Leif I, PY - 2009/10/28/entrez PY - 2009/10/28/pubmed PY - 2010/1/20/medline SP - 402 EP - 12 JF - Acta orthopaedica JO - Acta Orthop VL - 80 IS - 4 N2 - BACKGROUND AND PURPOSE: Few studies have compared the long-term survival of cemented primary total hip arthroplasties (THAs), and several prostheses have been used without adequate knowledge of their endurance. We studied long-term outcome based on data in the Norwegian Arthroplasty Register. PATIENTS AND METHODS: The 10 most used prosthesis brands in 62,305 primary Palacos or Simplex cemented THAs reported to the Register from 1987 through 2007 were included. Survival analyses with revision as endpoint (for any cause or for aseptic loosening) were performed using Kaplan-Meier and multiple Cox regression with time-dependent covariates. Revision rate ratios (RRs) were estimated for the follow-up intervals: 0-5, 6-10, and > 10 years. RESULTS: 5 prosthesis brands (cup/stem combinations) (Charnley, Exeter, Titan, Spectron/ITH, Link IP/Lubinus SP; n = 24,728) were investigated with 0-20 year follow-up (inserted 1987-1997). After 18 years, 11% (95% CI: 10.6-12.1) were revised for any cause and 8.4% (7.7-9.1) for aseptic loosening. Beyond 10 years of follow-up, the Charnley cup had a lower revision rate due to aseptic loosening than Exeter (RR = 1.8) and Spectron (RR = 2.4) cups. For stems, beyond 10 years we did not find statistically significant differences comparing Charnley with Titan, ITH, and SP stems, but the Exeter stem had better results (RR = 05). 10 prosthesis brands (9 cups in combination with 6 stems; n = 37,577) were investigated with 0-10 years of follow-up (inserted from 1998 through 2007). The Charnley cup had a lower revision rate due to aseptic loosening than all cups except the IP. Beyond 5 years follow-up, the Reflection All-Poly cup had a 14 times higher revision rate. For stems, beyond 5 years the Spectron-EF (RR = 6.1) and Titan (RR = 5.5) stems had higher revision rates due to aseptic loosening than Charnley. The analyses also showed a marked improvement in Charnley results between the periods 1987-1997 and 1998-2007. INTERPRETATION: We observed clinically important differences between cemented prosthesis brands and identified inferior results for previously largely undocumented prostheses, including the commonly used prosthesis combination Reflection All-Poly/ Spectron-EF. The results were, however, satisfactory according to international standards. SN - 1745-3674 UR - https://www.unboundmedicine.com/medline/citation/19857178/18_years_of_results_with_cemented_primary_hip_prostheses_in_the_Norwegian_Arthroplasty_Register:_concerns_about_some_newer_implants_ L2 - http://www.tandfonline.com/doi/full/10.3109/17453670903161124 DB - PRIME DP - Unbound Medicine ER -