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Study: Women have higher THA revision rates than men

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Women have a 29% higher risk of implant failure than men for total hip arthroplasty, according to a study published in JAMA Internal Medicine.

“The role of sex in relationship to implant failure after hip arthroplasty is critically important for patient management and device innovation but current evidence is limited,” Maria C.S. Inacio, MS, of the Surgical Outcomes and Analysis Department, Southern California Permanente Medical Group in San Diego, told Orthopedics Today. “Using a cohort of 35,140 hip arthroplasties from a U.S. Total Joint Replacement Registry, the risk of revision in females compared to males was evaluated. After considering patient, surgical, surgeon, volume and implant-specific risk factors, females had a 29% higher risk of implant failure than males in this community-based sample.”

Inacio and colleagues studied registry data from 46 hospitals and 319 surgeons collected between 2001 and 2010. Women encompassed 57% of this study, and those women had more 28-mm femoral heads (28/2% vs. 13.1%), more metal on highly crosslinked polyethylene bearing surfaces (60.6% vs. 53.7%) than men, according to the abstract.

At median 3-year follow-up, women had a 1.29 all-cause hazard ratio for revision compared to men, a 1.32 hazard ratio for aseptic revision and 1.17 hazard ratio for septic revision, according to the abstract. Implant survival at 5 years was also higher in women than in men.

Reference:

Inacio MCS. JAMA. 2013;doi:10.1001/jamainternmed.2013.3271.

Disclosure: The authors received funds from the Division of Epidemiology, Office of Surveillance and Biometrics, Center for Devices and Radiological and Health and the US Food and Drug Administration.