Ceramicized metal-on-crosslinked polyethylene for THA yielded low revision risk
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Published results showed ceramicized metal-on-crosslinked polyethylene and ceramic-on-crosslinked polyethylene bearing surfaces used in total hip arthroplasty yielded the lowest risk of revision for any reason.
To analyze implant survivorship after THA with uncemented acetabular components with different bearing combinations, Edward T. Davis, FRCS, and colleagues used polyethylene manufacturing properties to subdivide the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man dataset into crosslinked polyethylene and conventional polyethylene groups. Researchers used Kaplan-Meier and multivariate Cox proportional hazard regression survival analyses to analyze overall and cause-specific revisions for various THA bearing combinations.
Of the 420,339 primary THAs with an uncemented acetabular component included in the analysis, results showed 8,025 THAs underwent revision during an average follow-up period of 4.4 years. Patients with ceramicized metal-on-crosslinked polyethylene bearing surfaces had the lowest risk of revision for any reason followed by ceramic-on-crosslinked polyethylene, ceramic-on-polyethylene, ceramic-on-ceramic and metal-on-crosslinked polyethylene bearings, according to Cox regression model results with metal-on-conventional polyethylene bearings as the reference.
Researchers found a similar pattern when patients younger than 55 years were analyzed independently. Researchers also noted an association between higher risk of revision with younger age, male sex and cementless stem fixation.
The headline is that the ceramicized metal-on-highly crosslinked polyethylene appears to be the bearing to choose if you are having a hip replacement. The results we present adds to other registry data on this bearing combination which appears to suggest it provides the lowest revision rates,” Davis told Orthopedics Today. “In our analysis, we went to significant lengths in trying to eliminate other factors that could bias the result to ensure (as much as possible) that the results were not due to confounding factors. However, the nature of registry data is that it is impossible to eliminate all bias. The size of this cohort was such that it should provide patients and surgeons with strong evidence that this is a bearing that should be considered. The paper also examined the ceramic-on-highly crosslinked polyethylene combination, which also performed very well.”
- For more information:
- Edward T. Davis, FRCS, can be reached at The Royal Orthopaedic Hospital NHS Foundation Trust, The Woodlands Bristol Road South, Birmingham B31 2AP, United Kingdom; email: edward.davis@nhs.net.
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