Poor 10-year survivorship of hip resurfacing arthroplasty: 5,098 replacements from the Finnish Arthroplasty Register

Background and purpose — In a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associ...

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Main Authors: Matti Seppänen, Mikko Karvonen, Petri Virolainen, Ville Remes, Pekka Pulkkinen, Antti Eskelinen, Antti Liukas, Keijo T Mäkelä
Format: Article
Language:English
Published: Taylor & Francis Group 2016-11-01
Series:Acta Orthopaedica
Online Access:http://dx.doi.org/10.1080/17453674.2016.1246316
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spelling doaj-2428fd0f420545548f7ca5d6d06578282021-02-02T08:14:27ZengTaylor & Francis GroupActa Orthopaedica1745-36741745-36822016-11-0187655455910.1080/17453674.2016.12463161246316Poor 10-year survivorship of hip resurfacing arthroplasty: 5,098 replacements from the Finnish Arthroplasty RegisterMatti Seppänen0Mikko Karvonen1Petri Virolainen2Ville Remes3Pekka Pulkkinen4Antti Eskelinen5Antti Liukas6Keijo T Mäkelä7Turku University HospitalTurku University HospitalTurku University HospitalPihlajalinna LtdHelsinki UniversityCoxa Hospital for Joint ReplacementTurku University HospitalTurku University HospitalBackground and purpose — In a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associated with HRA, not only with large-diameter head metal-on-metal THA. The aim of the study was to assess medium- to long-term survivorship of HRA based on the Finnish Arthroplasty Register (FAR). Patients and methods — 5,068 HRAs performed during the period 2001–2013 in Finland were included. Kaplan-Meier survival analysis was used to calculate survival probabilities and their 95% confidence intervals (CIs). Cox multiple regression, with adjustment for age, sex, diagnosis, femoral head size, and hospital volume was used to analyze implant survival of HRA devices with revision for any reason as endpoint. The reference group consisted of 6,485 uncemented Vision/Bimetric and ABG II THAs performed in Finland over the same time period. Results — The 8-year survival, with any revision as an endpoint, was 93% (CI: 92–94) for Birmingham Hip Resurfacing (BHR), 86% (CI: 78–94) for Corin, 91% (CI: 89–94) for ReCap, 92% (CI: 89–96) for Durom, and was 72% (CI: 69–76) for the Articular Surface Replacement (ASR). The 10-year survival, with any revision as an endpoint, for reference THAs was 92% (CI: 91–92) and for all HRAs it was 86% (CI: 84–87%). Female HRA patients had about twice the revision risk of male patients. ASR had an inferior outcome: the revision risk was 4-fold higher than for BHR, the reference implant. Interpretation — The 10-year implant survival of HRAs is 86% in Finland. According to new recommendations from NICE (The National Institute for Health and Care Excellence), an HRA/THA should have a revision rate of 5% or less at 10 years. None of the HRAs studied achieved this goal.http://dx.doi.org/10.1080/17453674.2016.1246316
collection DOAJ
language English
format Article
sources DOAJ
author Matti Seppänen
Mikko Karvonen
Petri Virolainen
Ville Remes
Pekka Pulkkinen
Antti Eskelinen
Antti Liukas
Keijo T Mäkelä
spellingShingle Matti Seppänen
Mikko Karvonen
Petri Virolainen
Ville Remes
Pekka Pulkkinen
Antti Eskelinen
Antti Liukas
Keijo T Mäkelä
Poor 10-year survivorship of hip resurfacing arthroplasty: 5,098 replacements from the Finnish Arthroplasty Register
Acta Orthopaedica
author_facet Matti Seppänen
Mikko Karvonen
Petri Virolainen
Ville Remes
Pekka Pulkkinen
Antti Eskelinen
Antti Liukas
Keijo T Mäkelä
author_sort Matti Seppänen
title Poor 10-year survivorship of hip resurfacing arthroplasty: 5,098 replacements from the Finnish Arthroplasty Register
title_short Poor 10-year survivorship of hip resurfacing arthroplasty: 5,098 replacements from the Finnish Arthroplasty Register
title_full Poor 10-year survivorship of hip resurfacing arthroplasty: 5,098 replacements from the Finnish Arthroplasty Register
title_fullStr Poor 10-year survivorship of hip resurfacing arthroplasty: 5,098 replacements from the Finnish Arthroplasty Register
title_full_unstemmed Poor 10-year survivorship of hip resurfacing arthroplasty: 5,098 replacements from the Finnish Arthroplasty Register
title_sort poor 10-year survivorship of hip resurfacing arthroplasty: 5,098 replacements from the finnish arthroplasty register
publisher Taylor & Francis Group
series Acta Orthopaedica
issn 1745-3674
1745-3682
publishDate 2016-11-01
description Background and purpose — In a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associated with HRA, not only with large-diameter head metal-on-metal THA. The aim of the study was to assess medium- to long-term survivorship of HRA based on the Finnish Arthroplasty Register (FAR). Patients and methods — 5,068 HRAs performed during the period 2001–2013 in Finland were included. Kaplan-Meier survival analysis was used to calculate survival probabilities and their 95% confidence intervals (CIs). Cox multiple regression, with adjustment for age, sex, diagnosis, femoral head size, and hospital volume was used to analyze implant survival of HRA devices with revision for any reason as endpoint. The reference group consisted of 6,485 uncemented Vision/Bimetric and ABG II THAs performed in Finland over the same time period. Results — The 8-year survival, with any revision as an endpoint, was 93% (CI: 92–94) for Birmingham Hip Resurfacing (BHR), 86% (CI: 78–94) for Corin, 91% (CI: 89–94) for ReCap, 92% (CI: 89–96) for Durom, and was 72% (CI: 69–76) for the Articular Surface Replacement (ASR). The 10-year survival, with any revision as an endpoint, for reference THAs was 92% (CI: 91–92) and for all HRAs it was 86% (CI: 84–87%). Female HRA patients had about twice the revision risk of male patients. ASR had an inferior outcome: the revision risk was 4-fold higher than for BHR, the reference implant. Interpretation — The 10-year implant survival of HRAs is 86% in Finland. According to new recommendations from NICE (The National Institute for Health and Care Excellence), an HRA/THA should have a revision rate of 5% or less at 10 years. None of the HRAs studied achieved this goal.
url http://dx.doi.org/10.1080/17453674.2016.1246316
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