Systematic review of primary total hip arthroplasty using titanium-titanium modular-neck prostheses: the true risk of revision
| Autor: | Matthew Welch, Abbas See, George C. Babis, Johnathan R. Lex, Thomas C. Edwards, Nikolaos A. Stavropoulos |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Reoperation Arthroplasty Replacement Hip medicine.medical_treatment Dentistry chemistry.chemical_element Prosthesis Design Prosthesis Hip replacement (animal) medicine Humans Orthopedics and Sports Medicine Revision rate Retrospective Studies Femoral neck Titanium business.industry Modular neck Middle Aged Prosthesis Failure medicine.anatomical_structure chemistry Surgery Hip Prosthesis business Total hip arthroplasty |
| Zdroj: | HIP International. 31:295-303 |
| ISSN: | 1724-6067 1120-7000 |
| DOI: | 10.1177/1120700020916870 |
| Popis: | Aims: Modular-neck femoral implants are used to enable more variability in femoral neck version, offset and length. It has been reported that these implants carry a higher rate of revision. The aim of this review was to assess the overall and cause-specific revision rate of titanium-titanium alloy modular-neck implants in primary total hip arthroplasty (THA). Methods: A systematic review was conducted following PRISMA guidelines and utilising multiple databases. All results were screened for eligibility. Studies published from 2000 onwards, using a current-generation, titanium-titanium, modular-neck implant were included. Overall and cause-specific revision rates were analysed, comparing to fixed-neck prostheses where applicable. Results: 920 studies were screened. After applying exclusion criteria, 23 were assessed in full and 14 included. These consisted of 12 case series and 2 joint registry analyses. 21,841 patients underwent a modular-neck implant with a weighted mean follow-up of 5.7 years, mean age of 62.4 years, and average body mass index (BMI) of 28.4kg/m2. The overall revision rate was 3.95% and 2.98% for modular and fixed-neck prostheses, respectively. For studies with >5 years follow-up the mean revision rate was 3.08%. There was no difference in cause-specific revision rates by implant design. Mean improvement in Harris Hip Score was 41.9. Conclusions: At medium-term, revision rates for titanium-titanium primary modular-neck THA are acceptable. These prostheses are a sensible management option in patients with considerable anatomical hip deformity not amenable to correction with standard fixed-neck implants. Patients of male gender, high BMI and requiring prostheses with a larger neck, offset or head are at higher risk of implant failure. |
| Databáze: | OpenAIRE |
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