Implant survival of 662 dual-mobility cups and 727 constrained liners in primary THA: small femoral head size increases the cumulative incidence of revision

Autor:	Antti Eskelinen, Keijo T Mäkelä, Olli Lainiala, Oskari A. Pakarinen, Aleksi Reito, Perttu S. Neuvonen
Přispěvatelé:	Tampere University, Coxa PLC, Clinical Medicine, Department of Radiology
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Male Reoperation musculoskeletal diseases Arthroplasty Replacement Hip Dentistry Prosthesis Design Cohort Studies Femoral head CLs upper limits Humans Medicine Orthopedics and Sports Medicine Cumulative incidence Registries Finland Aged Aged 80 and over Orthopedic surgery business.industry food and beverages General Medicine Middle Aged 3126 Surgery anesthesiology intensive care radiology equipment and supplies Dual mobility Prosthesis Failure medicine.anatomical_structure Female Surgery Hip Prosthesis Implant business RD701-811 Research Article Total hip arthroplasty
Zdroj:	Acta Orthopaedica, Vol 92, Iss 6, Pp 658-664 (2021) Acta Orthopaedica article-version (VoR) Version of Record
ISSN:	1745-3682 1745-3674
Popis:	Background and purpose — In total hip arthroplasty (THA), the risk for dislocation can be reduced using either dual-mobility cups (DMCs) or constrained liners (CLs). There are few studies comparing these concepts in primary THA. Therefore, we compared the cumulative incidence of revision in primary THA patients treated with DMC or CL with varying head sizes with conventional THA patients as reference group. Patients and methods — We performed a cohort study based on the Finnish arthroplasty register, comparing DMCs and CLs operated over the period 2000–2017. DMCs were divided into 2 groups based on the implant design: “DMC Trident” group (n = 399) and “DMC Others” group (n = 263). CLs were divided based on the femoral head size: “CL 36 mm” group (n = 425) and “CL < 36 mm” group (n = 302). All conventional primary THAs operated on in 2000–2017 with 28–36 mm femoral head were included as control group (“Conventional THA” group, n = 102,276). Implant survival was calculated by the corresponding cumulative incidence function with revision as the endpoint and death as competing event. Also, the prevalence of different reasons for revision was compared. Results — The 6-year cumulative incidence function estimates for the first revision were 6.9% (95% CI 4.0–9.7) for DMC Trident, 5.0% (CI 1.5–8.5) for DMC Others, 13% (CI 9.3–17) for CL < 36 mm, 6.3% (3.7–8.9) for CL 36 mm, and 4.7% (CI 4.5–4.8) for control group (conventional THA). The prevalence of dislocation revision was high (5.0%, CI 2.9–8.2) in the CL < 36 mm group compared with other groups. Interpretation — The DMC and CL 36 mm groups had promising mid-term survival rates, comparable to those of primary conventional THA group. The revision rate of CLs with < 36 mm head was high, mostly due to high prevalence of dislocation revisions. Therefore, CLs with 36 mm femoral head should be preferred over smaller ones. publishedVersion
Databáze:	OpenAIRE
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