Is the rate of revision of 36 mm metal-on-metal total hip arthroplasties with Pinnacle acetabular components related to the year of the initial operation? AN INTERRUPTED TIME-SERIES ANALYSIS USING DATA FROM THE NATIONAL JOINT REGISTRY FOR ENGLAND AND WALES

被引：8

作者：

Matharu, G. S. ^{[1
,2
,3
,4
]}

Hunt, L. P. ^{[1
,5
]}

Murray, D. W. ^{[1
,6
]}

Howard, P. ^{[1
,7
]}

Pandit, H. G. ^{[1
,8
,9
]}

Blom, A. W. ^{[1
,10
]}

Bolland, B. ^{[1
,11
]}

Judge, A. ^{[1
,9
,10
,12
]}

机构：

[1] Univ Bristol, Bristol Med Sch, Dept Translat Hlth Sci, Musculoskeletal Res Unit, Bristol, Avon, England

[2] Univ Oxford, Nuffield Dept Orthopaed Rheumatol & Musculoskeleta, Orthopaed, Windmill Rd, Oxford OX3 7LD, England

[3] Univ Bristol, Musculoskeletal Res Unit, Bristol BS10 5NB, Avon, England

[4] Univ Bristol, Dept Translat Hlth Sci, Bristol BS10 5NB, Avon, England

[5] Univ Bristol, Dept Translat Hlth Sci, Musculoskeletal Res Unit, Bristol BS10 5NB, Avon, England

[6] Univ Oxford, Nuffield Orthopaed Ctr, Nuffield Dept Orthopaed Rheumatol & Musculoskeleta, Orthopaed Surg, Windmill Rd, Oxford OX3 7LD, England

[7] Royal Derby Hosp, Uttoxeter Rd, Derby DE22 3NE, England

[8] Univ Leeds, Chapel Allerton Hosp, Leeds Inst Rheumat & Musculoskeletal Med, Orthopaed, Chapeltown Rd, Leeds LS7 4SA, W Yorkshire, England

[9] Univ Oxford, Nuffield Dept Orthopaed Rheumatol & Musculoskeleta, Windmill Rd, Oxford OX3 7LD, England

[10] Univ Bristol, Bristol Med Sch, Dept Translat Hlth Sci, Bristol BS10 5NB, Avon, England

[11] Musgrove Pk Hosp, Taunton, Somerset, England

[12] Univ Southampton, MRC Lifecourse Southampton Gen Hosp, Tremona Rd, Southampton SO16 6YD, Hants, England

来源：

BONE & JOINT JOURNAL | 2018年 / 100B卷 / 01期

关键词：

IMPLANT RETRIEVAL CENTER; ADVERSE-REACTION; FAILURE RATES; RISK-FACTORS; REPLACEMENT; DEBRIS; OUTCOMES; RESURFACINGS; COHORT; BEARINGS;

D O I：

10.1302/0301-620X.100B1.BJJ-2017-0625.R2

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Aims & para;& para;The aim of this study was to determine whether the rates of revision for metal-on-metal (MoM) total hip arthroplasties (THAs) with Pinnacle components varied according to the year of the initial operation, and compare these with the rates of revision for other designs of MoM THA.& para;& para;Patients and Methods & para;& para;Data from the National Joint Registry for England and Wales included 36 mm MoM THAs with Pinnacle acetabular components which were undertaken between 2003 and 2012 with follow-up for at least five years (n = 10 776) and a control group of other MoM THAs (n = 13 817). The effect of the year of the primary operation on all-cause rates of revision was assessed using Cox regression and interrupted time-series analysis.& para;& para;Results & para;& para;For MoM THAs involving Pinnacle components, those undertaken between 2007 and 2012 had higher rates of revision compared with those undertaken between 2004 and 2006 (hazard ratio (HR) 2.01; 95% confidence interval (CI) 1.57 to 2.57; p < 0.001). For THAs undertaken during and after 2007, the number of revisions per 1000 implant-years at risk significantly increased by 5.20 (95% CI 0.52 to 9.89; p = 0.033) compared with those undertaken before this time.& para;& para;In the control group, THAs undertaken between 2007 and 2012 also had higher rates of revision (HR 1.77; 95% CI 1.49 to 2.10; p < 0.001), with revisions per 1000 implant-years for those undertaken during and after 2007 significantly increasing by 6.13 (95% CI 1.42 to 10.83; p = 0.016).& para;& para;Conclusion & para;& para;The five-year revision rates were significantly increased for all primary MoM THAs undertaken from 2007 onwards. Contrary to recent reports, this finding was not specific to those involving Pinnacle acetabular components and may be explained by increased surveillance and recent lowering of the threshold for revision.

引用

页码：33 / 41

页数：9

共 3 条

[1] Failure rates of metal-on-metal hip resurfacings: analysis of data from the National Joint Registry for England and Wales
Smith, Alison J.
Dieppe, Paul
Howard, Peter W.
Blom, Ashley W.
LANCET, 2012, 380 (9855): : 1759 - 1766
[2] Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris? AN ANALYSIS FROM THE NATIONAL JOINT REGISTRY FOR ENGLAND AND WALES
Matharu, G. S.
Judge, A.
Pandit, H. G.
Murray, D. W.
BONE & JOINT JOURNAL, 2017, 99B (08): : 1020 - 1027
[3] Trabecular Metal Acetabular Components Reduce the Risk of Revision Following Primary Total Hip Arthroplasty: A Propensity Score Matched Study From the National Joint Registry for England and Wales
Matharu, Gulraj S.
Judge, Andrew
Murray, David W.
Pandit, Hemant G.
JOURNAL OF ARTHROPLASTY, 2018, 33 (02): : 447 - 452

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