Ceramic-on-ceramic bearing surface and risk of revision due to dislocation after primary total hip replacement
S. A. Sexton, MA, FRCS(Orth), Arthroplasty Fellow; W. L. Walter, MBBS, FRACS(Orth), PhD(Surg), Consultant Orthopaedic Surgeon; M. P. Jackson, FRCS(Orth), Arthroplasty Fellow; R. De Steiger, FRACS(Orth), Chairman; and T. Stanford, B.Ma, Comp.Sc(Hons), Statistician
Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 11, 1448-1453
Dislocation is a common reason for revision following total hip replacement. This study investigated the relationship between the bearing surface and the risk of revision due to dislocation. It was based on 110 239 primary total hip replacements with a diagnosis of osteoarthritis collected by the Australian Orthopaedic Association National Joint Replacement Registry between September 1999 and December 2007. A total of 862 (0.78%) were revised because of dislocation. Ceramic-on-ceramic bearing surfaces had a lower risk of requiring revision due to dislocation than did metal-on-polyethylene and ceramic-on-polyethylene surfaces, with a follow-up of up to seven years. However, ceramic-on-ceramic implants were more likely to have larger prosthetic heads and to have been implanted in younger patients. The size of the head of the femoral component and age are known to be independent predictors of dislocation. Therefore, the outcomes were stratified by the size of the head and age.
There is a significantly higher rate of revision for dislocation in ceramic-on-ceramic bearing surfaces than in metal-on-polyethylene implants when smaller sizes ( 28 mm) of the head were used in younger patients (< 65 years) (hazard ratio = 1.53, p = 0.041) and also with larger (> 28 mm) and in older patients ( 65 years) (hazard ratio = 1.73, p = 0.016).
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- Risk factors for inflammatory pseudotumour formation following hip resurfacing
- Primary Total Hip Arthroplasty With Duraloc Cup in Patients Younger Than 50 Years
- Ten-year follow-up of the non-porous Allofit cementless acetabular component
- Ceramic-on-ceramic bearing surface and risk of revision due to dislocation after primary total hip replacement