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Title: Late dislocations after total hip arthroplasty: is the bearing a factor?
Epworth Authors: de Steiger, Richard
Other Authors: Shah, Siddharth
Walter, William
Tai, Stephen
Lorimer, Michelle
Keywords: Ceramic-On-Ceramic
Bearing Surface
Cross-Linked Polyethylene
Metal-On-Cross-Linked Polyethylene
Late Dislocation
Total Hip Arthroplasty
Kaplan-Meier Method
Australian Orthopaedic Association National Joint Replacement Registry
Department of Surgery, Epworth Healthcare, Melbourne, Victoria, Australia
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Sep-2017
Publisher: Elsevier
Citation: J Arthroplasty. 2017 Sep;32(9):2852-2856
Abstract: BACKGROUND: Dislocation is a leading cause of revision after primary total hip arthroplasty (THA). Although more common in the first few years after the procedure, dislocation can occur at any time. This study investigated the difference in late dislocation in ceramic-on-ceramic (CoC) bearings compared with metal-on-polyethylene and ceramic-on-polyethylene bearings in THA. METHODS: Data were used from the Australian Orthopaedic Association National Joint Replacement Registry, and the cumulative percent revision for dislocation was estimated using the Kaplan-Meier method for the different bearing surfaces. There were 192,275 THAs included in the study with 101,915 metal-on-cross-linked polyethylene (MoXLPE), 30,256 ceramic-on-cross-linked polyethylene (CoXLPE), and 60,104 CoC. RESULTS: The cumulative percent revision for dislocation at 13 years for MoXLPE, CoXLPE, and CoC groups was 1.2 (95% confidence interval [CI], 1.1-1.3), 1.0 (95% CI, 0.7-1.4), and 0.9 (95% CI, 0.8-1.1), respectively. There was an increased risk of revision for dislocation for MoXLPE compared with CoXLPE and CoC. When stratified for head size, there was no difference in the risk of revision for dislocation between MoXLPE, CoXLPE, and CoC in the 28- and 32-mm head sizes. With a head size of 36 mm, MoXLPE had a higher rate of dislocation compared with other materials. CONCLUSION: Bearing surface has little impact on revision for dislocation.
DOI: 10.1016/j.arth.2017.04.037
PubMed URL:
ISSN: 0883-5403
Journal Title: The Journal of Arthroplasty
Type: Journal Article
Affiliated Organisations: Department of Clinical Research, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, South Australia, Australia.
Type of Clinical Study or Trial: Comparative Study
Appears in Collections:Musculoskeletal

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