Cargando…
Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty: A population-based analysis of 42,379 primary procedures from the Finnish Arthroplasty Register
BACKGROUND AND PURPOSE: Previous population-based registry studies have shown that larger femoral head size is associated with reduced risk of revision for dislocation. However, the previous data have not included large numbers of hip resurfacing arthroplasties or large metal-on-metal (> 36-mm) f...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Informa Healthcare
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768031/ https://www.ncbi.nlm.nih.gov/pubmed/23799348 http://dx.doi.org/10.3109/17453674.2013.810518 |
_version_ | 1782283733842264064 |
---|---|
author | Kostensalo, Inari Junnila, Mika Virolainen, Petri Remes, Ville Matilainen, Markus Vahlberg, Tero Pulkkinen, Pekka Eskelinen, Antti Mäkelä, Keijo T |
author_facet | Kostensalo, Inari Junnila, Mika Virolainen, Petri Remes, Ville Matilainen, Markus Vahlberg, Tero Pulkkinen, Pekka Eskelinen, Antti Mäkelä, Keijo T |
author_sort | Kostensalo, Inari |
collection | PubMed |
description | BACKGROUND AND PURPOSE: Previous population-based registry studies have shown that larger femoral head size is associated with reduced risk of revision for dislocation. However, the previous data have not included large numbers of hip resurfacing arthroplasties or large metal-on-metal (> 36-mm) femoral head arthroplasties. We evaluated the association between femoral component head size and the risk of revision for dislocation after THA by using Finnish Arthroplasty Register data. PATIENTS AND METHODS: 42,379 patients who were operated during 1996–2010 fulfilled our criteria. 18 different cup/stem combinations were included. The head-size groups studied (numbers of cases) were 28 mm (23,800), 32 mm (4,815), 36 mm (3,320), and > 36 mm (10,444). Other risk factors studied were sex, age group (18–49 years, 50–59 years, 60–69 years, 70–79 years, and > 80 years), and time period of operation (1996–2000, 2001–2005, 2006–2010). RESULTS: The adjusted risk ratio in the Cox model for a revision operation due to dislocation was 0.40 (95% CI: 0.26–0.62) for 32-mm head size, 0.41 (0.24–0.70) for 36-mm head size, and 0.09 (0.05–0.17) for > 36-mm head size compared to implants with a head size of 28 mm. INTERPRETATION: Larger femoral heads clearly reduce the risk of dislocation. The difference in using heads of > 36 mm as opposed to 28-mm heads for the overall revision rate at 10 years follow-up is about 2%. Thus, although attractive from a mechanical point of view, based on recent less favorable clinical outcome data on these large heads, consisting mainly of metal-on-metal prostheses, one should be cautious using these implants. |
format | Online Article Text |
id | pubmed-3768031 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Informa Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-37680312013-09-16 Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty: A population-based analysis of 42,379 primary procedures from the Finnish Arthroplasty Register Kostensalo, Inari Junnila, Mika Virolainen, Petri Remes, Ville Matilainen, Markus Vahlberg, Tero Pulkkinen, Pekka Eskelinen, Antti Mäkelä, Keijo T Acta Orthop Register Studies BACKGROUND AND PURPOSE: Previous population-based registry studies have shown that larger femoral head size is associated with reduced risk of revision for dislocation. However, the previous data have not included large numbers of hip resurfacing arthroplasties or large metal-on-metal (> 36-mm) femoral head arthroplasties. We evaluated the association between femoral component head size and the risk of revision for dislocation after THA by using Finnish Arthroplasty Register data. PATIENTS AND METHODS: 42,379 patients who were operated during 1996–2010 fulfilled our criteria. 18 different cup/stem combinations were included. The head-size groups studied (numbers of cases) were 28 mm (23,800), 32 mm (4,815), 36 mm (3,320), and > 36 mm (10,444). Other risk factors studied were sex, age group (18–49 years, 50–59 years, 60–69 years, 70–79 years, and > 80 years), and time period of operation (1996–2000, 2001–2005, 2006–2010). RESULTS: The adjusted risk ratio in the Cox model for a revision operation due to dislocation was 0.40 (95% CI: 0.26–0.62) for 32-mm head size, 0.41 (0.24–0.70) for 36-mm head size, and 0.09 (0.05–0.17) for > 36-mm head size compared to implants with a head size of 28 mm. INTERPRETATION: Larger femoral heads clearly reduce the risk of dislocation. The difference in using heads of > 36 mm as opposed to 28-mm heads for the overall revision rate at 10 years follow-up is about 2%. Thus, although attractive from a mechanical point of view, based on recent less favorable clinical outcome data on these large heads, consisting mainly of metal-on-metal prostheses, one should be cautious using these implants. Informa Healthcare 2013-08 2013-09-02 /pmc/articles/PMC3768031/ /pubmed/23799348 http://dx.doi.org/10.3109/17453674.2013.810518 Text en Copyright: © Nordic Orthopaedic Federation http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited. |
spellingShingle | Register Studies Kostensalo, Inari Junnila, Mika Virolainen, Petri Remes, Ville Matilainen, Markus Vahlberg, Tero Pulkkinen, Pekka Eskelinen, Antti Mäkelä, Keijo T Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty: A population-based analysis of 42,379 primary procedures from the Finnish Arthroplasty Register |
title | Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty: A population-based analysis of 42,379 primary procedures from the Finnish Arthroplasty Register |
title_full | Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty: A population-based analysis of 42,379 primary procedures from the Finnish Arthroplasty Register |
title_fullStr | Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty: A population-based analysis of 42,379 primary procedures from the Finnish Arthroplasty Register |
title_full_unstemmed | Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty: A population-based analysis of 42,379 primary procedures from the Finnish Arthroplasty Register |
title_short | Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty: A population-based analysis of 42,379 primary procedures from the Finnish Arthroplasty Register |
title_sort | effect of femoral head size on risk of revision for dislocation after total hip arthroplasty: a population-based analysis of 42,379 primary procedures from the finnish arthroplasty register |
topic | Register Studies |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768031/ https://www.ncbi.nlm.nih.gov/pubmed/23799348 http://dx.doi.org/10.3109/17453674.2013.810518 |
work_keys_str_mv | AT kostensaloinari effectoffemoralheadsizeonriskofrevisionfordislocationaftertotalhiparthroplastyapopulationbasedanalysisof42379primaryproceduresfromthefinnisharthroplastyregister AT junnilamika effectoffemoralheadsizeonriskofrevisionfordislocationaftertotalhiparthroplastyapopulationbasedanalysisof42379primaryproceduresfromthefinnisharthroplastyregister AT virolainenpetri effectoffemoralheadsizeonriskofrevisionfordislocationaftertotalhiparthroplastyapopulationbasedanalysisof42379primaryproceduresfromthefinnisharthroplastyregister AT remesville effectoffemoralheadsizeonriskofrevisionfordislocationaftertotalhiparthroplastyapopulationbasedanalysisof42379primaryproceduresfromthefinnisharthroplastyregister AT matilainenmarkus effectoffemoralheadsizeonriskofrevisionfordislocationaftertotalhiparthroplastyapopulationbasedanalysisof42379primaryproceduresfromthefinnisharthroplastyregister AT vahlbergtero effectoffemoralheadsizeonriskofrevisionfordislocationaftertotalhiparthroplastyapopulationbasedanalysisof42379primaryproceduresfromthefinnisharthroplastyregister AT pulkkinenpekka effectoffemoralheadsizeonriskofrevisionfordislocationaftertotalhiparthroplastyapopulationbasedanalysisof42379primaryproceduresfromthefinnisharthroplastyregister AT eskelinenantti effectoffemoralheadsizeonriskofrevisionfordislocationaftertotalhiparthroplastyapopulationbasedanalysisof42379primaryproceduresfromthefinnisharthroplastyregister AT makelakeijot effectoffemoralheadsizeonriskofrevisionfordislocationaftertotalhiparthroplastyapopulationbasedanalysisof42379primaryproceduresfromthefinnisharthroplastyregister |