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The influence of bearing surfaces on revisions due to dislocations in total hip arthroplasty
INTRODUCTION: Recurrent dislocations are still the most frequent reason for revision in total hip arthroplasty (THA). The impact of bearing surfaces on dislocations is still controversial. We hypothesized that: (1) bearing surfaces influence the revisions due to dislocations; (2) ceramic-on-ceramic...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer US
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443492/ https://www.ncbi.nlm.nih.gov/pubmed/34524578 http://dx.doi.org/10.1007/s10856-021-06598-4 |
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author | Castagnini, Francesco Bordini, Barbara Cosentino, Monica Ancarani, Cristina Mariotti, Federica Biondi, Federico Faldini, Cesare Traina, Francesco |
author_facet | Castagnini, Francesco Bordini, Barbara Cosentino, Monica Ancarani, Cristina Mariotti, Federica Biondi, Federico Faldini, Cesare Traina, Francesco |
author_sort | Castagnini, Francesco |
collection | PubMed |
description | INTRODUCTION: Recurrent dislocations are still the most frequent reason for revision in total hip arthroplasty (THA). The impact of bearing surfaces on dislocations is still controversial. We hypothesized that: (1) bearing surfaces influence the revisions due to dislocations; (2) ceramic-on-ceramic reduced the revisions for dislocations in adjusted models; (3) Delta-on-Delta bearings reduced the revisions for dislocations in comparison to surfaces with cross-linked polyethylene. MATERIALS AND METHODS: The regional arthroplasty registry was enquired about bearing surfaces and revisions for dislocations and instability. Unadjusted and adjusted rates were provided, including sex, age (<65 years or ≥65 years), head diameter (≤28 mm or >28 mm; <36 mm or ≥36 mm) as variables. 44,065 THAs were included. RESULTS: The rate of revisions for dislocations was significantly lower in ceramic-on-ceramic and metal-on-metal bearings (unadjusted rates). After adjusting for age, sex, and head size (36 and 28 mm), hard-on-hard bearings were protective (p < 0.05): ceramic-on-ceramic had a lower risk of revisions due to dislocation than ceramic-on-polyethylene (HR 1.6, 95% CI 1.2–2.2 p = 0.0009). The rate of revisions for dislocation was similar in bearings with cross-linked polyethylene and Delta-on-Delta articulations, in unadjusted and adjusted models. CONCLUSION: Bearings with conventional polyethylene were more predisposed to dislocations. Currently adopted bearings exerted no significant influence on revisions due to dislocations. These findings could be primarily related to wear, but due to the time distribution, soft tissue envelopes and surface tension may also play a role. Pre-clinical biomechanical evaluations and prospective matched cohort studies are required to draw definitive conclusions. [Image: see text] |
format | Online Article Text |
id | pubmed-8443492 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-84434922021-10-07 The influence of bearing surfaces on revisions due to dislocations in total hip arthroplasty Castagnini, Francesco Bordini, Barbara Cosentino, Monica Ancarani, Cristina Mariotti, Federica Biondi, Federico Faldini, Cesare Traina, Francesco J Mater Sci Mater Med Clinical Applications of Biomaterials INTRODUCTION: Recurrent dislocations are still the most frequent reason for revision in total hip arthroplasty (THA). The impact of bearing surfaces on dislocations is still controversial. We hypothesized that: (1) bearing surfaces influence the revisions due to dislocations; (2) ceramic-on-ceramic reduced the revisions for dislocations in adjusted models; (3) Delta-on-Delta bearings reduced the revisions for dislocations in comparison to surfaces with cross-linked polyethylene. MATERIALS AND METHODS: The regional arthroplasty registry was enquired about bearing surfaces and revisions for dislocations and instability. Unadjusted and adjusted rates were provided, including sex, age (<65 years or ≥65 years), head diameter (≤28 mm or >28 mm; <36 mm or ≥36 mm) as variables. 44,065 THAs were included. RESULTS: The rate of revisions for dislocations was significantly lower in ceramic-on-ceramic and metal-on-metal bearings (unadjusted rates). After adjusting for age, sex, and head size (36 and 28 mm), hard-on-hard bearings were protective (p < 0.05): ceramic-on-ceramic had a lower risk of revisions due to dislocation than ceramic-on-polyethylene (HR 1.6, 95% CI 1.2–2.2 p = 0.0009). The rate of revisions for dislocation was similar in bearings with cross-linked polyethylene and Delta-on-Delta articulations, in unadjusted and adjusted models. CONCLUSION: Bearings with conventional polyethylene were more predisposed to dislocations. Currently adopted bearings exerted no significant influence on revisions due to dislocations. These findings could be primarily related to wear, but due to the time distribution, soft tissue envelopes and surface tension may also play a role. Pre-clinical biomechanical evaluations and prospective matched cohort studies are required to draw definitive conclusions. [Image: see text] Springer US 2021-09-15 2021 /pmc/articles/PMC8443492/ /pubmed/34524578 http://dx.doi.org/10.1007/s10856-021-06598-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Clinical Applications of Biomaterials Castagnini, Francesco Bordini, Barbara Cosentino, Monica Ancarani, Cristina Mariotti, Federica Biondi, Federico Faldini, Cesare Traina, Francesco The influence of bearing surfaces on revisions due to dislocations in total hip arthroplasty |
title | The influence of bearing surfaces on revisions due to dislocations in total hip arthroplasty |
title_full | The influence of bearing surfaces on revisions due to dislocations in total hip arthroplasty |
title_fullStr | The influence of bearing surfaces on revisions due to dislocations in total hip arthroplasty |
title_full_unstemmed | The influence of bearing surfaces on revisions due to dislocations in total hip arthroplasty |
title_short | The influence of bearing surfaces on revisions due to dislocations in total hip arthroplasty |
title_sort | influence of bearing surfaces on revisions due to dislocations in total hip arthroplasty |
topic | Clinical Applications of Biomaterials |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443492/ https://www.ncbi.nlm.nih.gov/pubmed/34524578 http://dx.doi.org/10.1007/s10856-021-06598-4 |
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