Population-based rates of revision of primary total hip arthroplasty: a systematic review

Kelly L Corbett, Elena Losina, Akosua A Nti, Julian J Z Prokopetz, Jeffrey N Katz, Kelly L Corbett, Elena Losina, Akosua A Nti, Julian J Z Prokopetz, Jeffrey N Katz

Abstract

Background: Most research on failure leading to revision total hip arthroplasty (THA) is reported from single centers. We searched PubMed between January 2000 and August 2010 to identify population- or community-based studies evaluating ten-year revision risks. We report ten-year revision risk using the Kaplan-Meier method, stratifying by age and fixation technique.

Results: Thirteen papers met the inclusion criteria. Cemented prostheses had Kaplan-Meier estimates of revision-free implant survival of ten years ranging from 88% to 95%; uncemented prostheses had Kaplan-Meier estimates from 80% to 85%. Estimates ranged from 72% to 86% in patients less than 60 years old and from 90 to 96% in older patients.

Conclusion: Data reported from national registries suggest revision risks of 5 to 20% ten years following primary THA. Revision risks are lower in older THA recipients. Uncemented implants may have higher ten-year rates of revision, regardless of age.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Manuscript search and selection process.
Figure 1. Manuscript search and selection process.
Figure 2. Kaplan-Meier ten-year hip prosthesis survival…
Figure 2. Kaplan-Meier ten-year hip prosthesis survival by fixation technique.
Kaplan-Meier ten-year estimates are presented, stratified by national register and fixation technique. Circle area is proportional to the sample size. Error bars represent 95% CIs. All estimates use revision for any reason as the endpoint. Cemented Norway and cemented England are single prosthesis studies, including only Charnley implants. The K-M 10 for uncemented THA in Norway is the weighted average of nine , or ten types of implant. All others are inclusive of all prosthesis brands. The Finnish K-M 10 data were estimated from K-M curves. Estimates are inclusive of all patient ages. 31% to 71% of the uncemented Norwegian sample, 87% of the English sample, and 100% of the remaining registers' samples were operated on for osteoarthritis. Each study reference is denoted next to the circle, representing the corresponding manuscript from which the Kaplan-Meier estimates were derived.
Figure 3. Kaplan-Meier ten-year hip prosthesis survival…
Figure 3. Kaplan-Meier ten-year hip prosthesis survival by age group.
Kaplan-Meier ten-year estimates are stratified by register and age group. Circle area is proportional to the sample size. Error bars represent 95% CIs. Estimates are inclusive of all prosthesis types. The endpoint was revision for any reason, except for the Swedish studies, where it was revision due to aseptic loosening only. 75% of the Swedish sample, 78% of the Finnish sample, and 100% of the Norwegian sample were operated on for osteoarthritis. Each study reference is denoted next to the circle, representing the corresponding manuscript from which the Kaplan-Meier estimates were derived.

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Source: PubMed

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