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Failure rate of cemented and uncemented total hip replacements: register study of combined Nordic database of four nations

Makela, Keijo T.; Matilainen, Markus; Pulkkinen, Pekka; Fenstad, Anne M.; Havelin, Leif; Engesaeter, Lars; Furnes, Ove; Pedersen, Alma B.; Overgaard, Soren and Karrholm, Johan, et al. (2014) In B M J: British Medical Journal1995-01-01+01:00 348. p.7592-7592
Abstract
Objective To assess the failure rate of cemented, uncemented, hybrid, and reverse hybrid total hip replacements in patients aged 55 years or older. Design Register study. Setting Nordic Arthroplasty Register Association database (combined data from Sweden, Norway, Denmark, and Finland). Participants 347 899 total hip replacements performed during 1995-2011. Main outcome measures Probability of implant survival (Kaplan-Meier analysis) along with implant survival with revision for any reason as endpoint (Cox multiple regression) adjusted for age, sex, and diagnosis in age groups 55-64, 65-74, and 75 years or older. Results The proportion of total hip replacements using uncemented implants increased rapidly towards the end of the study... (More)
Objective To assess the failure rate of cemented, uncemented, hybrid, and reverse hybrid total hip replacements in patients aged 55 years or older. Design Register study. Setting Nordic Arthroplasty Register Association database (combined data from Sweden, Norway, Denmark, and Finland). Participants 347 899 total hip replacements performed during 1995-2011. Main outcome measures Probability of implant survival (Kaplan-Meier analysis) along with implant survival with revision for any reason as endpoint (Cox multiple regression) adjusted for age, sex, and diagnosis in age groups 55-64, 65-74, and 75 years or older. Results The proportion of total hip replacements using uncemented implants increased rapidly towards the end of the study period. The 10 year survival of cemented implants in patients aged 65 to 74 and 75 or older (93.8%, 95% confidence interval 93.6% to 94.0% and 95.9%, 95.8% to 96.1%, respectively) was higher than that of uncemented (92.9%, 92.3% to 93.4% and 93.0%, 91.8% to 94.0%), hybrid (91.6%, 90.9% to 92.2% and 93.9%, 93.1% to 94.5%), and reverse hybrid (90.7%, 87.3% to 93.2% and 93.2%, 90.7% to 95.1%) implants. The survival of cemented (92.2%, 91.8% to 92.5%) and uncemented (91.8%, 91.3% to 92.2%) implants in patients aged 55 to 64 was similar. During the first six months the risk of revision with cemented implants was lower than with all other types of fixation in all age groups. Conclusion The survival of cemented implants for total hip replacement was higher than that of uncemented implants in patients aged 65 years or older. The increased use of uncemented implants in this age group is not supported by these data. However, because our dataset includes only basic information common to all national registers there is potential for residual confounding. (Less)
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B M J: British Medical Journal1995-01-01+01:00
volume
348
pages
7592 - 7592
publisher
BMJ Publishing Group
external identifiers
  • wos:000329975600002
  • scopus:84892750079
ISSN
1756-1833
DOI
10.1136/bmj.f7592
language
English
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yes
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60e0732d-f30c-46fe-9ee6-04aacf907ee7 (old id 4319566)
date added to LUP
2014-03-03 08:02:27
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2017-11-12 03:08:41
@article{60e0732d-f30c-46fe-9ee6-04aacf907ee7,
  abstract     = {Objective To assess the failure rate of cemented, uncemented, hybrid, and reverse hybrid total hip replacements in patients aged 55 years or older. Design Register study. Setting Nordic Arthroplasty Register Association database (combined data from Sweden, Norway, Denmark, and Finland). Participants 347 899 total hip replacements performed during 1995-2011. Main outcome measures Probability of implant survival (Kaplan-Meier analysis) along with implant survival with revision for any reason as endpoint (Cox multiple regression) adjusted for age, sex, and diagnosis in age groups 55-64, 65-74, and 75 years or older. Results The proportion of total hip replacements using uncemented implants increased rapidly towards the end of the study period. The 10 year survival of cemented implants in patients aged 65 to 74 and 75 or older (93.8%, 95% confidence interval 93.6% to 94.0% and 95.9%, 95.8% to 96.1%, respectively) was higher than that of uncemented (92.9%, 92.3% to 93.4% and 93.0%, 91.8% to 94.0%), hybrid (91.6%, 90.9% to 92.2% and 93.9%, 93.1% to 94.5%), and reverse hybrid (90.7%, 87.3% to 93.2% and 93.2%, 90.7% to 95.1%) implants. The survival of cemented (92.2%, 91.8% to 92.5%) and uncemented (91.8%, 91.3% to 92.2%) implants in patients aged 55 to 64 was similar. During the first six months the risk of revision with cemented implants was lower than with all other types of fixation in all age groups. Conclusion The survival of cemented implants for total hip replacement was higher than that of uncemented implants in patients aged 65 years or older. The increased use of uncemented implants in this age group is not supported by these data. However, because our dataset includes only basic information common to all national registers there is potential for residual confounding.},
  author       = {Makela, Keijo T. and Matilainen, Markus and Pulkkinen, Pekka and Fenstad, Anne M. and Havelin, Leif and Engesaeter, Lars and Furnes, Ove and Pedersen, Alma B. and Overgaard, Soren and Karrholm, Johan and Malchau, Henrik and Garellick, Goran and Ranstam, Jonas and Eskelinen, Antti},
  issn         = {1756-1833},
  language     = {eng},
  pages        = {7592--7592},
  publisher    = {BMJ Publishing Group},
  series       = {B M J: British Medical Journal1995-01-01+01:00},
  title        = {Failure rate of cemented and uncemented total hip replacements: register study of combined Nordic database of four nations},
  url          = {http://dx.doi.org/10.1136/bmj.f7592},
  volume       = {348},
  year         = {2014},
}