Risk of Complication and Revision Total Hip Arthroplasty Among Medicare Patients with Different Bearing Surfaces View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2010-09

AUTHORS

Kevin J. Bozic, Kevin Ong, Edmund Lau, Steven M. Kurtz, Thomas P. Vail, Harry E. Rubash, Daniel J. Berry

ABSTRACT

BACKGROUND: To address the long-term problems of bearing surface wear and osteolysis associated with conventional metal-polyethylene (M-PE) total hip arthroplasty (THA), metal-metal (M-M), and ceramic-ceramic (C-C) bearings have been introduced. These bearing surfaces are associated with unique risks and benefits and higher costs. However the relative risks of these three bearings in an older population is unknown. QUESTIONS/PURPOSES: We compared the short-term risk of complication and revision THA among Medicare patients having a primary THA with metal-polyethylene (M-PE), metal-metal (M-M), and ceramic-ceramic (C-C) bearings. METHODS: We used the 2005 to 2007 100% Medicare inpatient claim files to perform a matched cohort analysis in three separate cohorts of THA patients (M-PE, M-M, and C-C) who were matched by age, gender, and US census region. Multivariate Cox proportional-hazards models were constructed to compare complication and revision THA risk among cohorts, adjusting for medical comorbidities, race, socioeconomic status, and hospital factors. RESULTS: After adjusting for patient and hospital factors, M-M bearings were associated with a higher risk of periprosthetic joint infection (hazard ratio, 3.03; confidence interval, 1.02-9.09) when compared with C-C bearings (0.59% versus 0.32%, respectively). There were no other differences among bearing cohorts in the adjusted risk of revision THA or any other complication. CONCLUSIONS: The risk of short-term complication (including dislocation) and revision THA were similar among appropriately matched Medicare THA patients regardless of bearing surface. Hard-on-hard THA bearings are of questionable value in Medicare patients, given the higher cost associated with their use and uncertain long-term benefits in older patients. LEVEL OF EVIDENCE: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence. More... »

PAGES

2357-2362

References to SciGraph publications

  • 2006-03. Wear of crosslinked polyethylene under different tribological conditions in JOURNAL OF MATERIALS SCIENCE: MATERIALS IN MEDICINE
  • 2008-02. THA Using Metal-on-Metal Articulation in Active Patients Younger Than 50 Years in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11999-010-1262-3

    DOI

    http://dx.doi.org/10.1007/s11999-010-1262-3

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1051765185

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/20165935


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