The Epidemiology of Bearing Surface Usage in Total Hip Arthroplasty in the United States

Bozic, Kevin J.; Kurtz, Steven; Lau, Edmund; Ong, Kevin; Chiu, Vanessa; Vail, Thomas P.; Rubash, Harry E.; Berry, Daniel J.
July 2009
Journal of Bone & Joint Surgery, American Volume;Jul2009, Vol. 91-A Issue 7, p1614
Academic Journal
Background: Hard-on-hard bearings offer the potential to improve the survivorship of total hip arthroplasty implants. However, the specific indications for the use of these advanced technologies remain controversial. The purpose of this study was to characterize the epidemiology of bearing surface utilization in total hip arthroplasty in the United States with respect to patient, hospital, geographic, and payer characteristics. Methods: The Nationwide Inpatient Sample database was used to analyze bearingtype and demographic characteristics associated with 112,095 primary total hip arthroplasties performed in the United States between October 1, 2005, and December 31, 2006. The prevalence of each type of total hip arthroplasty bearing was calculated for population subgroups as a function of age, sex, census region, payer class, and hospital type. Results: The most commonly reported bearing was metal-on-polyethylene (51%) followed by metal-on-metal (35%) and ceramic-on-ceramic (14%). Metal-on-polyethylene bearings were most commonly reported in female Medicare patients who were sixty-five to seventy-four years old, while metal-on-metal and ceramic-on-ceramic bearings were most commonly reported in privately insured male patients who were less than sixty-five years old. Thirty-three percent of patients over sixty-five years old had a hard-on-hard bearing reported. There was substantial regional variation in bearing usage; the highest prevalence of metal-on-polyethylene bearings was reported in the Northeast and at nonteaching hospitals, and the highest prevalence of metal-on-metal bearings was reported in the South and at teaching hospitals. Conclusions: The usage of total hip arthroplasty bearings varies considerably by patient characteristics, hospital type, and geographic location throughout the United States. Despite uncertain advantages in older patients, hard-on-hard bearings are commonly used in patients over the age of sixty-five years. Further study is necessary to define the appropriate indications for these advanced technologies in total hip arthroplasty.


Related Articles

  • "MINIMALLY INVASIVE" TOTAL HIP ARTHROPLASTY. Berry, Daniel J. // Journal of Bone & Joint Surgery, American Volume;Apr2005, Vol. 87-A Issue 4, p699 

    Comments on the introduction of the total hip arthroplasty to the orthopedic community. Information about the benefits of minimally minimally invasive total hip arthroplasty; Differences in the rates of complications of total hip arthroplasty; Methods of invasive total hip arthroplasty.

  • Conflict of Interest in the Assessment of Thromboprophylaxis After Total Joint Arthroplasty. Young-Kyun Lee; Chin Youb Chung; Kyung-Hoi Koo; Kyotmg Min Lee; Hyung-Min li; Moon Seok Park // Journal of Bone & Joint Surgery, American Volume;1/4/2012, Vol. 94-A Issue 1, p27 

    Background: The choice of modalities for thromboprophylaxis after total joint arthroplasty is controversial. To address this issue, an evidence-based review of previous studies was performed. The characteristics of the studies selected for review can affect the final conclusion of an...

  • Influence of cementless femoral stems inserted in varus on functional outcome in primary total hip arthroplasty. de Beer, Justin; McKenzie, Scott; Hubmann, Matthias; Petruccelli, Danielle; Winemaker, Mitchell // Canadian Journal of Surgery;Dec2006, Vol. 49 Issue 6, p407 

    Introduction: Historically, cemented total hip arthroplasty (THA) femoral stems inserted in varus have yielded poor clinical results. Few studies to date have addressed the question of the effects of varus alignment on cementless stems. We conducted a retrospective review of 125 uncemented THA...

  • How Reliable is the Safe Zone of Hardinge Approach for Superior Gluteal Nerve? Bülbül, Murat; Ayanoğlu, Semih; Öztürk, Kahraman; İmren, Yunus; Esenyel, Cem; Yeşıltepe, Rıdvan; Gürbüz, Hakan // Medical Journal of Trakya University / Trakya Universitesi Tip F;2009, Vol. 26 Issue 2, p134 

    Objectives: Anterolateral Hardinge approach is one of the most common approaches used for total hip arthroplasty. Superior gluteal nerve is the main motor nerve of abductor mechanism of gluteus medius and tensor fascia lata muscles, where the injury to this nerve manifests itself as...

  • Primary cemented total hip arthroplasty–an Indian experience. Todkar, Manoj // European Journal of Orthopaedic Surgery & Traumatology;Jun2006, Vol. 16 Issue 2, p1 

    We report outcome of 9-year follow-up of 50 Charnley cemented primary arthroplasties in 47 patients performed between 1996 and 1999. The minimum follow-up period was 5 years with a mean of 7 years. All hip joints were thoroughly assessed preoperatively to document patients’ functional...

  • TOTAL HIP ARTHROPLASTY WITH CEMENT AND WITHOUT ACETABULAR BONE GRAFT FOR SEVERE HIP DYSPLASIA. Klapach, A.S.; Callaghan, J.J.; Miller, K.A.; Goetz, D.D.; Sullivan, P.M.; Pedersen, D.R.; Johnston, R.C. // Journal of Bone & Joint Surgery, American Volume;Feb2005, Vol. 87-A Issue 2, p280 

    We previously evaluated a cohort of fifty-three patients with severe hip dysplasia (Crowe Type-II, III, or IV subluxation) who underwent a total of sixty-six Charnley total hip arthroplasties. The acetabular component was placed at the anatomic hip center, the superolateral defect was filled...

  • Non-union following bilateral simultaneos Ganz trochanteric osteotomy. Dixon, Sean M.; Reddy, Ravi P.; Williams, Dan; Fern, Darren; Norton, Mark R. // Orthopedic Reviews;2009, Vol. 1, p97 

    Between January 2003 and December 2004, 13 patients underwent bilateral resurfacing arthroplasty via a Ganz trochanteric osteotomy. This bilateral group was mobilised fully weight-bearing with crutches. During the same period 139 Ganz trochanteric osteotomies were performed for unilateral hip...

  • THE USE OF STRUCTURAL DISTAL FEMORAL ALLOGRAFTS FOR ACETABULAR RECONSTRUCTION. Sporer, Scott M.; O'Rourke, Michael; Chong, Paul; Paprosky, Wayne G. // Journal of Bone & Joint Surgery, American Volume;Apr2005, Vol. 87-A Issue 4, p760 

    Background: Acetabular fixation during revision total hip arthroplasty in patients who have a nonsupportive superior dome and proximal migration of tile acetabular component (a Paprosky Type-IIIa defect) cannot be achieved reliably with use of a hemispherical porous-coated component alone. The...

  • Revision of well-fixed infected Birmingham hip resurfacing using the Explant system and cement mould: an useful technique. Kapoor, Aditya; Luscombe, John C.; Reading, A. D. // European Journal of Orthopaedic Surgery & Traumatology;Jul2007, Vol. 17 Issue 4, p381 

    Deep infections do occur during hip resurfacing despite all precautions. We present the method and use of the acetabular bone stock preserving Explant system in the removal of infected well-fixed cementless acetabular components and the technique of using an antibiotic impregnated cement spacer...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics