TITLE

Obesity, Age, Sex, Diagnosis, and Fixation Mode Differently Affect Early Cup Failure in Total Hip Arthroplasty: A Matched Case-Control Study of 4420 Patients

AUTHOR(S)
Röder, Christoph; Bach, Belinda; Berry, Daniel J.; Eggli, Stefan; Langenhahn, Ronny; Busato, Andre
PUB. DATE
August 2010
SOURCE
Journal of Bone & Joint Surgery, American Volume;Aug2010, Vol. 92-A Issue 10, p1954
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Studies about the influence of patient characteristics on mechanical failure of cups in total hip replacement have applied different methodologies and revealed inconclusive results. The fixation mode has rarely been investigated. Therefore, we conducted a detailed analysis of the influence of patient characteristics and fixation mode on cup failure risks. Methods: We conducted a case-control study of total hip arthroplasties in 4420 patients to test our hypothesis that patient characteristics of sex, age, weight, body mass index, and diagnosis have different influences on risks for early mechanical failure in cemented and uncemented cups. Results: Women had significantly reduced odds for failure of cups with cemented fixation (odds ratio = 0.59; 95% confidence interval, 0.43 to 0.83; p = 0.002) and uncemented fixation (odds ratio = 0.63; 95% confidence interval, 0.5 to 0.81; p = 0.0003) compared with that for men (odds ratio = 1). Each additional year of patient age at the time of surgery reduced the failure odds by a factor of 0.98 for both cemented cups (odds ratio = 0.98; 95% confidence interval, 0.96 to 0.99; p = 0.016) and uncemented cups (odds ratio = 0.98; 95% confidence interval, 0.97 to 0.99; p = 0.0002). In patients with cemented cups, the weight group of 73 to 82 kg had significantly lower failure odds (odds ratio = 0.63; 95% confidence interval, 0.4 to 0.98) than the lightest (<64 kg) weight group or the heaviest (>82 kg) weight group (odds ratios = 1.00 and 1.07, respectively). No significant effects of weight were noted in the uncemented group. In contrast, obese patients (a body mass index of >30 kg/m²) with uncemented cups had significantly elevated odds relative to patients with a body mass of <25 kg/m² (odds ratio = 1.41; 95% confidence interval, 1.03 to 1.91) for early failure of the cups compared with an insignificant effect in the cemented arm of the study. Compared with osteoarthritis as the reference diagnosis (odds ratio = 1), developmental dysplasia (odds ratio = 0.52; 95% confidence interval, 0.28 to 0.97) and hip fracture (odds ratio = 0.38; 95% confidence interval, 0.16 to 0.92) were significantly protective in cemented cups. Conclusions: Female sex and older age have similarly protective effects on the odds for early failure of cemented and uncemented cups. Although a certain body-weight range has a significant protective effect in cemented cups, the more important finding was the significantly increased risk for failure of uncemented cups in obese patients. Patients with developmental dysplasia and hip fracture were the only diagnostic groups with a significantly decreased risk for cup failure, but only with cemented fixation.
ACCESSION #
53494678

 

Related Articles

  • TOTAL HIP REPLACEMENT WITH THE CLS EXPANSION SHELL AND A STRUCTURAL FEMORAL HEAD AUTOGRAFT FOR PATIENTS WITH CONGENITAL HIP DISEASE. Rozkydal, Zbyňek; Janícek, Pavel; Šmíd, Zdeněk // Journal of Bone & Joint Surgery, American Volume;Apr2005, Vol. 87-A Issue 4, p801 

    Background: Reconstruction of a dysplastic acetabulum in a patient with osteoarthritis of the hip may be accomplished with a variety of surgical techniques. The aim of our study was to assess the outcomes of total hip replacement with the uncemented CLS expansion shell and a structural femoral...

  • Bilateral total hip arthroplasty in Severe Hereditary Multiple Exostosis: a report of two cases. MORRAN, MATTHEW; KRIEG, ANDREAS H.; BOYLE, RICHARD A.; STALLEY, PAUL D. // Hip International;Jul-Sep2009, Vol. 19 Issue 3, p279 

    Staged bilateral hip arthroplasties were carried out in two patients with osteoarthritis of the hip secondary to the development of hip dysplasia in Hereditary Multiple Exostosis (HME). Both patients had near ankylosis of their hips with pain and difficulty in performing activities of daily...

  • Hüftgelenkendoprothetik bei kongenitaler Dysplasie. Holzapfel, B. M.; Bürklein, D.; Greimel, F.; Nöth, U.; Hoberg, M.; Gollwitzer, H.; Rudert, M. // Der Orthopäde;Jun2011, Vol. 40 Issue 6, p543 

    Total hip arthroplasty is the procedure of choice for most patients with advanced, symptomatic osteoarthritis due to congenital dysplasia of the hip. However, the complexity of arthroplasty is significantly increased because of anatomic abnormalities associated with dysplasia of the hip. In...

  • Poor results of the cementless total hip arthroplasty with a nonporous coated acetabular component: AcSys Shearer Cup. Masahide Ikema; Masamizu Oyama; Atsushi Kita; Kanichi Funayama // Journal of Orthopaedic Science;Sep2007, Vol. 12 Issue 5, p466 

    Abstract Background  This study followed patients for a minimum of 7 years after primary total hip arthroplasty using cementless acetabular components and evaluated their outcomes. Methods  We followed 73 patients (75 hips), who had undergone total hip arthroplasty with cementless...

  • WHAT'S NEW IN ORTHOPAEDIC REHABILITATION. Hebela, Nader; Smith, Douclas G.; Keenan, Mary Ann // Journal of Bone & Joint Surgery, American Volume;Nov2004, Vol. 86-A Issue 11, p2577 

    The article presents information related to developments made in several areas of orthopaedic rehabilitaion. Gait analysis is an important tool that is used to understand the complexities of movement and lower extremity function. Dynamic electromyography has a proven role in the clinical...

  • Primary total hip arthroplasty with Asian-type AML total hip prosthesis: follow-up for more than 10 years. Mitsunori Kaya; Satoshi Nagoya; Mikito Sasaki; Yutaka Kukita; Toshihiko Yamashita // Journal of Orthopaedic Science;Jul2008, Vol. 13 Issue 4, p324 

    Abstract Background  We retrospectively reviewed 137 consecutive total hip arthroplasties performed with AML-A stems and Tri-Lock cups to see whether design modifications made to these components would achieve durable biological fixation in the Japanese population in whom developmental...

  • The influence of walking speed on kinetic and kinematic parameters in patients with osteoarthritis of the hip using a force-instrumented treadmill and standardised gait speeds. Möckel, Gregor; Perka, Carsten; Labs, Karsten; Duda, Georg // Archives of Orthopaedic & Trauma Surgery;Jul2003, Vol. 123 Issue 6, p278 

    Background. It is difficult to identify objective parameters for assessing the joint function when dealing with the evaluation of orthopaedic procedures, especially endoprosthetic hip replacement. Clinical gait analysis enables parameters of force and movement to be quantified. However, the...

  • An experience of arthroplasty in Klippel–Trenaunay Syndrome. Mallick, A.; Weeber, A. C. // European Journal of Orthopaedic Surgery & Traumatology;Jan2007, Vol. 17 Issue 1, p97 

    We wish to discuss the peri-operative problems, difficulties and management in a patient with Klippel–Trenaunay (KT) syndrome undergoing total hip arthroplasty. Although Klippel–Trenaunay is a well-described entity in the realm of haematology, we are unable to find any previous...

  • METAL-ON-METAL HIP RESURFACING IN OSTEONECROSIS OF THE FEMORAL HEAD. Revell, Matthew P.; McBryde, Callum W.; Bhatnagar, Sharad; Pynsent, Paul B.; Treacy, Ronan B. C. // Journal of Bone & Joint Surgery, American Volume;Nov2006 Supplement 3, Vol. 88-A, p98 

    Background: The treatment of end-stage osteonecrosis of the femoral head remains a challenge to the orthopaedic surgeon. Historically, total hip arthroplasty for this condition has been associated with poor rates of survival and function when compared with total hip arthroplasty for the...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

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

Try another library?
Sign out of this library

Other Topics