Revision ArthroplastyConstrained Acetabular Components Used in Revision Total Hip Arthroplasty: A Registry Analysis
Section snippets
Materials and Methods
The AOANJRR commenced data collection on September 1, 1999, achieving complete national implementation by mid-2002. Since then, the AOANJRR has collected data on almost 100% of hip and knee arthroplasty procedures performed in Australia. AOANJRR data are externally validated against patient-level data provided by all Australian state and territory health departments. A sequential, multilevel, matching process is used to identify any missing data which are subsequently retrieved by contacting
Results
A total of 9509 revision hip arthroplasty procedures of known primary THAs performed for OA were included. Of these, 700 used constrained acetabular components. These included 72 constrained cups and 628 constrained acetabular liners.
When the large-head metal-on-metal (MoM) components were included, constrained components had a significantly higher rate of revision after 3 months (HR = 1.37 [1.10-1.70]; P = .005). When large-head MoM components were excluded from the analysis, constrained hips
Discussion
This large Registry analysis has shown that when used in revision hip arthroplasty, constrained devices have similar results when compared with revisions using nonconstrained components. Studies reporting good results for constrained devices often have short follow-up periods with mean of <4 years [4], [17], [18], [19], [20], [21], [22], [23], [24], while 10-year minimum follow-up reports showed poorer results with a rerevision rate of 21%-42.1% [16], [25], [26]. In this study, constrained hips
Conclusions
This study of constrained acetabular components compared with nonconstrained components used for revision hip arthroplasty has shown similar second-revision rates, but a significant difference is evident after 3 months, where large-head MoM components were included. Disappointingly, when used specifically for treatment of dislocation, there is no difference in the overall second-revision rates, while constrained components have a higher second-revision rate for repeated dislocation. Although it
Acknowledgments
The authors thank the Australian Orthopaedic Association National Joint Replacement Registry and the hospitals, orthopedic surgeons, and patients whose data made this work possible.
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One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2017.04.043.
The Australian Government funds the Australian Orthopaedic Association National Joint Replacement Registry through the Department of Health and Ageing.