Lowest risk seen for implants with delta ceramic or oxidized zirconium head and HCLPE liner/cup
By Elana Gotkine HealthDay Reporter
TUESDAY, Nov. 12, 2024 (HealthDay News) — For patients undergoing primary total hip replacement (THR), the rate of revision varies by type of material used in the bearing surface, according to a study published online Nov. 7 in PLOS Medicine.
Michael R. Whitehouse, M.B., Ch.B., from the University of Bristol Medical School in the United Kingdom, and colleagues examined the revision rate of primary THR reported in the National Joint Registry. Data were analyzed for 1,026,481 primary THRs (monobloc: 378,979; modular: 647,502), of which 2 percent subsequently underwent a revision episode (monobloc: 7,381; modular: 13,488).
The researchers found that for monobloc implants, the all-cause risk for revision for monobloc acetabular implants was higher for patients with a cobalt chrome or stainless steel head and non-highly crosslinked polyethylene (HCLPE) cup versus those with a cobalt chrome head and HCLPE cup (hazard ratio at 10 years after surgery, 1.28 and 1.18, respectively). Patients with a delta ceramic head and HCLPE cup implant had a lower risk for revision at any postoperative period (hazard ratio at 10 years, 0.61). For modular implants, the all-cause risk for revision varied inconsistently for patients with modular acetabular implants compared with patients with a cobalt chrome head and HCLPE liner primary THR. The risk for revision was lower throughout the postoperative period for THRs with a delta ceramic or oxidized zirconium head and HCLPE liner (hazard ratios, 0.79 and 0.65, respectively).
“Further work is required to determine the association of implant bearing materials with the risk of rehospitalization, reoperation other than revision, mortality, and the cost-effectiveness of these materials,” the authors write.
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