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Type: Journal article
Title: Ceramic-on-ceramic bearing surface and risk of revision due to dislocation after primary total hip replacement
Author: Sexton, S.
Walter, W.
Jackson, M.
de Steiger, R.
Stanford, T.
Citation: Journal of Bone and Joint Surgery: British Volume, 2009; 91(11):1448-1453
Publisher: British Editorial Soc Bone Joint Surgery
Issue Date: 2009
ISSN: 0301-620X
Statement of
S. A. Sexton, W. L. Walter, M. P. Jackson, R. De Steiger and T. Stanford
Abstract: Dislocation is a common reason for revision following total hip replacement. This study investigated the relationship between the bearing surface and the risk of revision due to dislocation. It was based on 110 239 primary total hip replacements with a diagnosis of osteoarthritis collected by the Australian Orthopaedic Association National Joint Replacement Registry between September 1999 and December 2007. A total of 862 (0.78%) were revised because of dislocation. Ceramic-on-ceramic bearing surfaces had a lower risk of requiring revision due to dislocation than did metal-on-polyethylene and ceramic-on-polyethylene surfaces, with a follow-up of up to seven years. However, ceramic-on-ceramic implants were more likely to have larger prosthetic heads and to have been implanted in younger patients. The size of the head of the femoral component and age are known to be independent predictors of dislocation. Therefore, the outcomes were stratified by the size of the head and age. There is a significantly higher rate of revision for dislocation in ceramic-on-ceramic bearing surfaces than in metal-on-polyethylene implants when smaller sizes (< or = 28 mm) of the head were used in younger patients (< 65 years) (hazard ratio = 1.53, p = 0.041) and also with larger (> 28 mm) and in older patients (> or = 65 years) (hazard ratio = 1.73, p = 0.016).
Keywords: Femur Head
Osteoarthritis, Hip
Hip Dislocation
Prosthesis Failure
Arthroplasty, Replacement, Hip
Follow-Up Studies
Prosthesis Design
Hip Prosthesis
Age Factors
Surface Properties
Middle Aged
Description: Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
DOI: 10.1302/0301-620X.91B11.22100
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