Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/69923
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Type: Journal article
Title: Five-year results of the ASR XL acetabular system and the ASR hip resurfacing system: An analysis from the Australian Orthopaedic Association National Joint Replacement Registry
Author: de Steiger, R.
Hang, J.
Miller, L.
Graves, S.
Davidson, D.
Citation: Journal of Bone and Joint Surgery: American Volume, 2011; 93A(24):2287-2293
Publisher: Journal Bone Joint Surgery Inc
Issue Date: 2011
ISSN: 0021-9355
1535-1386
Statement of
Responsibility: 
Richard N. de Steiger, Jacqueline R. Hang, Lisa N. Miller, Stephen E. Graves, David C. Davidson
Abstract: <h4>Background</h4>Articular Surface Replacement (ASR) hip prostheses, which have metal-on-metal bearing surfaces, were manufactured by DePuy Orthopaedics (Warsaw, Indiana) for use in both conventional total hip arthroplasty and hip resurfacing. Both the ASR XL Acetabular System and the ASR Hip Resurfacing System were recently recalled worldwide by the manufacturer. This report summarizes an analysis by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) of the outcome of arthroplasties involving the ASR prostheses.<h4>Methods</h4>The first recorded use of the ASR XL Acetabular System in Australia occurred in 2004, and the Registry recorded 4406 procedures involving this system through December 31, 2009. The first recorded use of the ASR Hip Resurfacing System in Australia occurred in 2003, and the Registry recorded 1167 procedures through December 31, 2009. The Kaplan-Meier method and proportional-hazard modeling were used to compare the revision rate of primary total hip arthroplasties involving the ASR XL Acetabular System with that of arthroplasties involving all other conventional prostheses as well as with that of arthroplasties involving all other conventional prostheses with a metal-on-metal-articulation. In addition, the revision rate of primary arthroplasties involving the ASR Hip Resurfacing System was compared with that of arthroplasties involving all other hip resurfacing prostheses. Patient demographics, prosthesis characteristics, and information regarding the type of revision and the reason for revision were also compared.<h4>Results</h4>Arthroplasties involving both ASR designs had a significantly greater revision rate compared with those involving all other prostheses. The cumulative revision rate of arthroplasties involving the ASR XL Acetabular System at five years postoperatively was 9.3% (95% confidence interval [CI], 7.3% to 11.9%) compared with 3.4% (95% CI, 3.3% to 3.5%) for total hip arthroplasties involving all other conventional prostheses. The cumulative revision rate of arthroplasties involving the ASR Hip Resurfacing System at five years postoperatively was 10.9% (95% CI, 8.7% to 13.6%) compared with 4.0% (95% CI, 3.7% to 4.5%) for arthroplasties involving all other resurfacing prostheses. Arthroplasties involving the ASR XL Acetabular System had a greater rate of revision due to implant loosening and/or osteolysis and due to metal sensitivity compared with total hip arthroplasties involving all other conventional prostheses. Arthroplasties involving the ASR XL Acetabular System also had a significantly greater revision rate compared with total hip arthroplasties involving all other conventional metal-on-metal prostheses. Arthroplasties involving the ASR Hip Resurfacing System had a greater rate of revision due to metal sensitivity compared with total hip arthroplasties involving all other resurfacing prostheses.<h4>Conclusions</h4>ASR prostheses used in conventional hip arthroplasty and in hip resurfacing exhibited a greater revision rate compared with other prostheses in the AOANJRR. These results are consistent with those derived from other registries and from published studies of individual cohorts.
Keywords: Humans
Osteoarthritis, Hip
Prosthesis Failure
Radiography
Treatment Outcome
Arthroplasty, Replacement, Hip
Reoperation
Registries
Confidence Intervals
Proportional Hazards Models
Retrospective Studies
Cohort Studies
Follow-Up Studies
Prosthesis Design
Hip Prosthesis
Time Factors
Societies, Medical
Australia
Male
Kaplan-Meier Estimate
Rights: Copyright © The Journal of Bone and Joint Surgery, Inc.
DOI: 10.2106/JBJS.J.01727
Appears in Collections:Aurora harvest
Public Health publications

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