69.
Current fixation usage and registry outcomes in total hip arthroplasty:
The uncemented paradox
Anders Troelsen, Erik Malchau, Nanna Sillesen, Henrik Malchau
Clinical Orthopaedic Research Hvidovre Hvidovre University Hospital; Harris
Orthopaedic Laboratory, Massachusetts General Hospital, Boston; Harris
Orthopaedic Laboratory, Massachusetts General Hospital, Boston; Harris
Orthopaedic Laboratory, Massachusetts General Hospital, Boston
Background:
A high 86 % of total hip replacements (THR) performed in the
US are uncemented. This could be worrying for the future revision burden if
uncemented fixation is not associated with the lowest risk of revision
considering nationwide use of THR.
Purpose / Aim of Study:
To investigate trends for usage of uncemented
fixation and to analyze age stratified risk of revision comparing cemented,
hybrid, and uncemented fixation by inquiry to national hip arthroplasty
registries.
Materials and Methods:
Data were extracted from annual reports of national
hip arthroplasty registries if these were available in English or a Scandinavian
language and if the registry had a history of more than 5 years of data
collection.
Findings / Results:
Current usage of uncemented fixation varies between 15
%
in Sweden and 82 % in Canada for primary THR. From 2006 to 2010 the
registries of all countries reports overall increases in uncemented fixation
usage with Sweden reporting the least increase (10 % to 15 %) and Denmark
the greatest increase (47 % to 68 %). There is a clear pattern that risk of
revision is statistically significant lower using cemented compared with
uncemented fixation for the oldest age group (>75 years).
Conclusions:
Increasing use of uncemented fixation in THR is a worldwide
phenomenon. This trend is paradox to data from registries, representing
nationwide THR outcomes, suggesting that use of cemented fixation in
patients above 75 years provides the lowest risk of revision.
