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The association between cement type and the subsequent risk of revision surgery in primary total hip replacement: 199, 205 hips from the National Joint Registry for England, Wales and Northern Ireland

Research output: Contribution to journalArticle

Original languageEnglish
Number of pages7
JournalActa Orthopaedica
Early online date26 Oct 2017
DateAccepted/In press - 16 Sep 2017
DateE-pub ahead of print (current) - 26 Oct 2017


Background and purpose — To further improve the success of joint replacement surgery, attention needs to be paid to variations associated with improved or worsened outcomes. We investigated the association between the type of bone cement used and the risk of revision surgery after primary total hip replacement. Methods — We conducted a prospective study of data from the National Joint Registry for England and Wales between April 1, 2003 and December 31, 2013. 199,205 primary total hip replacements performed for osteoarthritis where bone cement was used were included. A multilevel over-dispersed piecewise Poisson model was used to estimate differences in the rate of revision by bone cement type adjusted for implant type, head size, age, sex, ASA grade, and surgical approach. Results — The rate of revision was higher in DePuy CMW3 medium viscosity with gentamicin (IRR 2.0, 95% CI 1.5–2.7) and DePuy SmartSet high viscosity plain (IRR 2.7, 95% CI 1.1–5.5), and lower in DePuy CMW1 high viscosity plain (IRR 0.44, 95% CI 0.19–0.89) bone cements compared with Heraeus Palacos high viscosity with gentamicin. Revision rates were similar between plain and antibiotic-loaded bone cement. Interpretation — The majority of bone cements performed similarly well, excluding DePuy SmartSet high viscosity and CMW3 high viscosity with gentamicin, which both had higher revision rates. We found no clear differences by viscosity or antibiotic content.

    Structured keywords

  • Centre for Surgical Research

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