Trabecular Metal Acetabular Components Reduce the Risk of Revision Following Primary Total Hip Arthroplasty: A Propensity Score Matched Study From the National Joint Registry for England and Wales

G.S. Matharu, A. Judge, D.W. Murray, H.G. Pandit

Research output: Contribution to journalArticle (Academic Journal)peer-review

14 Citations (Scopus)

Abstract

Trabecular metal (TM)-coated acetabular components are increasingly used in both primary and revision total hip arthroplasty (THA). However, previous studies assessing TM acetabular components have been small single-center cohorts with most lacking a control group. We compared revision rates following primary THA between TM and non-TM-coated acetabular components.A retrospective observational study was performed using National Joint Registry data, which included primary THAs with the same cementless acetabular component (either TM or non-TM coated). TM and non-TM implants were matched for multiple potential confounding factors using propensity scores. Outcomes following primary THA (revision for all-cause acetabular indications, aseptic acetabular loosening, and infection) were compared between matched groups using competing risk regression analysis.In 18,200 primary THAs (9100 TM and 9100 non-TM), the overall prevalence of acetabular revision, revision for aseptic acetabular loosening, and septic revision was 1.2%, 0.13%, and 0.59% respectively. Five-year revision rates for all-causes (1.0% vs 1.8%, sub-hazard ratio [SHR] 0.57, 95% confidence interval [CI] 0.43-0.76, P <.001), aseptic acetabular loosening (0.1% vs 0.2%, SHR 0.35, 95% CI 0.14-0.90, P = .029), and infection (0.5% vs 0.9%, SHR 0.51, 95% CI 0.34-0.76, P = .001) were all lower in TM compared with non-TM implants.Following primary THA, TM-coated acetabular implants had a reduced risk of both aseptic and septic revision compared with non-TM implants. Although absolute differences in revision risk were small, they may be clinically significant if TM designs were implanted in more complex cases.
Original languageEnglish
Pages (from-to)447-452
Number of pages6
JournalJournal of Arthroplasty
Volume33
Issue number2
Early online date5 Sep 2017
DOIs
Publication statusPublished - Feb 2018

Keywords

  • primary total hip arthroplasty
  • revision surgery
  • trabecular metal
  • aseptic loosening
  • infection

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