Is there a reduction in risk of revision when 36-mm heads instead of 32 mm are used in total hip arthroplasty for patients with proximal femur fractures? A matched analysis of 5,030 patients with a median of 2.5 years’ follow-up between 2006 and 2016 in the Nordic Arthroplasty Register Association

Georgios Tsikandylakis; Johan N Kärrholm; Geir  Hallan; Ove  Furnes; Antti  Eskelinen; Keijo  Mäkelä; Alma B Pedersen; Søren Overgaard; Maziar  Mohaddes

doi:10.1080/17453674.2020.1752559

Is there a reduction in risk of revision when 36-mm heads instead of 32 mm are used in total hip arthroplasty for patients with proximal femur fractures?

A matched analysis of 5,030 patients with a median of 2.5 years’ follow-up between 2006 and 2016 in the Nordic Arthroplasty Register Association

Authors

Georgios Tsikandylakis Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; The Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Dept of Orthopaedics, Gothenburg, Sweden
Johan N Kärrholm Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; The Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Dept of Orthopaedics, Gothenburg, Sweden
Geir Hallan The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Norway; Department of Clinical Medicine, University of Bergen, Norway
Ove Furnes The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Norway; Department of Clinical Medicine, University of Bergen, Norway
Antti Eskelinen Coxa Hospital of Joint Replacement, Tampere Finland; The Finnish Arthroplasty Register, Finland
Keijo Mäkelä The Finnish Arthroplasty Register, Finland; Department of Orthopaedics and Traumatology, Turku University Hospital, Finland
Alma B Pedersen Department of Clinical Epidemiology, Aarhus University Hospital, Denmark; The Danish Hip Arthroplasty Register, Denmark
Søren Overgaard The Danish Hip Arthroplasty Register, Denmark; Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark;Institute of Clinical Research, University of Southern Denmark
Maziar Mohaddes Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; The Swedish Hip Arthroplasty Register, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Dept of Orthopaedics, Gothenburg, Sweden

DOI:

https://doi.org/10.1080/17453674.2020.1752559

Abstract

Background and purpose — 32-mm heads are widely used in total hip arthroplasty (THA) in Scandinavia, while the proportion of 36-mm heads is increasing as they are expected to increase THA stability. We investigated whether the use of 36-mm heads in THA after proximal femur fracture (PFF) is associated with a lower risk of revision compared with 32-mm heads.

Patients and methods — We included 5,030 patients operated with THA due to PFF with 32- or 36-mm heads from the Nordic Arthroplasty Register Association database. Each patient with a 36-mm head was matched with a patient with a 32-mm head, using propensity score. The patients were operated between 2006 and 2016, with a metal or ceramic head on a polyethylene bearing. Cox proportional hazards models were fitted to estimate the unadjusted and adjusted hazard ratio (HR) with 95% confidence intervals (CI) for revision for any reason and revision due to dislocation for 36-mm heads compared with 32-mm heads.

Results — 36-mm heads had an HR of 0.9 (CI 0.7–1.2) for revision for any reason and 0.8 (CI 0.5–1.3) for revision due to dislocation compared with 32-mm heads at a median follow-up of 2.5 years (interquartile range 1–4.4).

Interpretation — We were not able to demonstrate any clinically relevant reduction of the risk of THA revision for any reason or due to dislocation when 36-mm heads were used versus 32-mm. Residual confounding due to lack of data on patient comorbidities and body mass index could bias our results.

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2020-04-14

How to Cite

Tsikandylakis, G., Kärrholm, J. N., Hallan, G. ., Furnes, O. ., Eskelinen, A. ., Mäkelä, K. ., … Mohaddes, M. . (2020). Is there a reduction in risk of revision when 36-mm heads instead of 32 mm are used in total hip arthroplasty for patients with proximal femur fractures? A matched analysis of 5,030 patients with a median of 2.5 years’ follow-up between 2006 and 2016 in the Nordic Arthroplasty Register Association. Acta Orthopaedica, 91(4), 401–407. https://doi.org/10.1080/17453674.2020.1752559

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Acta Orthopaedica, Volume 91, Issue 4 (2020)

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Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.