Do We Need to Follow up Primary Total Hip Replacements?

Author(s):  
Cronan Kerin ◽  
G. Cheung ◽  
N. Graham ◽  
P. Cool
1992 ◽  
Vol 41 (2) ◽  
pp. 604-607
Author(s):  
Kiyotaka Okuyama ◽  
Kenichiro Shibata ◽  
Masahiro Kina ◽  
Shinji Tomari ◽  
Shinichi Motomatsu ◽  
...  

2005 ◽  
Vol 15 (3) ◽  
pp. 129-135 ◽  
Author(s):  
B. Sonny Bal ◽  
T.J. Aleto ◽  
J.P. Garino ◽  
A. Toni ◽  
K.J. Hendricks

One reason why otherwise well-functioning total hip replacements have a finite service life is eventual aseptic loosening of the implants because of osteolysis induced by wear particles from the artificial bearing. Pain and osteolysis from wear debris can manifest even in the absence of aseptic loosening. Total hip replacements with ceramic-on-ceramic articulations have shown less wear both in vitro and in vivo. A randomized prospective clinical trial was conducted to compare the outcomes of ceramic-on-ceramic articulations to ceramic-on-polyethylene articulations. Two-year data are of interest because premature failures of ceramic femoral heads usually occur by this time interval. Of 500 patients enrolled in this trial, half received total hip replacements with alumina-on-alumina bearings, while the other half had ceramic-on-polyethylene bearings. At the two-year follow-up, 444 patients (217 study group and 227 control group) were available for review. The clinical and radiographic outcomes between the groups were comparable, and reflected the typical results of primary total hip replacements. No complications related to spontaneous failures of the ceramic bearings were observed at this early follow-up period. Further follow-up is needed to confirm these findings over the long-term, but the short-term safety of alumina ceramic bearings in hip replacements reported in other recent reports is further validated by our findings.


2020 ◽  
Author(s):  
Eva Dybvik ◽  
Ove Furnes ◽  
Leif I. Havelin ◽  
Sophie D. Fosså ◽  
Clement Trovik ◽  
...  

Abstract Background Concerns have been raised that implants used in total hip replacements (THR) could lead to a future increased cancer risk. Several different materials and metals are used in joint prosthesis, as well as different fixation techniques and types of articulation for the surface of the joint can lead to an increased escape of particles or ions into the human body. Methods Patients with THR registered in the Norwegian Arthroplasty Register during 1987-2009 were linked to the Cancer registry of Norway. Patients with THR due to osteoarthritis, under the age of 75 at time of surgery, were included. Standardized incidence ratios (SIR) were applied to compare cancer risk for THR patients to the general population. Types of THR were divided into cemented (both components), uncemented (both components), and hybrid (cemented femoral and uncemented acetabular component). To account for selection mechanisms, time dependent covariates were applied in Cox-regression, adjusting for cancer risk the first 10 years after surgery. The analyses were adjusted for age, gender, and if the patient had additional THR-surgery in the same or the opposite hip. The study is according to the STROBE guidelines.Results When comparing patients with THR to the general population in Norway we found no differences in the risk. The overall SIR for the THR-patients after 10 years of follow-up was 1.02 (95% CI: 0.97-1.07). For cemented THR, the SIR after 10 years of follow-up was 0.99 (95% CI: 0.94-1.05), while it was 1.16 (95% CI: 1.02-1.30) for uncemented THRs, and 1.12 (95% CI: 0.91-1.33) for hybrid THRs. Adjusted Cox analyses showed that patients with uncemented THRs had an elevated risk of cancer (hazard ratio: HR=1.24, 95% CI: 1.05-1.46, p=0.009) when compared to patients with cemented THRs after 10 years of follow-up. The risk for patients with hybrid THRs was not significantly increased (HR=1.07, 95% CI: 0.85-1.35, p=0.55) compared to patients with cemented THRs. Conclusions We found that receiving an uncemented THR was associated with a small increased risk of cancer, in particular prostate cancer for younger men.


2020 ◽  
Author(s):  
Eva Dybvik ◽  
Ove Furnes ◽  
Leif I. Havelin ◽  
Sophie D. Fosså ◽  
Clement Trovik ◽  
...  

Abstract Background: Concerns have been raised that implants used in total hip replacements (THR) could lead to increased cancer risk. Several different materials, metals and fixation techniques are used in joint prostheses and different types of articulation can cause an increased invasion of particles or ions into the human body. Methods: Patients with THR registered in the Norwegian Arthroplasty Register during 1987-2009 were linked to the Cancer registry of Norway. Patients with THR due to osteoarthritis, under the age of 75 at time of surgery, were included. Standardized incidence ratios (SIR) were applied to compare cancer risk for THR patients to the general population. Types of THR were divided into cemented (both components), uncemented (both components), and hybrid (cemented femoral and uncemented acetabular components). To account for selection mechanisms, time dependent covariates were applied in Cox-regression, adjusting for cancer risk the first 10 years after surgery. The analyses were adjusted for age, gender and if the patient had additional THR-surgery in the same or the opposite hip. The study follows the STROBE guidelines.Results: Comparing patients with THR to the general population in Norway we found no differences in cancer risk. The overall SIR for the THR-patients after 10 years follow-up was 1.02 (95% CI: 0.97-1.07). For cemented THR, the SIR after 10 years follow-up was 0.99 (95% CI: 0.94-1.05), for uncemented, 1.16 (95% CI: 1.02-1.30), and for hybrid 1.12 (95% CI: 0.91-1.33). Adjusted Cox analyses showed that patients with uncemented THRs had an elevated risk for cancer (hazard ratio: HR=1.24, 95% CI: 1.05-1.46, p=0.009) when compared to patients with cemented THRs after 10 years follow-up. Stratified by gender the increased risk was only present for men. The risk for patients with hybrid THRs was not significantly increased (HR=1.07, 95% CI: 0.85-1.35, p=0.55) compared to patients with cemented THRs.Conclusions: THR patients had no increased risk for cancer compared to the general population. We found, however, that receiving an uncemented THR was associated with a small increased risk for cancer compared to cemented THR in males, but that this may be prone to unmeasured confounding.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Eva Dybvik ◽  
Ove Furnes ◽  
Leif I. Havelin ◽  
Sophie D. Fosså ◽  
Clement Trovik ◽  
...  

Abstract Background Concerns have been raised that implants used in total hip replacements (THR) could lead to increased cancer risk. Several different materials, metals and fixation techniques are used in joint prostheses and different types of articulation can cause an increased invasion of particles or ions into the human body. Methods Patients with THR registered in the Norwegian Arthroplasty Register during 1987–2009 were linked to the Cancer registry of Norway. Patients with THR due to osteoarthritis, under the age of 75 at time of surgery, were included. Standardized incidence ratios (SIR) were applied to compare cancer risk for THR patients to the general population. Types of THR were divided into cemented (both components), uncemented (both components), and hybrid (cemented femoral and uncemented acetabular components). To account for selection mechanisms, time dependent covariates were applied in Cox-regression, adjusting for cancer risk the first 10 years after surgery. The analyses were adjusted for age, gender and if the patient had additional THR-surgery in the same or the opposite hip. The study follows the STROBE guidelines. Results Comparing patients with THR to the general population in Norway we found no differences in cancer risk. The overall SIR for the THR-patients after 10 years follow-up was 1.02 (95% CI: 0.97–1.07). For cemented THR, the SIR after 10 years follow-up was 0.99 (95% CI: 0.94–1.05), for uncemented, 1.16 (95% CI: 1.02–1.30), and for hybrid 1.12 (95% CI: 0.91–1.33). Adjusted Cox analyses showed that patients with uncemented THRs had an elevated risk for cancer (hazard ratio: HR = 1.24, 95% CI: 1.05–1.46, p = 0.009) when compared to patients with cemented THRs after 10 years follow-up. Stratified by gender the increased risk was only present for men. The risk for patients with hybrid THRs was not significantly increased (HR = 1.07, 95% CI: 0.85–1.35, p = 0.55) compared to patients with cemented THRs. Conclusions THR patients had no increased risk for cancer compared to the general population. We found, however, that receiving an uncemented THR was associated with a small increased risk for cancer compared to cemented THR in males, but that this may be prone to unmeasured confounding.


2007 ◽  
Vol 2 (3-4) ◽  
pp. 178-185 ◽  
Author(s):  
J. -Y. Lazennec ◽  
P. Boyer ◽  
J. Poupon ◽  
M. -A. Rousseau ◽  
F. Laude ◽  
...  

2013 ◽  
Vol 95 (3) ◽  
pp. 88-91
Author(s):  
J Lloyd ◽  
I Starks ◽  
T Wainwright ◽  
R Middleton

Metal-on-metal (MoM) hip resurfacings (HRs) and large head total hip replacements (LHTHRs) were perceived by many as a surgical revolution, with clear advantages over the traditional metal-on-polyethylene total hip replacement (THR). This is especially the case for younger, active individuals in whom conventional THR has been associated with higher rates of aseptic loosening. In addition to less bearing surface wear, frequently cited advantages for HR include the preservation of femoral bone stock, lower dislocation rates, and superior function and activity scores.


1978 ◽  
Vol 7 (2) ◽  
pp. 107-110 ◽  
Author(s):  
H. S. Dobbs

The paper reports on the incidence of fracture of the femoral component of total hip replacements in patients at the Royal National Orthopaedic Hospital over the period 1963-1976. The average incidence of fracture was approximately 0.2 per cent per year for air melt air cast cobalt chrome components. For vacuum melt vacuum cast components there were no fractures, but because of the small number of insertions with a long follow-up period, this result could have been fortuitous. There was a suggestion that the fracture rate increased with time, but even 0.2 per cent is considered too high.


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