Author/Authors :
SEPPÄNEN, Matti Department of Orthopaedics and Traumatology - Turku University Hospital, Turku , KARVONEN, Mikko Department of Orthopaedics and Traumatology - Turku University Hospital, Turku , VIROLAINEN, Petri Department of Orthopaedics and Traumatology - Turku University Hospital, Turku , REMES, Ville Pihlajalinna Ltd, Helsinki , PULKKINEN, Pekka Department of Public Health - Helsinki University, Helsink , ESKELINEN, Antti Coxa Hospital for Joint Replacement, Tampere , LIUKAS, Antti Department of Anesthesiology - Turku University Hospital, Turku, Finland , MÄKELÄ, Keijo T Department of Orthopaedics and Traumatology - Turku University Hospital, Turku
Abstract :
Background and purpose — In a previous registry report, short-
term implant survival of hip resurfacing arthroplasty (HRA) in
Finland was found to be comparable to that of total hip arthro-
plasty (THA). Since then, it has become evident that adverse reac-
tions to metal debris (ARMDs) may also be associated with HRA,
not only with large-diameter head metal-on-metal THA. The aim
of the study was to assess medium- to long-term survivorship of
HRA based on the Finnish Arthroplasty Register (FAR).
Patients and methods — 5,068 HRAs performed during the
period 2001–2013 in Finland were included. Kaplan-Meier sur-
vival analysis was used to calculate survival probabilities and
their 95% confi dence intervals (CIs). Cox multiple regression,
with adjustment for age, sex, diagnosis, femoral head size, and
hospital volume was used to analyze implant survival of HRA
devices with revision for any reason as endpoint. The reference
group consisted of 6,485 uncemented Vision/Bimetric and ABG II
THAs performed in Finland over the same time period.
Results — The 8-year survival, with any revision as an end-
point, was 93% (CI: 92–94) for Birmingham Hip Resurfacing
(BHR), 86% (CI: 78–94) for Corin, 91% (CI: 89–94) for ReCap,
92% (CI: 89–96) for Durom, and was 72% (CI: 69–76) for the
Articular Surface Replacement (ASR). The 10-year survival, with
any revision as an endpoint, for reference THAs was 92% (CI:
91–92) and for all HRAs it was 86% (CI: 84–87%). Female HRA
patients had about twice the revision risk of male patients. ASR
had an inferior outcome: the revision risk was 4-fold higher than
for BHR, the reference implant.
Interpretation — The 10-year implant survival of HRAs is 86%
in Finland. According to new recommendations from NICE (The
National Institute for Health and Care Excellence), an HRA/THA
should have a revision rate of 5% or less at 10 years. None of the
HRAs studied achieved this goal.
