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Lookup NU author(s): Dr Richard Holleyman, Professor James Mason, Dr Simon Jameson, Ajay MalviyaORCiD
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Copyright © 2021 Elsevier Inc. All rights reserved. BACKGROUND: Prosthetic joint infection (PJI) is a devastating complication. Studies have suggested reduction in PJI with the use of ceramic bearings. METHODS: Adult patients who underwent total hip arthroplasty (THA) using an uncemented acetabular component with ceramic-on-ceramic (CoC), ceramic-on-polyethylene (CoP), or metal-on-polyethylene (MoP) bearing surfaces between 2002 and 2016 were extracted from the National Joint Registry for England, Wales, Northern Ireland, and the Isle of Man. A competing risk regression model to investigate predictors of each revision outcome was used. Time-to-event was determined by duration of implantation since primary surgery with competing risks being death or revision. The results were adjusted for age, gender, American Association of Anaesthesiologists grade, body mass index, surgical indication, intraoperative complications, and implant data. RESULTS: In total, 456,457 THAs (228,786 MoP, 128,403 CoC, and 99,268 CoP) were identified. Multivariable modeling showed that the risk of revision for PJI was significantly lower with CoC (risk ratio 0.748, P < .001) and CoP (risk ratio 0.775, P < .001) compared to MoP. Significant reduction in risk of aseptic and all-cause revision was also seen. The significant protective effect of ceramic bearing was predominantly seen 2 years after implantation. Aseptic revision beyond 2 years reduced by 18.1% and 24.8% for CoC and CoP (P < .001), respectively. All-cause revision rate beyond 2 years reduced by 21.6% for CoC and 27.1% for CoP (P < .001) CONCLUSION: This study demonstrates an association between the use of ceramic as part of the bearing, with lower rates of revision for all causes, revision for infection, and revision for aseptic causes, supporting ceramic bearings in THA.
Author(s): Holleyman RJ, Critchley RJ, Mason JM, Jameson SS, Reed MR, Malviya A
Publication type: Article
Publication status: Published
Journal: Journal of Arthroplasty
Year: 2021
Volume: 36
Issue: 10
Pages: 3498-3506
Print publication date: 01/10/2021
Online publication date: 15/06/2021
Acceptance date: 13/05/2021
ISSN (print): 0883-5403
ISSN (electronic): 1532-8406
Publisher: Elsevier Inc.
URL: https://doi.org/10.1016/j.arth.2021.05.027
DOI: 10.1016/j.arth.2021.05.027
PubMed id: 34238620
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