Primary total hip arthroplasty: registry data for fixation methods and bearing options at a minimum of 10years.

Abstract

Registry data for total hip arthroplasty (THA) has allowed optimal fixation methods, bearing surfaces and many other factors to be assessed. We describe 10-year THA outcomes from an Irish perspective using regional THA registry data for the first time. We assess the main predictors of revision in primary total hip arthroplasty (THA) using regional registry data. This was a prospective study of registry data from a National Orthopaedic Hospital for all THAs with 10-year follow-up data. All metal-on-metal THAs and resurfacings were excluded from the analysis. All-cause revision was the primary outcome. Univariate and multivariate analyses controlling for confounding variables were performed to assess predictor impact on primary and secondary outcomes. A total of 1697 THAs were performed in 1553 patients. The three significant predictors for all-cause revision were fixation type (p < 0.01), surface bearing type (p < 0.01) and femoral head size (p < 0.05). The lowest 10-year all-cause revision rates were seen in cemented THRs at 1.2%. Ceramic-on-poly bearings had the lowest revision rate at 0.9%. The 22.225-mm head sizes had a significantly lower revision rate than other head sizes (p < 0.05). The causes for revision in order of decreasing frequency were infection (0.7%), dislocation (0.4%), periprosthetic fracture (0.2%) and aseptic loosening (0.1%). There were two re-revisions at 10years in total. Based on this registry and other emerging registry data, the shift towards uncemented THAs may not be fully supported. We also acknowledge that ceramic-on-polyethylene bearings afford the lowest revision rates in this registry.