Comparison of Postoperative Complications Following Metal-on-Metal Total Hip Arthroplasty With Other Hip Bearings in Medicare Population.

Published

Journal Article

BACKGROUND:The use of metal-on-metal (MoM) hip bearings has declined in the recent years due to strong evidence of their high complication rates and early failure. Hip implants with highly cross-linked polyethylene liners and ceramic bearings have become the modern implants of choice. We sought to determine if MoM implants are associated with higher complication and revision rates when compared to other hip bearings in the Medicare population. METHODS:We retrospectively reviewed a Medicare database (2005-2011) for patients who underwent a primary total hip arthroplasty with a MoM, metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), or ceramic-on-ceramic (CoC) implant (minimum 2 years of follow-up). Patient comorbidities and medical/surgical complication rates were analyzed at various time points postoperatively. RESULTS:We identified 288,118 patients, including 81,520 patients with a MoM implant, 162,881 with MoP, 33,819 with CoP, and 9898 with CoC implant. Surgical complication rates were higher for MoM implants including infection, osteolysis/polywear, mechanical complications, and need for hip irrigation and debridement. Overall revision rates were significantly higher for MoM implants (5.28%) compared to MoP (4.28%, odds ratio [OR] 1.26, P < .001) and CoP (3.52%, OR 1.55, P < .001) but only by one to two percent. MoM revision rates were similar to CoC implants (4.94%, OR 1.00, P = .096). CONCLUSIONS:MoM implants were associated with higher revision rates (5.28%) compared to MoP (4.28%) and CoP (3.52%) implants in the Medicare population. Both complication and revision rates were comparable to CoC implants.

Full Text

Duke Authors

Cited Authors

  • Kleeman, LT; Bala, A; Penrose, CT; Seyler, TM; Wellman, SS; Bolognesi, MP

Published Date

  • June 2018

Published In

Volume / Issue

  • 33 / 6

Start / End Page

  • 1826 - 1832

PubMed ID

  • 29510952

Pubmed Central ID

  • 29510952

Electronic International Standard Serial Number (EISSN)

  • 1532-8406

International Standard Serial Number (ISSN)

  • 0883-5403

Digital Object Identifier (DOI)

  • 10.1016/j.arth.2018.01.066

Language

  • eng