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

Publication ,  Journal Article
Kleeman, LT; Bala, A; Penrose, CT; Seyler, TM; Wellman, SS; Bolognesi, MP
Published in: J Arthroplasty
June 2018

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.

Duke Scholars

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

June 2018

Volume

33

Issue

6

Start / End Page

1826 / 1832

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Postoperative Period
  • Postoperative Complications
  • Polyethylene
  • Orthopedics
  • Odds Ratio
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kleeman, L. T., Bala, A., Penrose, C. T., Seyler, T. M., Wellman, S. S., & Bolognesi, M. P. (2018). Comparison of Postoperative Complications Following Metal-on-Metal Total Hip Arthroplasty With Other Hip Bearings in Medicare Population. J Arthroplasty, 33(6), 1826–1832. https://doi.org/10.1016/j.arth.2018.01.066
Kleeman, Lindsay T., Abiram Bala, Colin T. Penrose, Thorsten M. Seyler, Samuel S. Wellman, and Michael P. Bolognesi. “Comparison of Postoperative Complications Following Metal-on-Metal Total Hip Arthroplasty With Other Hip Bearings in Medicare Population.J Arthroplasty 33, no. 6 (June 2018): 1826–32. https://doi.org/10.1016/j.arth.2018.01.066.
Kleeman LT, Bala A, Penrose CT, Seyler TM, Wellman SS, Bolognesi MP. Comparison of Postoperative Complications Following Metal-on-Metal Total Hip Arthroplasty With Other Hip Bearings in Medicare Population. J Arthroplasty. 2018 Jun;33(6):1826–32.
Kleeman, Lindsay T., et al. “Comparison of Postoperative Complications Following Metal-on-Metal Total Hip Arthroplasty With Other Hip Bearings in Medicare Population.J Arthroplasty, vol. 33, no. 6, June 2018, pp. 1826–32. Pubmed, doi:10.1016/j.arth.2018.01.066.
Kleeman LT, Bala A, Penrose CT, Seyler TM, Wellman SS, Bolognesi MP. Comparison of Postoperative Complications Following Metal-on-Metal Total Hip Arthroplasty With Other Hip Bearings in Medicare Population. J Arthroplasty. 2018 Jun;33(6):1826–1832.

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

June 2018

Volume

33

Issue

6

Start / End Page

1826 / 1832

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Postoperative Period
  • Postoperative Complications
  • Polyethylene
  • Orthopedics
  • Odds Ratio
  • Middle Aged