Trabecular metal acetabular components reduce the risk of revision following primary total hip arthroplasty: A propensity score matched study from the National Joint Registry for England and Wales

Journal article

Background

Trabecular metal (TM) coated acetabular components are increasingly used in both primary and revision total hip arthroplasty (THA). However, previous studies assessing TM acetabular components have been small single-centre cohorts with most lacking a control group. We compared revision rates following primary THA between TM and non-TM coated acetabular components.

Methods

A retrospective observational study was performed using National Joint Registry data, which included primary THAs with the same cementless acetabular component (either TM or non- TM coated). TM and non-TM implants were matched for multiple potential confounding factors using propensity scores. Outcomes following primary THA (revision for all-cause acetabular indications, aseptic acetabular loosening, and infection) were compared between matched groups using competing risk regression analysis.

Results

In 18,200 primary THAs (9,100 TM and 9,100 non-TM), the overall prevalence of acetabular revision, revision for aseptic acetabular loosening, and septic revision was 1.2%, 0.13%, and 0.59% respectively. Five-year revision rates for all-causes (1.0% vs. 1.8%; sub-hazard ratio (SHR)=0.57, 95% CI=0.43-0.76; p<0.001), aseptic acetabular loosening (0.1% vs. 0.2%; SHR=0.35, CI=0.14-0.90; p=0.029), and infection (0.5% vs. 0.9%; SHR=0.51, CI=0.34-0.76; p=0.001) were all lower in TM compared with non-TM implants.

Conclusion

Following primary THA, TM coated implants had a reduced risk of both aseptic and septic revision compared with non-TM implants. Although absolute differences in revision risk were small, they may be clinically significant if TM designs were implanted in more complex cases.

Authors: Matharu, G; Judge, A; Murray, D; Pandit, H

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: Journal of Arthroplasty
• Volume: 33
• Issue: 2
• Pages: 447-452
• Publication date: 2017-09-05
• Acceptance date: 2017-08-26
• DOI: 10.1016/j.arth.2017.08.036
• Keywords: primary total hip arthroplasty; revision surgery; trabecular metal; infection; aseptic loosening