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Is the rate of revision of 36 mm metal-onmetal total hip arthroplasties with Pinnacle acetabular components related to the year of the initial operation? An interrupted time-series analysis using data from the national joint registry for England and Wales

Is the rate of revision of 36 mm metal-onmetal total hip arthroplasties with Pinnacle acetabular components related to the year of the initial operation? An interrupted time-series analysis using data from the national joint registry for England and Wales
Is the rate of revision of 36 mm metal-onmetal total hip arthroplasties with Pinnacle acetabular components related to the year of the initial operation? An interrupted time-series analysis using data from the national joint registry for England and Wales

Aims The aim of this study was to determine whether the rates of revision for metal-on-metal (MoM) total hip arthroplasties (THAs) with Pinnacle components varied according to the year of the initial operation, and compare these with the rates of revision for other designs of MoM THA. Patients and Methods Data from the National Joint Registry for England and Wales included 36 mm MoM THAs with Pinnacle acetabular components which were undertaken between 2003 and 2012 with follow-up for at least five years (n = 10 776) and a control group of other MoM THAs (n = 13 817). The effect of the year of the primary operation on all-cause rates of revision was assessed using Cox regression and interrupted time-series analysis. Results For MoM THAs involving Pinnacle components, those undertaken between 2007 and 2012 had higher rates of revision compared with those undertaken between 2004 and 2006 (hazard ratio (HR) 2.01; 95% confidence interval (CI) 1.57 to 2.57; p < 0.001). For THAs undertaken during and after 2007, the number of revisions per 1000 implant-years at risk significantly increased by 5.20 (95% CI 0.52 to 9.89; p = 0.033) compared with those undertaken before this time. In the control group, THAs undertaken between 2007 and 2012 also had higher rates of revision (HR 1.77; 95% CI 1.49 to 2.10; p < 0.001), with revisions per 1000 implant-years for those undertaken during and after 2007 significantly increasing by 6.13 (95% CI 1.42 to 10.83; p = 0.016). Conclusion The five-year revision rates were significantly increased for all primary MoM THAs undertaken from 2007 onwards. Contrary to recent reports, this finding was not specific to those involving Pinnacle acetabular components and may be explained by increased surveillance and recent lowering of the threshold for revision.

2049-4394
33-41
Matharu, G. S.
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Hunt, L. P.
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Murray, D.W.
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Howard, P.
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Pandit, H. G.
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Blom, A. W.
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Bolland, B.
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Judge, A.
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Matharu, G. S.
ff0c3613-eb2c-41ee-8873-1f3d309ee494
Hunt, L. P.
79158781-3328-4cad-9736-315b9c4cb739
Murray, D.W.
8b9e5879-3fa7-4e4a-98a9-e0f11dcb2462
Howard, P.
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Pandit, H. G.
91a11683-01d1-436c-bc49-99deeeae766e
Blom, A. W.
1faf6ee2-001c-4896-b072-c4023408271e
Bolland, B.
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Judge, A.
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Matharu, G. S., Hunt, L. P., Murray, D.W., Howard, P., Pandit, H. G., Blom, A. W., Bolland, B. and Judge, A. (2018) Is the rate of revision of 36 mm metal-onmetal total hip arthroplasties with Pinnacle acetabular components related to the year of the initial operation? An interrupted time-series analysis using data from the national joint registry for England and Wales. The Bone & Joint Journal, 100B (1), 33-41. (doi:10.1302/0301-620X.100B1.BJJ-2017-0625.R2).

Record type: Article

Abstract

Aims The aim of this study was to determine whether the rates of revision for metal-on-metal (MoM) total hip arthroplasties (THAs) with Pinnacle components varied according to the year of the initial operation, and compare these with the rates of revision for other designs of MoM THA. Patients and Methods Data from the National Joint Registry for England and Wales included 36 mm MoM THAs with Pinnacle acetabular components which were undertaken between 2003 and 2012 with follow-up for at least five years (n = 10 776) and a control group of other MoM THAs (n = 13 817). The effect of the year of the primary operation on all-cause rates of revision was assessed using Cox regression and interrupted time-series analysis. Results For MoM THAs involving Pinnacle components, those undertaken between 2007 and 2012 had higher rates of revision compared with those undertaken between 2004 and 2006 (hazard ratio (HR) 2.01; 95% confidence interval (CI) 1.57 to 2.57; p < 0.001). For THAs undertaken during and after 2007, the number of revisions per 1000 implant-years at risk significantly increased by 5.20 (95% CI 0.52 to 9.89; p = 0.033) compared with those undertaken before this time. In the control group, THAs undertaken between 2007 and 2012 also had higher rates of revision (HR 1.77; 95% CI 1.49 to 2.10; p < 0.001), with revisions per 1000 implant-years for those undertaken during and after 2007 significantly increasing by 6.13 (95% CI 1.42 to 10.83; p = 0.016). Conclusion The five-year revision rates were significantly increased for all primary MoM THAs undertaken from 2007 onwards. Contrary to recent reports, this finding was not specific to those involving Pinnacle acetabular components and may be explained by increased surveillance and recent lowering of the threshold for revision.

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Published date: 5 January 2018

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Local EPrints ID: 417534
URI: https://eprints.soton.ac.uk/id/eprint/417534
ISSN: 2049-4394
PURE UUID: f0a114d4-624c-426c-87ff-a01bcf058974

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Date deposited: 02 Feb 2018 17:30
Last modified: 02 Feb 2018 17:30

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Author: G. S. Matharu
Author: L. P. Hunt
Author: D.W. Murray
Author: P. Howard
Author: H. G. Pandit
Author: A. W. Blom
Author: B. Bolland
Author: A. Judge

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