Seventeen-year outcomes for a contemporary total hip resurfacing prosthesis in Australia: an analysis of registry data with comparison to best performing conventional and most prevalent resurfacing prostheses

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-14 DOI:10.1016/j.jor.2025.07.012

Cameron J. Wilson , Michelle F. Lorimer , Carl Holder , James D. Stoney , Patrick C.L. Weinrauch

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引用次数: 0

Abstract

Background

This study addresses survivorship up to 17 years for the hip resurfacing arthroplasty (HRA) system most commonly used in Australia at present. Here we compare overall and age-stratified revision rates of the study HRA to a benchmark HRA and the five conventional prostheses with the lowest 10-year cumulative percent revision (5THA) in the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). We further compare outcomes for the resurfacing target cohort of men under 65 years. Finally, we compare revision diagnoses for the study prosthesis and benchmarks.

Methods

AOANJRR data were analysed for osteoarthritis patients who underwent total hip arthroplasty, to the end of 2023. Using Cox proportional hazards models, we compared revision rates (estimated using Kaplan–Meier survival curves with 95 % confidence intervals) across the three groups. Femoral head sizes <50 mm for HRA and <32 mm for 5THA were excluded. Cumulative incidence plots were used to compare revision diagnoses.

Results

For the study HRA, the 17-year survivorship was 94 %, with revision risks comparable to the benchmark HRA but inferior to 5THA. For patients under 55 years, revision rates were comparable to those of 5THA and superior to the benchmark HRA. Revision risks were not significantly different between the three groups for men under 65 (95 % survivorship for the study HRA). Fracture and metal-related pathology were the most likely reasons for early and late revision respectively, while loosening and fracture were the most common revision diagnoses for the benchmark HRA and 5THA respectively.

Conclusion

The study HRA achieved similar survivorship to the benchmark HRA and 5THA in men <65 years, but inferior to 5THA overall. Outcomes were best for younger patients. Adverse metal reactions remain a concern, with longer follow-up essential to assess their impacts and other trends in revision diagnoses.

查看原文本刊更多论文

澳大利亚当代全髋关节表面置换假体17年的结果：与最佳表现的传统和最流行的表面置换假体比较的注册数据分析

本研究探讨了目前在澳大利亚最常用的髋关节置换术（HRA）系统长达17年的生存率。在这里，我们比较了研究HRA与基准HRA的总体翻修率和年龄分层翻修率，以及澳大利亚骨科协会国家关节置换登记处（AOANJRR）中最低10年累积翻修率（5THA）的五种传统假体。我们进一步比较了65岁以下男性重铺手术目标人群的结果。最后，我们比较研究假体和基准的修正诊断。方法分析截至2023年底接受全髋关节置换术的骨关节炎患者的saoanjrr数据。使用Cox比例风险模型，我们比较了三组的修正率（使用Kaplan-Meier生存曲线估算，95%置信区间）。HRA股骨头尺寸为50mm， 5THA股骨头尺寸为32mm。累积发生率图用于比较修正诊断。结果研究HRA的17年生存率为94%，修订风险与基准HRA相当，但低于5THA。对于55岁以下的患者，修订率与5THA相当，优于基准HRA。对于65岁以下的男性（研究HRA的存活率为95%），三组之间的修订风险无显著差异。骨折和金属相关病理分别是早期和晚期翻修最可能的原因，而松动和骨折分别是基准HRA和5THA最常见的翻修诊断。结论：在65岁的男性中，HRA的生存率与基准HRA和5THA相似，但总体上低于5THA。年轻患者的预后最好。金属不良反应仍然是一个值得关注的问题，需要更长的随访时间来评估其影响和翻修诊断的其他趋势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.