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British and Danish surgeons advise against using dangerous hips.

https://arctichealth.org/en/permalink/ahliterature126289
Source
BMJ. 2012;344:e1725
Publication Type
Article
Date
2012

Cemented total hip replacement for primary osteoarthritis in patients aged 55 years or older: results of the 12 most common cemented implants followed for 25 years in the Finnish Arthroplasty Register.

https://arctichealth.org/en/permalink/ahliterature153964
Source
J Bone Joint Surg Br. 2008 Dec;90(12):1562-9
Publication Type
Article
Date
Dec-2008
Author
K. Mäkelä
A. Eskelinen
P. Pulkkinen
P. Paavolainen
V. Remes
Author Affiliation
Department of Orthopaedics and Traumatology, Turku University Central Hospital, Rauhankatu 24 D 32, 20100 Turku, Finland. keijo.makela@tyks.fi
Source
J Bone Joint Surg Br. 2008 Dec;90(12):1562-9
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - methods - statistics & numerical data
Bone Cements - therapeutic use
Equipment Failure Analysis - statistics & numerical data
Female
Finland
Follow-Up Studies
Hip Prosthesis - standards - statistics & numerical data
Humans
Male
Middle Aged
Osteoarthritis, Hip - surgery
Prosthesis Design
Prosthesis Failure
Reoperation - statistics & numerical data
Time Factors
Treatment Outcome
Abstract
We have analysed from the Finnish Arthroplasty Register the long-term survivorship of the 12 most commonly-used cemented implants between 1980 and 2005 in patients aged 55 years or older with osteoarthritis. Only two designs of femoral component, the Exeter Universal and the Müller Straight femoral component had a survivorship of over 95% at ten years with revision for aseptic loosening as the endpoint. At 15 years of the femoral and acetabular component combinations, only the Exeter Universal/Exeter All-poly implant had a survival rate of over 90% with revision for aseptic loosening as the endpoint. In the subgroup of patients aged between 55 and 64 years, survivorship overall was less than 90% at ten years. The variation in the long-term rates of survival of different cemented hip implants was considerable in patients aged 55 years or older. In those aged between 55 and 64 years, none of the cemented prostheses studied yielded excellent long-term survival rates (> or = 90% at 15 years).
PubMed ID
19043125 View in PubMed
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Comparison of the performance of hip implants with data from different arthroplasty registers.

https://arctichealth.org/en/permalink/ahliterature147060
Source
J Bone Joint Surg Br. 2009 Dec;91(12):1545-9
Publication Type
Article
Date
Dec-2009
Author
A. Migliore
M R Perrini
E. Romanini
D. Fella
A. Cavallo
M. Cerbo
T. Jefferson
Author Affiliation
Agenzia Nazionale per io servizi sanitari regionali, Rome, Italy. migliore@agenas.it
Source
J Bone Joint Surg Br. 2009 Dec;91(12):1545-9
Date
Dec-2009
Language
English
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - mortality - standards - statistics & numerical data
Hip Prosthesis - standards
Humans
Prosthesis Design
Quality Assurance, Health Care - standards
Registries - statistics & numerical data
Scandinavia
Treatment Outcome
Abstract
This study evaluated the feasibility of using published data from more than one register to define the performance of different hip implants. In order to obtain estimates of performance for specific types of hip system from different register, we analysed data from the annual reports of five national and one Italian regional register. We extracted the number of implants and rates of implant survival at different periods of follow-up. Our aim was to assess whether estimates of cumulative survival rate were comparable with data from registers from different countries, and our conclusion was that such a comparison could only be performed incompletely.
PubMed ID
19949114 View in PubMed
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Dependency issues in survival analyses of 55,782 primary hip replacements from 47,355 patients.

https://arctichealth.org/en/permalink/ahliterature178220
Source
Stat Med. 2004 Oct 30;23(20):3227-40
Publication Type
Article
Date
Oct-30-2004
Author
Stein Atle Lie
Lars B Engesaeter
Leif I Havelin
Håkon K Gjessing
Stein E Vollset
Author Affiliation
Section for Epidemiology and Medical Statistics, Armauer Hansens Huse, University of Bergen, Haukeland Hospital, N-5018 Bergen, Norway. stein.lie@smis.uib.no
Source
Stat Med. 2004 Oct 30;23(20):3227-40
Date
Oct-30-2004
Language
English
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - standards - statistics & numerical data
Female
Hip Prosthesis - standards - statistics & numerical data
Humans
Male
Norway
Proportional Hazards Models
Abstract
Artificial hip joints are used in only one hip for about 85 per cent of the patients and in both hips (bilateral) for about 15 per cent of the patients. The occurrence of bilateral prostheses and the influence they have in survival analyses of joint arthroplasties are seldom considered. In this study we therefore focus on issues related to bilateral primary hip prostheses, time to revision surgery, and some commonly used statistical methods. We used information from 47,355 patients with 55,782 primary hip prostheses reported to the Norwegian Arthroplasty Register between 1987 and 2000. Due to the large number of diagnoses, fixation techniques for the prostheses, and combination of prostheses brands, we furthermore considered a 'homogeneous' subset of 8703 prostheses from 7930 patients with primary osteoarthritis, and Charnley prosthesis fixed with antibiotic-containing Palacos cement. Kaplan-Meier curves for all prostheses, ignoring that some patients have bilateral prostheses, were compared with Kaplan-Meier curves using only the first inserted prostheses, and with survival curves modified for patients with bilateral prostheses. Cox regression analyses were used to assess explanatory variables and to adjust for confounding factors. The results from the ordinary Cox regression analyses were compared with results from a marginal model, a shared gamma frailty model, and a model using a time dependent covariate to condition on failures in the opposite hip. We found no practical difference between the three calculated survival curves for the hip replacement data. The ordinary Cox-model and the marginal model gave equivalent results. In the shared gamma frailty model estimates for the risk factors were comparable with the former two approaches. The estimated frailty variance was higher when all data were used, even after adjustment for confounding factors. For the 'homogeneous' data the estimated frailty variance was negligible. Using a time dependent covariate to condition on previous revisions in the opposite hip, we found a higher risk of revision for the remaining primary hip prosthesis if the opposite hip had been revised (RR = 3.49, p
PubMed ID
15449328 View in PubMed
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Documentation of hip prostheses used in Norway: a critical review of the literature from 1996--2000.

https://arctichealth.org/en/permalink/ahliterature175771
Source
Acta Orthop Scand. 2004 Dec;75(6):663-76
Publication Type
Article
Date
Dec-2004
Author
Arild Aamodt
Lars Nordsletten
Leif I Havelin
Kari Indrekvam
Stein Erik Utvåg
Krystyna Hviding
Author Affiliation
Department of Orthopaedic Surgery, Trondheim University Hospital, Trondheim. arild.aamodt@medisin.ntnu.no
Source
Acta Orthop Scand. 2004 Dec;75(6):663-76
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Arthroplasty, Replacement, Hip - methods - standards
Bone Cements
Clinical Trials as Topic - standards
Controlled Clinical Trials as Topic - standards
Documentation - standards
Follow-Up Studies
Hip Prosthesis - standards
Humans
Meta-Analysis as Topic
Norway
Prosthesis Design
Prosthesis Failure
Randomized Controlled Trials as Topic - standards
Treatment Outcome
Abstract
We have conducted a systematic review of the scientific literature concerning outcome and clinical effectiveness of prostheses used for primary total hip replacement (THR) in Norway. The study is based on two Health Technology Assessment reports from the UK (Faulkner et al. 1998, Fitzpatrick et al. 1998), reviewing the literature from 1980 to 1995. Using a similar search strategy, we have evaluated the literature from 1996 through 2000. We included 129 scientific and medical publications which were assessed according to a specific appraisal protocol. The majority (72%) were observational studies, whereas only 9% were randomized studies. We could not retrieve any peer-reviewed documentation for one third of the implants. The Charnley prosthesis had by far the best and most comprehensive evidence base with better than 90% implant survival after about 10 years. Survival of the Charnley prosthesis declines by about 10% during each of the two following decades. Except for the Charnley and Lubinus IP, no other prosthesis on the market in Norway has given long-term results (> 15 years). 5 other cemented implants have given comparable results at about 10 years of follow-up. Some uncemented stems have shown promising medium-term outcome, but no combination of uncemented cup and stem fulfilled the benchmark criterion of > or = 90% implant survival at 10 years, which we propose as a minimum requirement for unrestricted clinical use for prostheses used in primary THR. New or undocumented implants should be introduced through a four-step model including preclinical testing, small series evaluated by radiosterometry, randomized clinical trial involving comparison with a well-documented prosthesis, and finally, surveillance of clinical use through registers.
PubMed ID
15762255 View in PubMed
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[Failure analysis as basis for quality assurance strategies in implant technology].

https://arctichealth.org/en/permalink/ahliterature260666
Source
Orthopade. 2014 Jun;43(6):555-60
Publication Type
Article
Date
Jun-2014
Author
D. Behrend
M. Warkentin
D. Klüß
R. Bader
S. Kopp
M. Frank
W. Mittelmeier
Source
Orthopade. 2014 Jun;43(6):555-60
Date
Jun-2014
Language
German
Publication Type
Article
Keywords
Data Interpretation, Statistical
Early Diagnosis
Equipment Failure Analysis - methods - standards - statistics & numerical data
Germany - epidemiology
Hip Prosthesis - standards - statistics & numerical data
Humans
Kaplan-Meier Estimate
Knee Prosthesis - standards - statistics & numerical data
Population Surveillance - methods
Product Surveillance, Postmarketing - methods - standards - statistics & numerical data
Proportional Hazards Models
Prosthesis Failure
Registries - standards - statistics & numerical data
Reproducibility of Results
Sensitivity and specificity
Sweden - epidemiology
Abstract
Implant safety is a topic gaining more and more public interest. Implants are safety relevant medical devices which in the case of failure can lead to life-threatening situations.
A well-founded failure analysis requires expert knowledge not only of materials and implant design but also a qualified explantation procedure and storage conditions.
A selective literature search was carried out putting the main emphasis on implant failure analysis supplemented with own investigations.
The reasons for implant breakdown are mostly failures of materials and in the manufacturing process. In some cases false material combinations can lead to tribocorrosion effects under cyclic loading.
The increased level of knowledge gained from complex analyses of failed implants produces valuable evidence for better quality management.
PubMed ID
24816979 View in PubMed
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Hip resurfacing arthroplasty: short-term survivorship of 4,401 hips from the Finnish Arthroplasty Register.

https://arctichealth.org/en/permalink/ahliterature124159
Source
Acta Orthop. 2012 Jun;83(3):207-13
Publication Type
Article
Date
Jun-2012
Author
Matti Seppänen
Keijo Mäkelä
Petri Virolainen
Ville Remes
Pekka Pulkkinen
Antti Eskelinen
Author Affiliation
Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland.
Source
Acta Orthop. 2012 Jun;83(3):207-13
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - standards - statistics & numerical data
Child
Female
Health Facility Size - statistics & numerical data
Hip Prosthesis - standards - statistics & numerical data
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Norway - epidemiology
Osteoarthritis, Hip - surgery
Prosthesis Design - statistics & numerical data
Prosthesis Failure
Registries
Reoperation - statistics & numerical data
Risk factors
Sexual Dysfunction, Physiological
Young Adult
Abstract
Population-based registry data from the Nordic Arthroplasty Register Association (NARA) and from the National Joint Register of England and Wales have revealed that the outcome after hip resurfacing arthroplasty (HRA) is inferior to that of conventional total hip arthroplasty (THA). We analyzed the short-term survival of 4,401 HRAs in the Finnish Arthroplasty Register.
We compared the revision risk of the 4,401 HRAs from the Register to that of 48,409 THAs performed during the same time period. The median follow-up time was 3.5 (0-9) years for HRAs and 3.9 (0-9) years for THAs.
There was no statistically significant difference in revision risk between HRAs and THAs (RR = 0.93, 95% CI: 0.78-1.10). Female patients had about double the revision risk of male patients (RR = 2.0, CI: 1.4-2.7). Hospitals that had performed 100 or more HRA procedures had a lower revision risk than those with less than 100 HRAs (RR = 0.6, CI: 0.4-0.9). Articular Surface Replacement (ASR, DePuy) had inferior outcome with higher revision risk than the Birmingham Hip Resurfacing implant (BHR, Smith & Nephew), the reference implant (RR = 1.8, CI: 1.2-2.7).
We found that HRA had comparable short-term survivorship to THA at a nationwide level. Implant design had an influence on revision rates. ASR had higher revision risk. Low hospital procedure volume worsened the outcome of HRA. Female patients had twice the revision risk of male patients.
Notes
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Cites: Acta Orthop. 2011 Oct;82(5):521-921992084
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Cites: BMC Musculoskelet Disord. 2003 Feb 5;4:112570876
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Cites: N Engl J Med. 2000 Jun 22;342(25):1887-9210861325
PubMed ID
22616745 View in PubMed
Less detail

Increased risk of dislocation with collar reinforced modular heads of the Lubinus SP-2 hip prosthesis.

https://arctichealth.org/en/permalink/ahliterature212322
Source
Acta Orthop Scand. 1996 Apr;67(2):204-5
Publication Type
Article
Date
Apr-1996

[Long-term results following cemented total hip alloplasty in primary hip arthrosis. What to expect?]

https://arctichealth.org/en/permalink/ahliterature52427
Source
Ugeskr Laeger. 2000 Nov 20;162(47):6416-9
Publication Type
Article
Date
Nov-20-2000
Author
J O Laursen
N. Mossing
S. Overgaard
H. Husted
Author Affiliation
Sønderborg Sygehus, ortopaedkirurgisk afdeling. jens_ole_laursen@sbs.sja.dk
Source
Ugeskr Laeger. 2000 Nov 20;162(47):6416-9
Date
Nov-20-2000
Language
Danish
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - adverse effects - methods - standards
Bone Cements
Denmark
English Abstract
Female
Follow-Up Studies
Hip Prosthesis - standards
Humans
Male
Middle Aged
Prosthesis Design
Reoperation
Abstract
The aim was to investigate the age-, gender- and implant related survival up to 14 years postsurgery in patients with primary hiparthrosis in one or both hips and operated in county hospitals with cemented prosthesis designs. The subjects consisted of 1,199 patients operated in the years 1981-1990, and the cohort was followed till 31.12.1994. The 1,199 patients had a total of 1,477 cemented total hipalloplastics (THA's) inserted. Two hundred and fourty-eight patients died during follow-up. Until 1990, 278 patients had had both hips operated, and a further 58 patients had the contralateral hip operated during follow-up to 31.12.1994. Fourty-nine hips were revised between four and 14 years (median: nine years) postsurgery. The cumulative survival for all THA's was 92.5%. Respective figures for the Richard Series 2 and the Charnley-prosthesis were 91.5% and 92%, now more than 14 years from the first operations. In conclusion, cemented total hip arthroplasty is a good treatment option for patients with primary hip arthrosis. Younger patients have an increased risk of revision, and alternative fixation may be considered. With an overall prosthesis-survival more than 14 years postsurgery of 92.5%, the treatment can take place at local orthopaedic departments. Our results are comparable to figures from the Swedish national register.
PubMed ID
11116454 View in PubMed
Less detail

[Many years of registration have improved the quality of hip arthroplasty].

https://arctichealth.org/en/permalink/ahliterature201746
Source
Lakartidningen. 1999 May 19;96(20):2469-73, 2475-6
Publication Type
Article
Date
May-19-1999
Author
P. Herberts
H. Malchau
Author Affiliation
Dept of Orthopaedics, Gothenburg University, Sahlgrenska Universitetssjukhuset, Göteborg, Sweden. peter.herberts@orthop.gu.se
Source
Lakartidningen. 1999 May 19;96(20):2469-73, 2475-6
Date
May-19-1999
Language
Swedish
Publication Type
Article
Keywords
Arthroplasty, Replacement, Hip - adverse effects - standards - statistics & numerical data
Databases, Factual
Evidence-Based Medicine
Follow-Up Studies
Hip Prosthesis - standards
Humans
Prosthesis Failure
Quality Assurance, Health Care
Registries
Reoperation
Risk factors
Sweden
Abstract
The Swedish Hip Replacement Registry has defined the epidemiology of total hip replacement in this country. Most hip replacements are fully cemented. Serious complication and revision rates associated with total hip replacement have declined significantly despite increase in the number of patients at risk. During the past five-year period, only 8(9 per cent of hip replacement procedures have been revisions. Although aseptic loosening with or without osteolysis is the major problem, accounting for 73 per cent of revisions, its incidence has decreased four-fold over the past 15 years to less than three per cent at 10-year follow-up. Quality of the surgical technique is the crucial determinant of the risk of revision due to aseptic loosening, but the choice of implant is also important. Total hip replacement practice in Sweden has improved due to the information available from the registry concerning individual risk factors, implant safety, and the efficacy of improving surgical and cementing techniques.
PubMed ID
10380492 View in PubMed
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18 records – page 1 of 2.