Improved results of primary total hip replacement.
Background and purpose Over the past 20 years, several changes in treatment policy and treatment options have taken place regarding hip replacement. For this reason, we wanted to investigate the results after hip replacement in terms of revision rate, during a 21-year period among hip replacements r...
| Publicado en: | Acta Orthopaedica Vol. 81; no. 6; pp. 649 - 660 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
Dec2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104949137&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104949137 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: Dec2010 vid: 81 iid: 6 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 104949137 55447668 10.3109/17453674.2010.537807 NLM21110699 104949137 ppf: 649 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Improved results of primary total hip replacement. aug: au: Fevang BS Lie SA Havelin LI Engesæter LB Furnes O affil: Department of Rheumatology; bjorg.tilde.svanes.fevang@helse-bergen.no sug: subj: Arthroplasty, Replacement, Hip Outcomes (Health Care) Human Registries, Disease Arthroplasty, Replacement, Hip Adverse Effects Postoperative Complications Reoperation Relative Risk Confidence Intervals Descriptive Statistics Aged Male Female Kaplan-Meier Estimator Cox Proportional Hazards Model Data Analysis Software Prostheses and Implants Equipment and Supplies Aged: 65+ years Male Female ab: Background and purpose Over the past 20 years, several changes in treatment policy and treatment options have taken place regarding hip replacement. For this reason, we wanted to investigate the results after hip replacement in terms of revision rate, during a 21-year period among hip replacements reported to the Norwegian Arthroplasty Register. Methods 110,882 primary total hip replacements were reported to the Norwegian Arthroplasty Register from 1987 through 2007. Risk of revision during the time periods 1993-1997, 1998-2002, and 2003-2007 was compared to that of the reference period 1987-1992. Adjusted Cox regression analyses were performed to compare the risk of revision in different time periods and extended analyses were done to investigate revision within the first postoperative year and after the first year. Results There was an overall reduced risk of revision in the time periods 1993-1997, 1998-2002, and 2003-2007 compared to the reference period: RR = 0.81 (95% CI 0.77-0.86), 0.51 (CI 0.47-0.55), and 0.77 (CI 0.68-0.85), respectively. The improved results were due to a marked reduction in aseptic loosening of the femoral and acetabular components in all time periods and in all subgroups of prostheses. A change in the timing of revision took place, with more early revisions and fewer late revisions in the later time periods. Revision due to dislocation and infection increased over time. Interpretation The risk of revision decreased during the study period, due to fewer cases of aseptic loosening of prosthetic components. The best results were obtained with the use of cemented prostheses. Prevention of dislocation and infection should be a major goal in the future, as revision due to these causes increased during the study period. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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