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dc.contributor.authorVarnum, Clausen_US
dc.contributor.authorPedersen, Alma Ben_US
dc.contributor.authorMäkelä, Keijoen_US
dc.contributor.authorEskelinen, Anttien_US
dc.contributor.authorHavelin, Leif Ivaren_US
dc.contributor.authorFurnes, Oveen_US
dc.contributor.authorKärrholm, Johanen_US
dc.contributor.authorGarellick, Göranen_US
dc.contributor.authorOvergaard, Sørenen_US
dc.PublishedActa Orthopaedica 2015, 86(4):469-476eng
dc.description.abstractBackground and purpose — Data from the national joint registries in Australia and England and Wales have revealed inferior medium-term survivorship for metal-on-metal (MoM) total hip arthroplasty (THA) than for metal-on-polyethylene (MoP) THA. Based on data from the Nordic Arthroplasty Register Association (NARA), we compared the revision risk of cementless stemmed THA with MoM and MoP bearings and we also compared MoM THA to each other. Patients and methods — We identified 32,678 patients who were operated from 2002 through 2010 with cementless stemmed THA with either MoM bearings (11,567 patients, 35%) or MoP bearings (21,111 patients, 65%). The patients were followed until revision, death, emigration, or the end of the study period (December 31, 2011), and median follow-up was 3.6 (interquartile range (IQR): 2.4–4.8) years for MoM bearings and 3.4 (IQR: 2.0–5.8) years for MoP bearings. Multivariable regression in the presence of competing risk of death was used to assess the relative risk (RR) of revision for any reason (with 95% confidence interval (CI)). Results — The cumulative incidence of revision at 8 years of follow-up was 7.0% (CI: 6.0–8.1) for MoM bearings and 5.1% (CI: 4.7–5.6) for MoP bearings. At 6 years of follow-up, the RR of revision for any reason was 1.5 (CI: 1.3–1.7) for MoM bearings compared to MoP bearings. The RR of revision for any reason was higher for the ASR (adjusted RR = 6.4, CI: 5.0–8.1), the Conserve Plus (adjusted RR = 1.7, CI: 1.1–2.5) and “other” acetabular components (adjusted RR = 2.4, CI: 1.5–3.9) than for MoP THA at 6 years of follow-up. Interpretation — At medium-term follow-up, the survivorship for cementless stemmed MoM THA was inferior to that for MoP THA, and metal-related problems may cause higher revision rates for MoM bearings with longer follow-up.en_US
dc.publisherTaylor & Franciseng
dc.rightsAttribution CC BY-NCeng
dc.titleIncreased risk of revision of cementless stemmed total hip arthroplasty with metal-on-metal bearingsData from the Nordic Arthroplasty Register Associationen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright Nordic Orthopaedic Federation

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