2009 / Revision Rates 8 year
Prosthesis Type All Diagnosis 7 year
Unipolar Monoblock 6.8%
Unipolar Modular 6.8%
Bipolar Hemi 4.2%
Cemented THR 3.8%
Cementless THR 4.4%
Hybrid THR 3.9%
Total Resurfacing 5.4%
Thrust Plate 3.0%
Revision for OA 8 year
Conventional THR 4.0%
Total Resurfacing 5.3%
Partial Hip Replacement
Cemented better than cementless in all categories
Hemiarthroplasty
1. > 85
- unipolar monoblock 3.4% 7 years
- unipolar modular 2.1% 5 years
- bipolar 2.9% 7 year
2. 75-84
- unipolar monoblock 8.5% 9 years
- unipolar modular 5.5% 7 years
- bipolar 3.5% 7 years
3. < 75
- unipolar monoblock 17.5% 7 year
- unipolar modular 13.4% 7 year
- bipolar 6% 7 year revision rate
Primary Conventional THR
By Age
< 55 4.9%
55-64 4.6%
65-74 3.6%
>75 3.7%
By Gender
Female 3.8%
Male 4.3%
By Fixation
Cemented 3.9%
Cementless 4.4%
Hybrid 3.4%
By Age & Fixation
< 55 hybrid (4.6) < cementless (4.8)
55-64 hybrid (3.6) < cementless (4.7) < cemented (6.1)
65-74 hybrid (3.2) < cemented (3.8) < cementless (3.9)
> 75 cemented (3.1) < Hybrid (3.3) < cementless (4.2)
By Diagnosis
AVN 5.1%
DDH 3.5%
NOF 5.2%
OA 4.0%
RA 5.4%
By Bearing Surface
Ceramic / Ceramic 3.9%
Metal / Poly 3.2%
Ceramic / Poly 4.1%
Metal / Metal 7.7% (Head sizes > 28mm)
By Head Size
Ceramic / Ceramic
</= 28 4.6%
> 28 3.5%
Metal / Poly
>/= 28 3.9%
> 28 3.0%
By Cemented THR
MS30/Low Profile cup 1.0%
Exeter/Exeter 3.2%
Exeter / Contemporary 6.6%
Spectron / Reflection 6.9%
By Cementless THR
Securefit Plus / Trident 2.8%
Mallory Head 5.5%
Synergy/Reflection 3.8%
ABGII/ABGII 5.6%
By Hybrid THR
Definition / Vitalock 1.5
Exeter/Vitalock 3.6%
Spectron/Reflection 5.4%
Identified as higher than expected
Corail / ASR
Hip Resurfacing
13 300 procedures
Best outcome
- male < 65 with OA
- able to get > 50 mm head size
- 3.9% 9 year
Revision rate
Cumulative revision rate
- 7.2% 9 years for OA
Birmingham Resurfacing
- 6.2% 9 year
Reasons for revision
- fracture 36%
- loosening 33%
- metal sensitivity 7%
Revision by diagnosis 7 years
- OA 5.8%
- DDH 14%
- AVN 6%
Revision by prosthesis
- BHR 96.5% 5 year
Revision by age 7 years
- < 55 5.6%
- 55 - 64 5.8%
- > 65 7.3%
Revision by sex 7 years
- male 4.5%
- female 9.3%
Revision by head size 7 years
- < 44mm: 13.8%
- 45 - 49mm: 8.8%
- 50 - 54mm: 3.7%
- > 55mm: 2.2%
Revision
Type
Femoral only 21.5%
Acetabular only 37.1%
Combined 35.8%
Reason
Loosening 45.7%
Dislocation 14.8%
Lysis 10.1%
Fracture 9.2%
Infection 9.1%
Wear Acetabulum 3.3%
Pain 2.1%
Re-revision Rate
Minor (head, liner) 19.4% 5 year
Major Partial 14.1% 5 year
Major Total 8.2% 3 year