Abstract:
We present key information from international registries in relation to primary total hip arthroplasty. The specific questions of interest include which bearings are superior in total hip arthroplasty (THA), which fixation types are optimal, do any specific implants perform better than others, and what is the latest update in the hip fracture setting? This is a comprehensive review of the major English-speaking hip arthroplasty registries across the globe. Key trends and developments in implant performance are identified and presented in the current article. Key points from review of all registries confirm that ceramic-on-polyethylene and metal-on-polyethylene continue to be the commonest bearings. The use of cemented femoral stems is increasing across most regions. Hybrid fixation is now the commonest fixation method in the UK for the first time in registry history. Uncemented femoral stems have a higher early revision rate for periprosthetic fracture than cemented stems across most regions. Dual mobility (DM) bearings are increasing in use and show higher early revision rates than unipolar bearings-they tend to be used for more complex indications (fracture/tumor/revision) and show similar revision rates to unipolar bearings when used exclusively in primary elective THA for osteoarthritis. We present current trends in THA based on current registry data from across the globe. Clinical signals of concern are emerging for THA uncemented femoral stem fixation and DM bearings in specific clinical contexts. These signals should be monitored across the literature in order to reduce the overall revision burden.
摘要:
我们提供了有关初次全髋关节置换术的国际注册信息。感兴趣的具体问题包括哪些轴承在全髋关节置换术(THA)中更好,哪种固定类型是最佳的,做任何特定的植入物比其他更好,髋部骨折背景的最新更新是什么?这是对全球主要的英语髋关节置换术注册的全面回顾。本文确定并介绍了植入物性能的主要趋势和发展。对所有注册管理机构的审查要点证实,聚乙烯上陶瓷和聚乙烯上金属仍然是最常见的轴承。在大多数地区,骨水泥股骨茎的使用正在增加。混合固定现在是注册历史上首次在英国最常见的固定方法。在大多数区域,未骨水泥的股骨茎对假体周围骨折的早期翻修率高于骨水泥的茎。双移动性(DM)轴承的使用正在增加,并且显示出比单极轴承更高的早期翻修率-它们倾向于用于更复杂的适应症(骨折/肿瘤/翻修),并且当仅用于骨关节炎的主要选择性THA时,它们显示出与单极轴承相似的翻修率。我们根据来自全球的当前注册表数据介绍了THA的当前趋势。在特定的临床环境中,THA未加固的股骨柄固定和DM轴承正在出现值得关注的临床信号。应在整个文献中监测这些信号,以减少整体修订负担。