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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004402naa a2200421 4500
001oai:DiVA.org:uu-232491
003SwePub
008140919s2015 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-2324912 URI
0247 a https://doi.org/10.3109/17453674.2014.9570882 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Hailer, Nils Pu Uppsala universitet,Ortopedi4 aut0 (Swepub:uu)nilha837
2451 0a Hydroxyapatite coating does not improve uncemented stem survival after total hip arthroplasty! :b An analysis of 116,069 THAs in the Nordic Arthroplasty Register Association (NARA) database
264 c 2014-09
264 1b Medical Journals Sweden AB,c 2015
338 a print2 rdacarrier
520 a Background and purposeIt is still being debated whether HA coating of uncemented stems used in total hip arthroplasty (THA) improves implant survival. We therefore investigated different uncemented stem brands, with and without HA coating, regarding early and long-term survival.Patients and methods We identified 152,410 THA procedures using uncemented stems that were performed between 1995 and 2011 and registered in the Nordic Arthroplasty Register Association (NARA) database. We excluded 19,446 procedures that used stem brands less than 500 times in each country, procedures performed due to diagnoses other than osteoarthritis or pediatric hip disease, and procedures with missing information on the type of coating. 22 stem brands remained (which were used in 116,069 procedures) for analysis of revision of any component. 79,192 procedures from Denmark, Norway, and Sweden were analyzed for the endpoint stem revision. Unadjusted survival rates were calculated according to Kaplan-Meier, and Cox proportional hazards models were fitted in order to calculate hazard ratios (HRs) for the risk of revision with 95% confidence intervals (CIs).ResultsUnadjusted 10-year survival with the endpoint revision of any component for any reason was 92.1% (CI: 91.8-92.4). Unadjusted 10-year survival with the endpoint stem revision due to aseptic loosening varied between the stem brands investigated and ranged from 96.7% (CI: 94.4-99.0) to 99.9% (CI: 99.6-100). Of the stem brands with the best survival, stems with and without HA coating were found. The presence of HA coating was not associated with statistically significant effects on the adjusted risk of stem revision due to aseptic loosening, with an HR of 0.8 (CI: 0.5-1.3; p = 0.4). The adjusted risk of revision due to infection was similar in the groups of THAs using HA-coated and non-HA-coated stems, with an HR of 0.9 (CI: 0.8-1.1; p = 0.6) for the presence of HA coating. The commonly used Bimetric stem (n = 25,329) was available both with and without HA coating, and the adjusted risk of stem revision due to aseptic loosening was similar for the 2 variants, with an HR of 0.9 (CI: 0.5-1.4; p = 0.5) for the HA-coated Bimetric stem.Interpretation Uncemented HA-coated stems had similar results to those of uncemented stems with porous coating or rough sand-blasted stems. The use of HA coating on stems available both with and without this surface treatment had no clinically relevant effect on their outcome, and we thus question whether HA coating adds any value to well-functioning stem designs.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Ortopedi0 (SwePub)302112 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Orthopaedics0 (SwePub)302112 hsv//eng
7001 a Lazarinis, Stergiosu Uppsala universitet,Ortopedi4 aut0 (Swepub:uu)stela456
7001 a Mäkelä, Keijo T4 aut
7001 a Eskelinen, Antti4 aut
7001 a Fenstad, Anne M4 aut
7001 a Hallan, Geir4 aut
7001 a Havelin, Leif4 aut
7001 a Overgaard, Søren4 aut
7001 a Pedersen, Alma B4 aut
7001 a Mehnert, Frank4 aut
7001 a Kärrholm, Johan4 aut
7102 a Uppsala universitetb Ortopedi4 org
7730 t Acta Orthopaedicad : Medical Journals Sweden ABg 86:1, s. 18-25q 86:1<18-25x 1745-3674x 1745-3682
8564 u https://doi.org/10.3109/17453674.2014.957088
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-232491
8564 8u https://doi.org/10.3109/17453674.2014.957088

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