Research identifies the best materials for long-lasting hip implants

Hip implants with delta ceramic or zirconium oxide heads and highly cross-linked polyethylene liners or cups had the lowest risk of revision 15 years after surgery, new research led by the University of Bristol has found. This study could help hospitals, surgeons, and patients choose which hip implants to use for replacement surgery.

The purpose of this study was to establish materials for hip implants that are at risk of revision to assist orthopedic surgeons and patients, and to identify hip implants with the lowest risk of revision in order to assist orthopedic surgeons and patients in identifying hip implant materials with the lowest risk of revision. It was about making better decisions.

The independently conducted study PLOS medicine today [7 November]was funded by CeramTec and supported by the National Institute for Health Research (NIHR) and the NIHR Bristol Biomedical Research Center (Bristol BRC).

Researchers studied the National Joint Registry (NJR) from 1,026,481 hip replacement patients performed up to 15 years after their first hip replacement (2003 to 2019) in the NHS and private sector in England and Wales. The data were analyzed.

After examining hip implants from NJR data, the research team found that the risk of revision surgery after hip arthroplasty was influenced by the type of material used for the supporting surface. The seat is the movable part of the hip prosthesis that slides against each other during activity.

Data showed that hip implants with delta ceramic or zirconium oxide heads and highly cross-linked polyethylene liners or cups had the lowest risk of revision over 15 years after hip replacement.

These findings were confirmed when the research team investigated the specific reasons why hip revision surgery is performed. The data also showed that 20,869 (2%) hip replacement patients had to undergo revision surgery after their initial surgery.

Dr Eric Lengeland, Senior Lecturer in Medical Statistics and Quantitative Epidemiology at the School of Translational Health Sciences (THS) at the University of Bristol and lead author of the paper, said: “Our study reveals the risks of hip replacement surgery” Revision surgery depends on the hip implant material used in the original surgery. The lowest risk of revision surgery is with highly cross-linked implants with delta ceramic or zirconium oxide heads. Polyethylene (HCLPE) liner or cup.

“Further research is needed to determine the association between implant materials and the risk of readmission, non-revision reoperation, mortality, and cost-effectiveness of these materials.”

Michael Whitehouse, professor of trauma and orthopedics at Bristol Medical School THS and senior clinical lead on the paper, explained: This means the data is more generally applicable than previous data, which were limited by broad groupings of implant types or much smaller study sizes. This highlights the importance of considering the overall structure created when assembling the implant. to build a hip replacement rather than focusing on individual components.

“Our findings will help hospitals, surgeons, and patients select hip implants and combinations with the lowest risk of revision after initial hip replacement surgery.”

We are always pleased when researchers can use data from NJR to produce important studies of this type that provide meaningful analyzes to guide decision-making for surgeons and patients. The important value of NJR data is that it allows researchers unique insights to evaluate the long-term performance of different hip implant materials.

This study reveals the role of implant material selection on surgical outcomes by tracking the combination of materials used and subsequent revision rates. This ensures that the materials used are optimized for longevity and patient health. Surgeons are encouraged to carefully consider these findings regarding implant selection and utilize the information in preoperative discussions with patients. As the demand for joint replacement surgery continues to rise, this insight could be invaluable in reducing reoperations. ”

Tim Wilton, National Joint Registry (NJR) Medical Director

Because this study was not a randomized controlled trial, we were unable to control for all factors that may influence the risk of revision.

The classification of hip implants used as part of a total hip replacement procedure is often extensive in national joint replacement surgery registries, with related revision procedures within the different types of implant materials grouped together. The differences in risk cannot be adequately demonstrated.

Joint replacement surgery is a common and highly effective surgical procedure used to treat a variety of musculoskeletal problems such as osteoarthritis and acute trauma, with over 110,000 surgeries performed annually in the UK. has been. By 2060, demand for joint replacements is expected to increase by almost 40% from current levels. Joint replacements last for a long time, with more than half of hip and knee replacements lasting more than 25 years.

The research team would like to thank the patients and staff of all hospitals in England, Wales and Northern Ireland who provided data to NJR, as well as the Healthcare Quality Improvement Partnership, the NJR Research Committee and staff at NJR. Promote research.