A1 Refereed original research article in a scientific journal
Survival of 11,390 Continuum cups in primary total hip arthroplasty based on data from the Finnish Arthroplasty Register
Authors: Hemmilä M, Karvonen M, Laaksonen I, Matilainen M, Eskelinen A, Haapakoski J, Puhto AP, Kettunen J, Manninen M, Mäkelä KT
Publisher: TAYLOR & FRANCIS LTD
Publication year: 2019
Journal: Acta Orthopaedica
Journal name in source: ACTA ORTHOPAEDICA
Journal acronym: ACTA ORTHOP
Volume: 90
Issue: 4
First page : 312
Last page: 317
Number of pages: 6
ISSN: 1745-3674
eISSN: 1745-3682
DOI: https://doi.org/10.1080/17453674.2019.1603596
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/40256586
Background and purpose - The use of trabecular metal (TM) cups for primary total hip arthroplasty (THA) is increasing. Some recent data suggest that the use of TM in primary THA might be associated with an increased risk of revision. We compared implant survival of Continuum acetabular cups with other commonly used uncemented cups. Patients and methods - Data on 11,390 primary THAs with the Continuum cup and 30,372 THAs with other uncemented cups (reference group) were collected from the Finnish Arthroplasty Register. Kaplan-Meier survival estimates were calculated; the endpoint was revision for any reason, for infection, or for dislocation. Revision risks were assessed with adjusted Cox multiple regression models. A subgroup analysis on the use of neutral or elevated liners in the Continuum group was made. Results - The 7-year survivorship of the Continuum group was 94.6% (95% CI 94.0-95.2) versus 95.6% (CI 95.3-95.8) in the reference group for revision for any reason. The risk for revision was higher in the Continuum group than in the reference group both for revision for any reason (HR 1.3 [CI 1.2-1.5)]) and for revision for dislocation (HR 1.9 [CI 1.5-2.3]). There was no difference in the rates of revision because of infection (HR 0.99 [CI 0.78-1.3]). Use of a neutral liner increased the risk for revision due to dislocation in comparison with the use of an elevated rim liner in the Continuum group (HR 1.7 [CI 1.2-2.5]). Interpretation - THA with Continuum cups is associated with an increased risk of revision compared with other uncemented cups, mainly due to revisions because of dislocation. Our results support the use of an elevated liner when Continuum cups are used for primary THA.
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