TY - JOUR
T1 - The influence of bearing surfaces on periprosthetic hip infections: analysis of thirty nine thousand, two hundred and six cementless total hip arthroplasties
AU - Bordini, Barbara
AU - Stea, Susanna
AU - Castagnini, Francesco
AU - Busanelli, Luca
AU - Giardina, Federico
AU - Toni, Aldo
PY - 2018/8/11
Y1 - 2018/8/11
N2 - Purpose: Periprosthetic hip infection (PHI) is a devastating complication. The association between PHI and bearing surfaces as well as patient-related factors has been recently investigated, with contradictive outcomes. The dataset of Emilia-Romagna region Registry for Orthopaedic Prosthetic Implants (RIPO) has been assessed to investigate, if the bearing choice influenced the risk of septic loosening occurrence. Methods: RIPO data about 39,206 cementless total hip arthroplasties (THA), collected since 2003, were analysed. Age, gender, BMI, diabetes and bearing surfaces were evaluated. The end point of the study was the revision of at least a single component due to sepsis. Results: Adjusted and unadjusted survival rates showed that ceramic-on-ceramic (COC) implants had the lower incidence of PHIs, whereas metal-on-metal (MOM) THAs were significantly more prone to infection. In MOM cohort, stemmed implants were involved in 28 out of 30 cases. Among the demographical features and comorbid conditions, only diabetes statistically influenced the rate of sepsis. Conclusions: Bearing surfaces influenced the rate of PHI; in particular, stemmed MOM implants were at higher risk, probably due to metal debris consequent to taperosis. Despite the preliminary results, stemmed MOM THAs should be used with care, and diabetic patients should be warned about increased septic risks.
AB - Purpose: Periprosthetic hip infection (PHI) is a devastating complication. The association between PHI and bearing surfaces as well as patient-related factors has been recently investigated, with contradictive outcomes. The dataset of Emilia-Romagna region Registry for Orthopaedic Prosthetic Implants (RIPO) has been assessed to investigate, if the bearing choice influenced the risk of septic loosening occurrence. Methods: RIPO data about 39,206 cementless total hip arthroplasties (THA), collected since 2003, were analysed. Age, gender, BMI, diabetes and bearing surfaces were evaluated. The end point of the study was the revision of at least a single component due to sepsis. Results: Adjusted and unadjusted survival rates showed that ceramic-on-ceramic (COC) implants had the lower incidence of PHIs, whereas metal-on-metal (MOM) THAs were significantly more prone to infection. In MOM cohort, stemmed implants were involved in 28 out of 30 cases. Among the demographical features and comorbid conditions, only diabetes statistically influenced the rate of sepsis. Conclusions: Bearing surfaces influenced the rate of PHI; in particular, stemmed MOM implants were at higher risk, probably due to metal debris consequent to taperosis. Despite the preliminary results, stemmed MOM THAs should be used with care, and diabetic patients should be warned about increased septic risks.
KW - Articular coupling
KW - Ceramic
KW - Diabetes
KW - Metal
KW - Polyethylene
KW - Septic loosening
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U2 - 10.1007/s00264-018-4097-2
DO - 10.1007/s00264-018-4097-2
M3 - Article
AN - SCOPUS:85051556503
VL - 43
SP - 103
EP - 109
JO - International Orthopaedics
JF - International Orthopaedics
SN - 0341-2695
IS - 1
ER -