The influence of bearing surfaces on periprosthetic hip infections: analysis of thirty nine thousand, two hundred and six cementless total hip arthroplasties

Barbara Bordini, Susanna Stea, Francesco Castagnini, Luca Busanelli, Federico Giardina, Aldo Toni

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)103-109
Number of pages7
JournalInternational Orthopaedics
Volume43
Issue number1
DOIs
Publication statusE-pub ahead of print - Aug 11 2018

Keywords

  • Articular coupling
  • Ceramic
  • Diabetes
  • Metal
  • Polyethylene
  • Septic loosening

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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