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The Bone & Joint Journal
Vol. 106-B, Issue 6 | Pages 565 - 572
1 Jun 2024
Resl M Becker L Steinbrück A Wu Y Perka C

Aims

This study compares the re-revision rate and mortality following septic and aseptic revision hip arthroplasty (rTHA) in registry data, and compares the outcomes to previously reported data.

Methods

This is an observational cohort study using data from the German Arthroplasty Registry (EPRD). A total of 17,842 rTHAs were included, and the rates and cumulative incidence of hip re-revision and mortality following septic and aseptic rTHA were analyzed with seven-year follow-up. The Kaplan-Meier estimates were used to determine the re-revision rate and cumulative probability of mortality following rTHA.


The Bone & Joint Journal
Vol. 104-B, Issue 7 | Pages 801 - 810
1 Jul 2022
Krull P Steinbrück A Grimberg AW Melsheimer O Morlock M Perka C

Aims

Registry studies on modified acetabular polyethylene (PE) liner designs are limited. We investigated the influence of standard and modified PE acetabular liner designs on the revision rate for mechanical complications in primary cementless total hip arthroplasty (THA).

Methods

We analyzed 151,096 primary cementless THAs from the German Arthroplasty Registry (EPRD) between November 2012 and November 2020. Cumulative incidence of revision for mechanical complications for standard and four modified PE liners (lipped, offset, angulated/offset, and angulated) was determined using competing risk analysis at one and seven years. Confounders were investigated with a Cox proportional-hazards model.


Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_14 | Pages 28 - 28
1 Nov 2021
Perka C Krull P Steinbrück A Morlock M
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Special acetabular polyethylene (PE) liners are intended to increase the stability of the artificial hip joint, yet registry studies on them are limited. The pupose of this study was to investigate differences in revision rates for mechanical complications in primary cementless total hip arthroplasty (THA) with standard and special PE acetabular liners in patients with ostheoarthritis.

Data from the German Arthroplasty Registry (EPRD) between 2012 until 2020 were analysed. Patients with diagnosed ostheoarthritis of the hip without relevant prior surgeries, who received a primary cementless THA with a ceramic/PE bearing articulation were included. Cumulative incidences of revision for mechanical complications for Standard and 4 special PE liners (Lipped, Increased Offset, Angulated, Angulated|Increased Offset) were determined using the Kaplan-Meier Estimator. Confounding factors were investigated with a Cox proportional-hazards model.

In total 151.104 cases were included. 7-year unadjusted revision-free survival for mechanical complications compared to Standard liners (97.7%) was lower for Angulated (97.4%), Lipped (97.2%) and Angulated|Increased Offset liners (94.7%), but higher for Increased Offset liners (98.1%). Risk of revision for mechanical complications was not significantly different between Standard, Lipped and Angulated liners. Increased Offset liners (HR=0.68; 95% CI=0.5–0.92) reduced, while Angulated|Increased Offset liners (HR= 1.81; 95% CI=1.38–2.36) increased the risk. Higher age at admission and an Elixhauser comorbidity index greater zero increased the risk, whereas a larger liner share slightly reduced the risk.

Only the use of Increased Offset liners reduced the risk of revision for mechanical complications compared to Standard liners — other special liners did not.