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International Orthopaedics

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01-03-2021 | Hip-TEP | Original Paper

Acetabular screws do not improve early revision rates in primary total hip arthroplasty. An instrumented registry analysis

Authors: Mary Nugent, David G. Campbell, Peter L. Lewis, Alana R. Cuthbert, Lucien B. Solomon

Published in: International Orthopaedics | Issue 3/2021

Abstract

Background

Initial stability of uncemented acetabular components in total hip arthroplasty (THA) is important for osseointegration and potentially enhanced by screw fixation. We used Australian Orthopaedic Association National Joint Replacement Registry data to determine whether screw usage influences uncemented acetabular component survival.

Methods

Primary THA with uncemented acetabular components performed for osteoarthritis from 1999 to 2018 was included. Survivorship was calculated using Kaplan-Meier estimates of cumulative percent revision (CPR). Comparisons used Cox proportional hazards method. An instrumental variable analysis adjusted for surgeon preference for screws as a confounding factor was used.

Results

Three hundred thirty thousand one hundred ninety-two THAs were included (31.8% with screws, 68.2% without). Two hundred twenty thousand six hundred seven were included in the instrumental variable analysis. Revision rate of acetabular components (all causes) was higher with screws during the first six years (hazard ratio (HR) = 1.45 (95% CI 1.34, 1.57), p < 0.001) and lower thereafter (HR = 0.81 (95% CI 0.67, 0.98), p = 0.027). Revision rate of acetabular components for loosening was higher with screws over the entire study period (HR = 1.73 (95% CI 1.51, 1.98), p < 0.001). Overall THA revision rate was higher with screws during the first six years (HR = 1.20 (95% CI 1.15, 1.26), p < 0.001) but lower thereafter (HR = 0.89 (95% CI 0.81, 0.98), p = 0.020). Revision rate for dislocation was higher with screws over the entire period (HR = 1.16 (95% CI 1.06, 1.26), p < 0.001). Instrumental variable analysis revealed higher revision rates with acetabular screws in the first six years. (HR = 1.18 (95% CI 1.09–1.29), p < 0.001).

Conclusion

Screws did not confer a protective effect against acetabular loosening and were not associated with long-term negative consequences.

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Title: Acetabular screws do not improve early revision rates in primary total hip arthroplasty. An instrumented registry analysis
Authors: Mary Nugent
David G. Campbell
Peter L. Lewis
Alana R. Cuthbert
Lucien B. Solomon
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keywords: Hip-TEP
Hip-TEP
Published in: International Orthopaedics / Issue 3/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-021-04949-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Acetabular screws do not improve early revision rates in primary total hip arthroplasty. An instrumented registry analysis

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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