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Published on: September 7, 2022
[Evidence-based update in hip arthroplasty]
H Gollwitzer1, L Gerdesmeyer, R Gradinger
1Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Deutschland. gollwitzer@bone-and-joint.org
Der Orthopade
|May 18, 2011
Summary
This review covers hip arthroplasty advancements, focusing on metal-on-metal implant risks and new ceramic options. Evidence-based data guides prevention of complications and implant failure.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Clinical Trials
Background:
- Hip arthroplasty is a common procedure with ongoing research into implant longevity and patient outcomes.
- Concerns regarding metal-on-metal implants have prompted investigations into alternative bearing surfaces and risk factors for failure.
- Advances in materials and surgical techniques aim to improve patient safety and reduce complications.
Purpose of the Study:
- To provide an overview of current evidence-based data in hip arthroplasty.
- To highlight new clinically relevant developments, including tribology and implant materials.
- To summarize findings on risk factors for implant failure and pseudotumors.
Main Methods:
- Review of current clinical trials and large implant registry data.
- Analysis of randomized trials investigating ceramic liners and femoral head implants.
- Synthesis of results from meta-analyses on various aspects of hip arthroplasty.
Main Results:
- Identification of specific risk factors for early implant failure and pseudotumors associated with surface replacement (metal-on-metal).
- Evaluation of new ceramic liners and femoral head implants in randomized trials.
- Availability of meta-analyses results for laboratory values in periprosthetic infection, antibiotic prophylaxis, regional anesthesia, thromboembolism prevention, implant fixation, and navigation.
Conclusions:
- Current evidence guides the understanding of risks and benefits in hip arthroplasty, particularly concerning metal-on-metal implants.
- Newer ceramic materials show promise in randomized trials, potentially offering improved safety and performance.
- Comprehensive data from meta-analyses supports evidence-based strategies for preventing complications and optimizing patient pathways in hip arthroplasty.
