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Is reverse hybrid hip replacement the solution?

Einar Lindalen1, Leif I Havelin, Lars Nordsletten

  • 1Department of Orthopaedic Surgery, Lovisenberg Deaconal Hospital, Oslo, Norway. eli@lds.no

Acta Orthopaedica
|October 18, 2011
PubMed
Summary

Reverse hybrid hip replacement shows similar survival rates to all-cemented total hip replacement (THR) over 10 years. This method is a viable alternative, though longer follow-up is needed to confirm long-term advantages.

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Clinical outcomes research

Background:

  • Reverse hybrid hip replacement combines a cemented all-polyethylene cup with an uncemented stem.
  • Increasing adoption in Scandinavia contrasts with limited published outcome data.
  • Analysis of the Norwegian Arthroplasty Register (NAR) provides up to 10 years of follow-up data.

Purpose of the Study:

  • To evaluate the clinical outcomes and survival rates of reverse hybrid total hip replacement (THR).
  • To compare the performance of reverse hybrid THR with traditional all-cemented THR.
  • To assess the risk of revision surgery for reverse hybrid THR compared to cemented THR.

Main Methods:

  • Utilized data from the Norwegian Arthroplasty Register (NAR) from 2000 to December 31, 2009.

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  • Included specific cup/stem combinations with ≥100 cases, introduced by 2005.
  • Employed Kaplan-Meier and Cox regression analyses for survival and revision risk estimation.

    • Main Results:

    • Reverse hybrid THR demonstrated comparable survival rates to cemented THR at 5 and 7 years.
    • The adjusted relative risk of revision for reverse hybrid THR was 1.1 (0.9-1.4).
    • In patients under 60, survival was similar, with an adjusted revision risk of 0.9 (0.6-1.3) for reverse hybrid THR.

    Conclusions:

    • Reverse hybrid THR exhibits comparable performance to all-cemented THR up to 10 years.
    • The reverse hybrid technique presents a potential alternative to all-cemented THR.
    • Extended follow-up is necessary to ascertain any long-term benefits of reverse hybrid hip replacement.