Quality and reproducibility of French publications on total hip arthroplasty

The goal of the Quality of Literature in Arthroplasty (QoLA) project launched in 2009 was to compare the implant results from clinical studies published in indexed scientific journals with those found in reference national registers. The potential biases in the chosen articles (country of origin, inventor involved in study, methodological quality) were systematically analyzed and the revisions per 100 observed component years (Revp100OCY) index was calculated. For a given implant, a differential factor greater than 3 between the Revp100OCY index for published series and the one from registers was considered as indicative of a potential selection (inventor) or publication (conflict of interest) bias. Although initially performed on English publications, this methodology was subsequently applied to French publications in the field of total hip arthroplasty (THA).

French publications indexed in Medline (Rev Chir Orthop and Orthop Trauma Surg Res since 2009) were analyzed. These studies involved implants designed in France (ABG, Corail stem, Cerafit/Osteal, Bousquet) or that were used worldwide (Omnifit stem, Alloclassic and Charnley-type or Müller-type implants). The articles or abstracts selected had to contain sufficient information (number of revisions, number of cases and/or revisions, average follow-up) to allow the Revp100OCY index to be calculated.

Overall, the average Revp100OCY index for THA series published in French was 0.76, which is consistent with the worldwide average of 1.29. For the ABG System, the Revp100OCY index was 1.5, which was higher than register data (0.77). Cemented Charnley-type stems had a Revp100OCY index of 1.68 (register 0.64) and low friction arthroplasty type THA had a Revp100OCY index of 0.59 (register 0.33). The Revp100OCY index was slightly lower relative to register data for the Müller THA (0.22 versus 0.33), Corail stem (0.1 versus 0.24), Omnifit (0.26 versus 0.37) and Alloclassic (0.21 versus 0.49). Other implants without comparable register data had a relatively high Revp100OCY index: 1.2 for the Bousquet dual mobility cup and 1.35 for the Osteal/Cerafit hybrid system.

The few studies published in French include only a limited number of cases, but their follow-up is long and the revision rate consistent with register data. There is no indication of any type of bias in French scientific publications relative to the reproducibility of THA results.