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Reverse hybrid total hip arthroplasty.

Helge Wangen1, Leif I Havelin2,3, Anne M Fenstad2

  • 1a Department of Orthopaedic Surgery, Elverum , Innlandet Hospital Trust.

Acta Orthopaedica
|January 19, 2017
PubMed
Summary

Reverse hybrid total hip arthroplasty (THA) shows a slightly higher revision rate than cemented THA, particularly in patients over 55. This is mainly due to increased early periprosthetic femoral fractures.

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Area of Science:

  • Orthopedic Surgery
  • Arthroplasty Research
  • Biomaterials Engineering

Background:

  • Reverse hybrid total hip arthroplasty (THA), combining cemented cups with uncemented stems, has gained popularity.
  • Limited data exists on the long-term outcomes of this prosthetic concept.

Purpose of the Study:

  • To analyze the outcomes of reverse hybrid THA using a large national registry.
  • To compare reverse hybrid THA with cemented THA, focusing on revision rates and reasons.
  • To investigate specific cup/stem combinations within the reverse hybrid group.

Main Methods:

  • Utilized data from the Nordic Arthroplasty Register Association (NARA) for reverse hybrid THAs (2000-2013).
  • Included 38,415 reverse hybrid THAs for analysis and comparison with cemented THAs.
  • Employed Kaplan-Meier survival analysis and Cox regression to assess prosthesis survival and revision risk.

Main Results:

  • Reverse hybrid THA demonstrated a higher revision rate compared to cemented THA (adjusted RR 1.4).
  • Ten-year survival rates were 92% for reverse hybrid THA versus 94% for cemented THA.
  • In patients aged 55+, reverse hybrid THA showed inferior results (RR 1.1) with a significantly higher rate of early revision due to periprosthetic femoral fracture (RR 3.1).

Conclusions:

  • Reverse hybrid THA exhibits a slightly increased revision rate compared to cemented THA in patients aged 55 and older.
  • The primary driver for this difference is a higher incidence of early periprosthetic femoral fractures in reverse hybrid THAs.
  • Careful consideration of patient age and prosthesis selection is warranted for reverse hybrid THA procedures.