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Midterm analysis of the seleXys cup with ceramic inlay
Tamas Halasi1, David Kieser1, Christopher M A Frampton1
1Department of Orthopaedic Surgery and MSM, University of Otago, Christchurch, New Zealand.
Arthroplasty Today
|September 16, 2017
Summary
The seleXys TPS cup and Bionit2 liner total hip replacement (THR) shows a significantly higher revision rate compared to other ceramic-on-ceramic (CoC) implants. This specific CoC coupling should be avoided due to high failure rates.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Device Analysis
Background:
- Ceramic-on-ceramic (CoC) total hip replacements (THR) offer reliable mid-term outcomes.
- Recent data suggests increased revision rates for certain CoC implants.
- This study evaluates the nationwide performance of the seleXys TPS cup with Bionit2 liner.
Purpose of the Study:
- To analyze implant survival, revision causes, and mortality rates of the seleXys TPS cup/Bionit2 liner.
- To compare these outcomes against other CoC articulations using the same femoral stem.
- To identify patient-specific risk factors influencing revision rates.
Main Methods:
- Utilized the New Zealand Joint Registry data from 2006-2013.
- Compared 1035 seleXys THR cases with 375 control CoC THR cases using the Twinsys stem.
- Employed multivariate analysis for age, gender, ASA score, and head size impact on revision rates.
Main Results:
- The seleXys/Bionit2 group experienced 77 revisions (1.4/100 component years) versus 2 in the control group (0.12/100 component years).
- The seleXys/Bionit2 implant had a 12.22 times higher hazard ratio for revision.
- Common revision causes included disturbing noises (23.4%), acetabular loosening (20.8%), and liner fracture (18.2%). Female gender increased revision risk (HR 1.77).
Conclusions:
- The seleXys TPS cup with Bionit2 liner demonstrates an unacceptably high failure rate.
- Avoidance of this specific implant coupling is recommended.
- Patients with this implant require vigilant clinical and radiological monitoring.
