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Outcomes of Ceramic Bearings After Primary Total Hip Arthroplasty in the Medicare Population
Journal article   Open access   Peer reviewed

Outcomes of Ceramic Bearings After Primary Total Hip Arthroplasty in the Medicare Population

Steven M. Kurtz, Edmund Lau, Doruk Baykal and Bryan D. Springer
The Journal of arthroplasty, v 32(3), pp 743-749
Mar 2017
DOI: https://doi.org/10.1016/j.arth.2016.08.038
PMID: 27814917
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1016/j.arth.2016.08.038View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

ceramic dislocation infection mortality primary total hip arthroplasty revision
The purpose of this study was to analyze the outcomes of ceramic bearings used in primary total hip arthroplasty (THA) in the Medicare population. A total of 315,784 elderly Medicare patients (65+) who underwent primary THA between 2005 and 2014 were identified from the United States Medicare 100% national administrative hospital claims database. Outcomes of interest included infection, dislocation, revision, or mortality at any time point after primary surgery. Propensity scores were developed to adjust for selection bias in the choice of bearing type at index primary surgery. For primary THA patients treated with ceramic-on-polyethylene (C-PE) bearings and ceramic-on-ceramic (COC) bearings, there was significantly reduced risk of infection relative to metal-on-polyethylene (M-PE) bearings (C-PE hazard ratio [HR]: 0.86, P = .001; COC HR: 0.74, P = .01). For the C-PE cohort, we also observed reduced risk of dislocation (HR: 0.81, P < .001) and mortality (HR: 0.92, P < .001). There was no significant difference in risk of revision for either the C-PE or COC bearing cohorts when compared with M-PE. For the COC cohort, there was no significant difference in dislocation or mortality risk. As in previous studies, we found that ceramic bearings have similar overall revision risk as M-PE bearings in primary THA at 8-9 years of follow-up. The results indicate that, after adjusting for selection bias and various confounding patient-, surgeon-, and hospital-related factors, Medicare primary THA patients treated with ceramic bearings exhibit lower risk of infection than those treated with M-PE bearings. In addition, C-PE bearings were associated with lower risk of dislocation and mortality.

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30 citations in Web of Science
31 citations in Scopus

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Web of Science research areas
Orthopedics
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