| What works best, a cemented or cementless primary total hip arthroplasty?: minimum 17-year followup of a randomized controlled trial. | |
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MedLine Citation:
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PMID: 20625950 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Total hip arthroplasty (THA) has been associated with high survival rates, but debate remains concerning the best fixation mode of THA. QUESTIONS/PURPOSES: We conducted a randomized controlled trial (RCT) with 250 patients with a mean age of 64 years between October 1987 and January 1992 to compare the results of cementless and cemented fixation. PATIENTS AND METHODS: Patients were evaluated for revision of either of the components. One hundred twenty-seven patients had died (51%) and 12 (4.8%) were lost to followup. The minimum 17-year followup data (mean, 20 years; range, 17-21 years) for 52 patients of the cementless group and 41 patients of the cemented group were available for evaluation. RESULTS: Kaplan-Meier survivorship analysis at 20 years revealed lower survival rates of cemented compared with cementless THA. The cementless tapered stem was associated with a survivorship of 99%. Age younger than 65 years and male gender were predictors of revision surgery. CONCLUSIONS: The efficacy of future RCTs can be enhanced by randomizing patients in specific patient cohorts stratified to age and gender in multicenter RCTs. Including only younger patients might improve the efficacy of a future RCT with smaller sample sizes being required. A minimum 10-year followup should be anticipated, but this can be expected to be longer if the difference in level of quality between the compared implants is smaller. LEVEL OF EVIDENCE: Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. |
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Authors:
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Kristoff Corten; Robert B Bourne; Kory D Charron; Keegan Au; Cecil H Rorabeck |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2010-07-13 |
Journal Detail:
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Title: Clinical orthopaedics and related research Volume: 469 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-24 Completed Date: 2011-01-25 Revised Date: 2012-01-02 |
Medline Journal Info:
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Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: United States |
Other Details:
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Languages: eng Pagination: 209-17 Citation Subset: AIM; IM |
Affiliation:
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London Health Sciences Centre, University Campus, 339 Windermere Road, London, ON N6A 5A5, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Aged Arthroplasty, Replacement, Hip / adverse effects, instrumentation*, methods* Bone Cements / therapeutic use* Female Follow-Up Studies Hip Joint / physiopathology, radiography, surgery* Hip Prosthesis* Humans Kaplan-Meier Estimate Male Middle Aged Ontario Osteoarthritis, Hip / physiopathology, radiography, surgery* Proportional Hazards Models Prosthesis Design Prosthesis Failure Reoperation Risk Assessment Risk Factors Sex Factors Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Bone Cements |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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