Uncemented femoral stems in THA patients potentially linked to elevated revision rate

Thien TM. J Bone Joint Surg Am. 2014. doi:10.2106/JBJS.M.00643.

The risk and rate of revision for total hip arthroplasty were found to be higher in patients who received uncemented femoral stems compared with those who received cemented femoral stems, according to study findings.

Researchers included 437,629 patients who underwent primary total hip arthroplasty between 1995 and 2009 in the study. Of those, 325,730 had received cemented femoral stems and 111,899 had received uncemented stems. Patient data were culled from the Nordic Arthroplasty Register Association database to evaluate whether age, sex, preoperative diagnosis, fixation and implant design were influential on the risk for revision arthroplasty due to periprosthetic fracture within 2 years after primary total hip replacement.

Both cemented and uncemented femoral stems were found to have a low revision rate (0.07% and 0.47%, respectively) at 2-year follow-up. The relative risk of revision was 8.72 higher in uncemented stems vs. cemented stems, according to the researchers.

Although age did not consistently impact this risk in cemented stems, those receiving uncemented stems had an increase in revision rates as age increased. Additionally, women had a lower risk of revision than men when receiving cemented stems, whereas men exhibited a lower risk than women when receiving uncemented stems.

After adjusting for both demographic factors and fixation, patients who underwent total knee arthroplasty from 2003 to 2009 had an elevated relative risk of revision compared with those who underwent surgery from 1995 to 2002.

Disclosure: The authors have no relevant financial disclosures.


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Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

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