1. Acetabular screws do not improve early revision rates in primary total hip arthroplasty. An instrumented registry analysis
- Author
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David G. Campbell, Mary Nugent, Lucien B. Solomon, Peter L. Lewis, and Alana Cuthbert
- Subjects
musculoskeletal diseases ,030203 arthritis & rheumatology ,030222 orthopedics ,medicine.medical_specialty ,Proportional hazards model ,business.industry ,medicine.medical_treatment ,Hazard ratio ,Confounding ,Initial stability ,musculoskeletal system ,equipment and supplies ,Arthroplasty ,Acetabulum ,Surgery ,03 medical and health sciences ,surgical procedures, operative ,0302 clinical medicine ,Joint replacement registry ,Orthopedic surgery ,medicine ,Orthopedics and Sports Medicine ,business - Abstract
Initial stability of uncemented acetabular components in total hip arthroplasty (THA) is important for osseointegration and potentially enhanced by screw fixation. We used Australian Orthopaedic Association National Joint Replacement Registry data to determine whether screw usage influences uncemented acetabular component survival. Primary THA with uncemented acetabular components performed for osteoarthritis from 1999 to 2018 was included. Survivorship was calculated using Kaplan-Meier estimates of cumulative percent revision (CPR). Comparisons used Cox proportional hazards method. An instrumental variable analysis adjusted for surgeon preference for screws as a confounding factor was used. Three hundred thirty thousand one hundred ninety-two THAs were included (31.8% with screws, 68.2% without). Two hundred twenty thousand six hundred seven were included in the instrumental variable analysis. Revision rate of acetabular components (all causes) was higher with screws during the first six years (hazard ratio (HR) = 1.45 (95% CI 1.34, 1.57), p
- Published
- 2021
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