Article

Reverse hybrid hip replacement uses a cemented
all-polyethylene cup and an uncemented stem. Despite increasing use of this
method in Scandinavia, there has been very little documentation of results. We
have therefore analyzed the results from the Norwegian Arthroplasty Register
(NAR), with up to 10 years of follow-up. METHODS: The NAR has been
collecting data on total hip replacement (THR) since 1987. Reverse hybrid hip
replacements were used mainly from 2000. We extracted data on reverse hybrid THR
from this year onward until December 31, 2009, and compared the results with
those from cemented implants over the same period. Specific cup/stem combinations
involving 100 cases or more were selected. In addition, only combinations that
were taken into use in 2005 or earlier were included. 3,963 operations in 3,630
patients were included. We used the Kaplan-Meier method and Cox regression
analysis for estimation of prosthesis survival and relative risk of revision. The
main endpoint was revision for any cause, but we also performed specific analyses
on different reasons for revision. RESULTS: We found equal survival to that from
cemented THR at 5 years (cemented: 97.0% (95% CI: 96.8-97.2); reverse hybrid:
96.7% (96.0-97.4)) and at 7 years (cemented: 96.0% (95.7-96.2); reverse hybrid:
95.6% (94.4-96.7)). Adjusted relative risk of revision of the reverse hybrids was
1.1 (0.9-1.4). In patients under 60 years of age, we found similar survival of
the 2 groups at 5 and 7 years, with an adjusted relative risk of revision of
reverse hybrids of 0.9 (0.6-1.3) compared to cemented implants. INTERPRETATION:
With a follow-up of up to 10 years, reverse hybrid THRs performed well, and
similarly to all-cemented THRs from the same time period. The reverse hybrid
method might therefore be an alternative to all-cemented THR. Longer follow-up
time is needed to evaluate whether reverse hybrid hip replacement has any
advantages over all-cemented THR.

Langue : ANGLAIS