Does the Risk of Rerevision Vary Between Porous Tantalum Cups and Other Cementless Designs After Revision Hip Arthroplasty?

Abstract

Level III, therapeutic study.

Do Trabecular Metal Acetabular Components Reduce the Risk of Rerevision After Revision THA Performed for Periprosthetic Joint Infection? A Study Using the NJR Data Set

“…In the NJR for England and Wales we earlier reported lower revision rates for infection when TM (versus non-TM) was used in primary THA [9], but no difference in re-revision rates for infection when TM was used for all-cause revision THAs [11]. The latter findings in allcause revisions were also confirmed in a study from the Swedish and Australian registries [8]. It is possible that TM only reduces the risk of infection when it is specifically used for PJI revisions, rather than revisions for all-causes.…”

“…Using the same registry we also earlier reported no difference in re-revision rates for infection when TM (versus non-TM) was used for 3,862 all-cause revision THAs [11]. Another study of 6,843 all-cause revisions from two large registries (Sweden and Australia) similarly showed that the re-revision rate for PJI was not different when TM or non-TM components were used at revision THA [8].…”

“…It was suggested that TM was protective against infection after revision, and that TM may be useful when revising THAs for PJI. Three registry studies have subsequently assessed the effect of TM on future infection [8,9,11]. In the NJR for England and Wales we earlier reported lower revision rates for infection when TM (versus non-TM) was used in primary THA [9], but no difference in re-revision rates for infection when TM was used for all-cause revision THAs [11].…”

“…It was suggested that TM was protective against infection after revision, and that TM may be useful when revising THAs for PJI. Three registry studies have since assessed the effect of TM on the risk of subsequent revision for infection [8,9,11]. In the National Joint Registry (NJR)…”

“…The study from the Swedish and Australian registries was unable to assess this issue because the authors felt that the small number of revision THAs performed for PJI (n = 272) precluded any useful analysis [8]. Our previous analysis of 247 revision THAs for PJI from the NJR showed no difference in implant survival rates for both aseptic and septic indications between TM and non-TM components; however, the analysis was similarly underpowered because of the propensity matched analysis approach which was used [11].…”