What is the lifetime risk of revision for patients undergoing total hip arthroplasty? a 40-year observational study of patients treated with the charnley cemented total hip arthroplasty

Matthew Abdel, P. Von Roth, W. S. Harmsen, D. J. Berry

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Aims The purpose of this study was to determine the lifetime risk of revision surgery for patients undergoing Charnley cemented total hip arthroplasty (THA), with 40-year follow up, using death as a competing risk. Materials and Methods We retrospectively reviewed 2000 cemented Charnley THAs, with 51 living hips available at 40 years. Results The cumulative risk of revision or removal for any reason was 13% (95% confidence interval (CI) 12 to 15). Patients aged under 50 years at the time of surgery had a 35% (95% CI 28 to 42) risk of revision or removal for any reason (Hazard Ratio (HR) 3.6; 95% CI 2.5 to 5.2; p < 0.001), patients 50 to 59 years old had a 20% risk (95% CI 16 to 24) (HR 2.1; 95% CI 1.5 to 2.8; p < 0.0001), patients aged 60 to 69 years had a 9% risk (95% CI 7 to 11) (reference point), and patients ? 70 years old had a 5% risk (95% CI 4 to 7) (HR 0.96; 95% CI 0.6 to 1.5; p = 0.86) during their lifetime. Men had a higher risk of revision or removal for any reason (HR 2.1; 95% CI 1.7 to 2.7; p < 0.001). Conclusion With almost all the patients in this series followed up till either death or revision, we have been able to develop a 'rule of thumb' for lifetime likelihood of revision or implant removal for the Charnley THA: one in three for patients < 50 years, one in five for patients 50 to 59 years, one in ten for patients 60 to 69 years, and one in 20 for patients ? 70 years. The results provide a benchmark for comparison of outcomes, for the newer designs of THA.

Original languageEnglish (US)
Pages (from-to)1436-1440
Number of pages5
JournalBone and Joint Journal
Volume98-B
Issue number11
DOIs
StatePublished - Nov 1 2016

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Arthroplasty
Observational Studies
Hip
Confidence Intervals
Tacrine
Benchmarking
Reoperation

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

What is the lifetime risk of revision for patients undergoing total hip arthroplasty? a 40-year observational study of patients treated with the charnley cemented total hip arthroplasty. / Abdel, Matthew; Von Roth, P.; Harmsen, W. S.; Berry, D. J.

In: Bone and Joint Journal, Vol. 98-B, No. 11, 01.11.2016, p. 1436-1440.

Research output: Contribution to journalArticle

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title = "What is the lifetime risk of revision for patients undergoing total hip arthroplasty? a 40-year observational study of patients treated with the charnley cemented total hip arthroplasty",
abstract = "Aims The purpose of this study was to determine the lifetime risk of revision surgery for patients undergoing Charnley cemented total hip arthroplasty (THA), with 40-year follow up, using death as a competing risk. Materials and Methods We retrospectively reviewed 2000 cemented Charnley THAs, with 51 living hips available at 40 years. Results The cumulative risk of revision or removal for any reason was 13{\%} (95{\%} confidence interval (CI) 12 to 15). Patients aged under 50 years at the time of surgery had a 35{\%} (95{\%} CI 28 to 42) risk of revision or removal for any reason (Hazard Ratio (HR) 3.6; 95{\%} CI 2.5 to 5.2; p < 0.001), patients 50 to 59 years old had a 20{\%} risk (95{\%} CI 16 to 24) (HR 2.1; 95{\%} CI 1.5 to 2.8; p < 0.0001), patients aged 60 to 69 years had a 9{\%} risk (95{\%} CI 7 to 11) (reference point), and patients ? 70 years old had a 5{\%} risk (95{\%} CI 4 to 7) (HR 0.96; 95{\%} CI 0.6 to 1.5; p = 0.86) during their lifetime. Men had a higher risk of revision or removal for any reason (HR 2.1; 95{\%} CI 1.7 to 2.7; p < 0.001). Conclusion With almost all the patients in this series followed up till either death or revision, we have been able to develop a 'rule of thumb' for lifetime likelihood of revision or implant removal for the Charnley THA: one in three for patients < 50 years, one in five for patients 50 to 59 years, one in ten for patients 60 to 69 years, and one in 20 for patients ? 70 years. The results provide a benchmark for comparison of outcomes, for the newer designs of THA.",
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N2 - Aims The purpose of this study was to determine the lifetime risk of revision surgery for patients undergoing Charnley cemented total hip arthroplasty (THA), with 40-year follow up, using death as a competing risk. Materials and Methods We retrospectively reviewed 2000 cemented Charnley THAs, with 51 living hips available at 40 years. Results The cumulative risk of revision or removal for any reason was 13% (95% confidence interval (CI) 12 to 15). Patients aged under 50 years at the time of surgery had a 35% (95% CI 28 to 42) risk of revision or removal for any reason (Hazard Ratio (HR) 3.6; 95% CI 2.5 to 5.2; p < 0.001), patients 50 to 59 years old had a 20% risk (95% CI 16 to 24) (HR 2.1; 95% CI 1.5 to 2.8; p < 0.0001), patients aged 60 to 69 years had a 9% risk (95% CI 7 to 11) (reference point), and patients ? 70 years old had a 5% risk (95% CI 4 to 7) (HR 0.96; 95% CI 0.6 to 1.5; p = 0.86) during their lifetime. Men had a higher risk of revision or removal for any reason (HR 2.1; 95% CI 1.7 to 2.7; p < 0.001). Conclusion With almost all the patients in this series followed up till either death or revision, we have been able to develop a 'rule of thumb' for lifetime likelihood of revision or implant removal for the Charnley THA: one in three for patients < 50 years, one in five for patients 50 to 59 years, one in ten for patients 60 to 69 years, and one in 20 for patients ? 70 years. The results provide a benchmark for comparison of outcomes, for the newer designs of THA.

AB - Aims The purpose of this study was to determine the lifetime risk of revision surgery for patients undergoing Charnley cemented total hip arthroplasty (THA), with 40-year follow up, using death as a competing risk. Materials and Methods We retrospectively reviewed 2000 cemented Charnley THAs, with 51 living hips available at 40 years. Results The cumulative risk of revision or removal for any reason was 13% (95% confidence interval (CI) 12 to 15). Patients aged under 50 years at the time of surgery had a 35% (95% CI 28 to 42) risk of revision or removal for any reason (Hazard Ratio (HR) 3.6; 95% CI 2.5 to 5.2; p < 0.001), patients 50 to 59 years old had a 20% risk (95% CI 16 to 24) (HR 2.1; 95% CI 1.5 to 2.8; p < 0.0001), patients aged 60 to 69 years had a 9% risk (95% CI 7 to 11) (reference point), and patients ? 70 years old had a 5% risk (95% CI 4 to 7) (HR 0.96; 95% CI 0.6 to 1.5; p = 0.86) during their lifetime. Men had a higher risk of revision or removal for any reason (HR 2.1; 95% CI 1.7 to 2.7; p < 0.001). Conclusion With almost all the patients in this series followed up till either death or revision, we have been able to develop a 'rule of thumb' for lifetime likelihood of revision or implant removal for the Charnley THA: one in three for patients < 50 years, one in five for patients 50 to 59 years, one in ten for patients 60 to 69 years, and one in 20 for patients ? 70 years. The results provide a benchmark for comparison of outcomes, for the newer designs of THA.

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