The aim of the study was to establish hip implant materials at risk of revision to help orthopaedic surgeons, and patients, and to improve shared decision making before surgery by identifying hip implants with the lowest risk of revision.
The independently conducted research, published in PLOS Medicine recently, was funded by CeramTec and was supported by the National Institute for Health and Care Research (NIHR) and the NIHR Bristol Biomedical Research Centre (Bristol BRC).
The researchers analysed National Joint Registry (NJR) data from 1,026,481 hip replacement patients carried out in the NHS and private sectors in England and Wales for up to 15 years after initial hip replacement operations (between 2003 to 2019).
After reviewing hip implants from the NJR data, the research team found the risk of revision following a hip replacement is influenced by the type of material used in the bearing surface. Bearing surfaces are the moving parts of an artificial hip joint that glide against each other during activity.
The data indicated hip implants with a delta ceramic or oxidised zirconium head and highly crosslinked polyethylene liner or cup had the lowest risk of revision throughout the 15 years following hip replacement surgery.
These findings were confirmed when the research team investigated the specific reasons for revision hip replacements being performed. The data also showed 20,869 (2 per cent) of hip replacement patients had to undergo revision after the initial surgery.
Dr Erik Lenguerrand, Senior Lecturer in Medical Statistics and Quantitative Epidemiologist in the Bristol Medical School: Translational Health Sciences (THS) at the University of Bristol, and a senior author on the paper, said: “Our research has found the risk of hip replacement revision depends on the hip implant materials used in the original surgery. The lowest risk of revision are from implants with delta ceramic or oxidised zirconium head and a highly crosslinked polyethylene (HCLPE) liner or cup.
“Further research is needed to find out the association of implant materials with the risk of rehospitalisation, re-operation other than revision, mortality and the cost-effectiveness of these materials.”
Michael Whitehouse, Professor of Trauma and Orthopaedics at Bristol Medical School: THS, and senior clinical lead for the paper, explained: “Our study has used data from one of the largest registries in the world that includes all public and