Acetabular screws do not improve early revision rates in primary total hip arthroplasty. An instrumented registry analysis

Background 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 influenc...

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Bibliographic Details
Published in:International orthopaedics 2021-03, Vol.45 (3), p.593-604
Main Authors: Nugent, Mary, Campbell, David G., Lewis, Peter L., Cuthbert, Alana R., Solomon, Lucien B.
Format: Article
Language:English
Subjects:
Acetabulum - surgery
Arthroplasty, Replacement, Hip - adverse effects
Australia - epidemiology
Bone Screws
Hip Prosthesis
Humans
Medicine
Medicine & Public Health
Original Paper
Orthopedics
Prosthesis Design
Prosthesis Failure
Registries
Reoperation
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Summary:Background 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. Methods 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. Results 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  
ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-021-04949-y