In addition, IPD did not appear to be a concern with respect to the benefit in term of instability prevention though caution is advised in acetabular-only revision associated with a poor head-to-neck ratio.
Risk of THR and TKR revision associated with BMI, age and gender, after adjusting for the competing risk of death.
One medium size comparative clinical trial reported a substantially lower rate of revision associated with ceramic on ceramic implants compared with metal on polyethylene implants.
The high rate of osteolysis, aseptic loosening and revision associated with earlier uncemented femoral components has been greatly reduced by using better designed implants incorporating circumferential porous coating.
While one clinical study reported fewer dislocations associated with metal on metal implants, in the three largest national registries there was evidence of higher rates of implant revision associated with metal on metal implants compared with metal on polyethylene.
Thus, individual studies require large sample sizes and/or lengthy follow-up periods to detect statistically and clinically significant differences in the risk of revision associated with purported risk factors.
In younger patients (< 65 years old), the lower risk of early revision associated with monoblock all-polyethylene components was even more pronounced, as it was approximately 74% lower than that for metal-backed modular components.
After adjusting for age and sex (no other variables were found to be confounders), in the all-cause revision models, the early risk of revision associated with using a monoblock all-polyethylene tibial component was 0.51 (CI: 0.33 0.78) times the risk of revision with a metal-backed modular component.
While one study reported fewer dislocations associated with metal on metal implants, three other trials did not support this finding, and the three largest national registries reported substantially higher occurrence of revision associated with metal on metal implants compared with metal on polyethylene bearing (fig 2).
Our results indicated that redo revisions are associated with 4 days longer LOS when compared to the first revision.
