Arthroplasty Research Updates

In a retrospective series of 96 patients (mean age 76, 62% female) undergoing revision total hip arthroplasty (rTHA) for femoral periprosthetic fractures (mostly Vancouver B2), postoperative dislocation occurred in 10% and 29% required reoperation. Higher Charlson Comorbidity Index and postoperative dislocation (OR 4.8) were associated with increased 1-year mortality, while modular tapered fluted stems (used in 83 cases) showed 2- and 5-year re-revision survivorships of ~95% and 94%, respectively.

In a nationwide time-varying cohort of 1,620,585 individuals aged ≥50 (2010–2022), degenerative spine disease (SPINE_DX) and spinal fusion (SPINE_FUSION) were modeled as exposures and compared with controls for incident hip osteoarthritis (HOA) and progression to total hip arthroplasty (THA). Both SPINE_DX (HR 1.66, 95% CI 1.64–1.68) and SPINE_FUSION (HR 1.22, 95% CI 1.19–1.25) were associated with increased HOA incidence, and among those with HOA progression to THA was higher with SPINE_FUSION (HR 2.32, 95% CI 2.06–2.62) and SPINE_DX (HR 1.51, 95% CI 1.41–1.62); results were consistent after inverse probability weighting.

An American Joint Replacement Registry analysis of 9,121 revision total hip arthroplasties in patients >65 years compared outcomes between modular (n=7,565) and monoblock (n=1,556) fluted tapered femoral stems and found no significant difference in all-cause re-revision, infection, periprosthetic fracture, or aseptic loosening by stem type. Index revision for dislocation and for periprosthetic fracture were associated with higher re-revision risk overall, and monoblock stems were associated with a lower hazard of re-revision for dislocation compared with modular stems (adjusted HR 0.6, P=0.045).