Dieses Dokument steht unter einer CreativeCommons Lizenz by/2.0
Verlagslink DOI: 10.1186/1741-7015-9-113
Titel: Sex differences in the morphological failure patterns following hip resurfacing arthroplasty
Sprache: English
Autor/Autorin: Hinsch, Andrea 
Vettorazzi, Eik 
Morlock, Michael 
Rüther, Wolfgang 
Amling, Michael 
Zustin, Jozef 
Schlagwörter: Osteonecrosis;Femoral Component;Groin Pain;Failure Pattern;Periprosthetic Fracture
Erscheinungsdatum: 13-Okt-2011
Verlag: BioMed Central
Quellenangabe: BMC Medicine 1 (9): - (2011)
Zeitschrift oder Schriftenreihe: BMC medicine 
Zusammenfassung (englisch): Background: Metal-on-metal hybrid hip resurfacing arthroplasty (with a cementless acetabular component and a cemented femoral component) is offered as an alternative to traditional total hip arthroplasty for the young and active adult with advanced osteoarthritis. Although it has been suggested that women are less appropriate candidates for metal-on-metal arthroplasty, the mechanisms of prosthesis failure has not been fully explained. While specific failure patterns, particularly osteonecrosis and delayed type hypersensitivity reactions have been suggested to be specifically linked to the sex of the patient, we wished to examine the potential influence of sex, clinical diagnosis, age of the patient and the size of the femoral component on morphological failure patterns in a large cohort of retrieved specimens following aseptic failure of hip resurfacing arthroplasty. Methods: Femoral remnants retrieved from 173 hips with known patient’s sex were morphologically analyzed for the cause of failure. The results were compared with the control group of the remaining 31 failures from patients of unknown sex. The odds ratios (OR) and 95% confidence intervals (CI) of the following morphologically defined variables were calculated using logistic regression analysis: periprosthetic fractures (n = 133), osteonecrosis (n = 151), the presence of excessive intraosseous lymphocyte infiltration (n = 11), and interface hyperosteoidosis (n = 30). Logistic regression analysis was performed both unadjusted and after adjustment for sex, age, the size of the femoral component, and preoperative clinical diagnosis. Results: Femoral remnants from female patients had a smaller OR for fracture (adjusted OR: 0.29, 95% CI 0.11, 0.80, P for difference = 0.02) and for the presence of osteonecrosis (adjusted OR: 0.16, 95% CI 0.04, 0.63, P for difference = 0.01). However, women had a higher OR for both the presence of excessive intraosseous lymphocyte infiltration (adjusted OR: 10.22, 95% CI 0.79, 132.57, P for difference = 0.08) and interface hyperosteoidosis (adjusted OR: 4.19, 95% CI 1.14, 15.38, P for difference = 0.03). Conclusions: Within the limitations of this study, we demonstrated substantial sex differences in distinct failure patterns of metal-on-metal hip resurfacing. Recognition of pathogenically distinct failure modes will enable further stratification of risk factors for certain failure mechanisms and thus affect future therapeutic options for selected patient groups.
URI: https://tubdok.tub.tuhh.de/handle/11420/1962
DOI: 10.15480/882.1959
ISSN: 1741-7015
Institut: Biomechanik M-3 
Dokumenttyp: (wissenschaftlicher) Artikel
Enthalten in den Sammlungen:Publications (tub.dok)

Dateien zu dieser Ressource:
Datei Beschreibung GrößeFormat
1741-7015-9-113.pdfVerlags-PDF2,27 MBAdobe PDFÖffnen/Anzeigen
Zur Langanzeige

Seitenansichten

47
Letzte Woche
0
Letzten Monat
6
checked on 23.03.2019

Download(s)

6
checked on 23.03.2019

Google ScholarTM

Prüfe

Export

Diese Ressource wurde unter folgender Copyright-Bestimmung veröffentlicht: Lizenz von Creative Commons Creative Commons