Implant survival of the most common cemented total hip devices from the Nordic Arthroplasty Register Association database

Figures & data

Table 1. Number and proportion of study implants, and demographic data

		Proportion	Mean	Female	POA	Mean follow-up
THA	n	%	age	%	%	years
Charnley	43,849	15	72	69	78	9.6
Lubinus	116,186	41	72	61	81	6.9
Exeter	75,880	26	72	64	84	7.0
Spectron EF	25,214	8.8	73	69	80	7.2
Müller	3,192	1.1	71	66	88	8.9
MS-30	8,674	3.0	71	64	89	4.3
CPT	6,222	2.2	73	66	85	8.8
Elite	5,647	2.0	70	66	74	10.1
C-stem	2,082	0.7	71	63	86	7.8
Total	286,946	100	72	64	82	7.4

POA: Primary osteoarthritis.

Table 3. Number and proportion of Exeter-subgroup devices, and demographic data

		Proportion	Mean	Female	Primary OA	Mean follow-up
Exeter THA	n	%	age	%	%	years
X3 Rimfit	7,189	9.5	73	65	84	1.4
Contemporary	19,889	26	74	67	85	6.1
All-poly	25,032	33	72	65	81	9.3
Duration	23,770	31	71	61	86	7.0
Total	75,880	100	72	64	83	7.0

OA: osteoarthritis.

Figure 1. •••

Table 4. Kaplan-Meier survivorship of the study devices at 10 and 15 years with revision for any reason as the endpoint, and adjusted revision rate (RR) (age, sex, diagnosis, femoral head material) for revision using Cox regression

	At risk at	10-year survival	At risk at	15-year survival	Adjusted RR
THA	10 years	(95% CI), %	15 years	(95% CI), %	(95% CI), %	p-value
Charnley	21,794	94.1 (93.9–94.3)	7,199	90.7 (90.3–91.1)	1.0	–
Lubinus	29,016	95.7 (95.5–95.9)	6,685	92.4 (92.0–92.8)	0.77 (0.73–0.81)	< 0.001
Exeter	19,606	93.5 (93.3–93.7)	4,066	86.0 (85.4–86.6)	1.25 (1.18–1.31)	< 0.001
Spectron EF	5,311	89.9 (89.3–90.5)	512	79.8 (78.2–81.4)	1.73 (1.62–1.84)	< 0.001
Müller	1,225	94.9 (93.9–95.9)	372	92.6 (91.2–94.0)	0.83 (0.70–0.99)	0.03
MS-30	834	96.6 (95.8–97.4)	–	–	0.73 (0.63–0.86)	< 0.001
CPT	2,756	94.9 (94.3–95.5)	391	91.6 (90.4–92.8)	0.94 (0.84–1.06)	0.3
Elite	3,201	89.8 (89.0–90.6)	986	83.9 (82.5–85.3)	1.65 (1.51–1.80)	< 0.001
C-stem	550	95.8 (94.8–96.8)	–	–	0.70 (0.55–0.90)	0.005

Figure 2. •••

Figure 3. •••

Table 5. Implant survival at 7 years for the time periods 1995–2004 and 2005–2013, with any reason for revision as the endpoint

		7-year survival for 1995–2004		7-year survival for 2005–2013
THA	At risk	(95% CI), %	At risk	(95% CI), %
Charnley	27,686	95.7 (95.5–95.9)	1,953	95.7 (95.1–96.3)
Lubinus	40,948	97.1 (96.9–97.3)	11,662	96.9 (96.7–97.1)
Exeter	27,748	95.8 (95.6–96.0)	7,411	96.1 (95.9–96.3)
Spectron	8,783	95.2 (94.8–95.6)	4,000	95.1 (94.7–95.5)
Müller	1,656	96.6 (95.8–97.4)	437	95.9 (94.5–97.3)
MS-30	1,005	97.3 (96.3–98.3)	493	97.5 (96.9–98.1)
CPT	3,609	96.6 (96.0–97.2)	719	95.1 (93.7–96.5)
Elite	3,959	92.7 (91.9–93.5)	13	–
C-stem	929	97.5 (96.5–98.5)	496	96.4 (95.0–97.8)

Table 6. Kaplan-Meier survivorship of the study devices with either Palacos-type, Simplex-type, or other bone cement at 10 years with aseptic loosening as the endpoint

		At risk at	10-year survival
THA	n	10 years	(95% CI), %
Charnley + Palacos	38,925	18,950	97.2 (97.0–97.4)
Charnley + Simplex	411	242	92.4 (89.5–95.3)
Charnley + other	4,335	2,542	91.7 (90.7–92.7)
Lubinus + Palacos	93,393	24,918	98.1 (97.9–98.3)
Lubinus + Simplex	2,430	1,483	97.4 (96.6–98.2)
Lubinus + other	20,224	2,724	95.6 (95.0–96.2)
Exeter + Palacos	51,729	12,200	97.2 (97.0–97.4)
Exeter + Simplex	13,366	4,148	96.2 (95.8–96.6)
Exeter + other	10,310	3,057	96.1 (95.5–96.7)
Spectron + Palacos	22,152	5,031	92.6 (92.0–93.2)
Spectron + Simplex	1,523	144	92.8 (90.1–95.5)
Spectron + other	1,497	141	85.0 (80.5–89.5)
Müller + Palacos	2,108	888	97.7 (96.9–98.5)
Müller + Simplex	234	140	97.9 (95.5–100)
Müller + other	850	233	92.9 (90.5–95.3)
MS-30 + Palacos	4,250	898	98.8 (98.2–99.4)
CPT + Palacos	5,630	2,610	98.7 (98.3–99.1)
CPT + other	469	116	97.3 (94.8–99.8)
Elite + Palacos	4,222	2,450	94.4 (93.6–95.2)
Elite + Simplex	166	98	87.8 (82.5–93.1)
Elite + other	1,254	668	88.2 (86.2–90.2)
C-stem + Palacos	1,599	683	99.0 (98.4–99.6)

Table 7. Adjusted revision risk (age, sex, diagnosis, femoral head material) for revision of the Exeter-subgroup devices

THA	Adjusted revision risk (95% CI)	p-value
Charnley	1.0	–
Exeter X3 Rimfit/Exeter	1.13 (0.91–1.39)	0.3
Exeter Contemporary/Exeter	1.41 (1.31–1.52)	< 0.001
Exeter All-poly/Exeter	1.47 (1.39–1.56)	< 0.001
Exeter Duration/Exeter	0.84 (0.77–0.90)	< 0.001