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. 2023 Nov 21;13(1):20327.
doi: 10.1038/s41598-023-47670-z.

Head, acetabular liner composition, and rate of revision and wear in total hip arthroplasty: a Bayesian network meta-analysis

Ricarda Merfort  1 , Nicola Maffulli  2   3   4 , Ulf Krister Hofmann  1 , Frank Hildebrand  1 , Francesco Simeone  5 , Jörg Eschweiler #  1 , Filippo Migliorini #  6   7
Affiliations

Head, acetabular liner composition, and rate of revision and wear in total hip arthroplasty: a Bayesian network meta-analysis

Ricarda Merfort et al. Sci Rep. .

Abstract

Total hip arthroplasty (THA) is a common procedure for patients suffering from hip pain e.g. from osteoarthritis, osteonecrosis, or hip fractures. The satisfaction of patients undergoing THA is influenced by the choice of implant type and material, with one key factor being the selection of the appropriate material combination for the bearing surface. In this Bayesian network meta-analysis, we investigated the impact of material combinations for the bearing surface on the longevity of hip implants. The wear penetration rate per year and the total wear penetration in the liner resulting from different material combinations, as well as the survival rate at last follow-up, were examined. We analyzed a total of 663,038 THAs, with 55% of patients being women. Mean patient age was 59.0 ± 8.1 years and mean BMI 27.6 ± 2.6 kg/m2. The combination of an aluminium oxide (Al2O3) head and an Al2O3 liner demonstrated the lowest wear penetration at last follow-up and the lowest rate of wear penetration per year. Additionally, the combination of a crosslinked polyethylene (XLPE) liner and a zircon oxide (ZrO2) head demonstrated the lowest rate of revision at last follow-up. These findings underscore the importance of careful material selection for hip implant bearing surfaces to optimize their longevity and patient satisfaction after THA.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow chart of the literature search.
Figure 2
Figure 2
Cochrane risk of bias tool.
Figure 3
Figure 3
From left to the right: edge, funnel and interval plots of the comparison: overall wear penetration.
Figure 4
Figure 4
From left to the right: edge, funnel and interval plots of the comparison: wear penetration per year.
Figure 5
Figure 5
From left to the right: edge, funnel and interval plots of the comparison: rate of revision at last follow-up.
See this image and copyright information in PMC

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