Higher Risk of Hip Implant Failure for Women Than Men

Higher Risk of Hip Implant Failure for Women Than Men
Higher Risk of Hip Implant Failure for Women Than Men

(HealthDay News) – After adjustment, implant failure is more likely for women than men who undergo total hip arthroplasty (THA), according to a study published online Feb. 18 in JAMA Internal Medicine.

Maria C. S. Inacio, from Southern California Permanente Medical Group in San Diego, and colleagues conducted a prospective evaluation of a cohort of patients undergoing primary, elective, unilateral THA, enrolled in a total joint replacement registry from April 2001, through December 2010. The patients (mean age, 65.7 years; 57.5% women) underwent 35,140 THAs, with a median follow-up of 3 years.

The researchers found that a higher proportion of women than men received 28-mm femoral heads (28.2% vs. 13.1%) and had metal on highly cross-linked polyethylene-bearing surfaces (60.6% vs. 53.7%); whereas a higher proportion of men than women had 36-mm or larger heads (55.4% vs. 32.8%) and metal on metal-bearing surfaces (19.4% vs. 9.6%). Implant survival was 97.4% at five-year follow-up. In men, device survival was significantly higher than in women (97.7% vs. 97.1%; P=0.01). After adjustment, women had a significantly increased risk of all-cause revision (hazard ratio, 1.29), aseptic revision (hazard ratio, 1.32), and an increased risk of septic revision (hazard ratio, 1.17; 95% confidence interval, 0.81–1.68).

"After considering patient-, surgery-, surgeon-, volume-, and implant-specific risk factors, women had a 29% higher risk of implant failure than men after THA in this community-based sample," write the authors.

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