(HealthDay News) – About one-quarter of all hip replacement implants available for use in primary hip replacements in the United Kingdom have no evidence for their clinical effectiveness, according to a review published online Dec. 19 in BMJ.

Francis Kynaston-Pearson, from the Old Queen Elizabeth Hospital in Birmingham, UK, and colleagues conducted a systematic literature review to examine the extent to which prostheses with no readily available evidence to support their use are being implanted in primary total hip arthroplasty. Analyses were conducted for prostheses used in primary total hip arthroplasty as published in the ninth annual report of the National Joint Registry of England and Wales.

The researchers found no evidence for the clinical effectiveness of 24% of all hip replacement implants available to surgeons in the United Kingdom (57/235). Furthermore, in 2011, 7.8% of the 136,593 components used in primary hip replacements were implanted despite there being no readily available evidence of clinical effectiveness. These included 0.5% of all cemented stems; 2.8% of uncemented stems; 7.1% of cemented cups; and 17.1% of uncemented cups.

“This study shows that a considerable proportion of prostheses available to orthopedic surgeons have no readily available evidence of clinical effectiveness to support their use,” the authors write. “Concern exists about the current system of device regulation, and the need for a revised process for introducing new orthopedic devices is highlighted.”

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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