Study using NJR data identifies hip implant materials with the lowest risk of later needing revision
A new study, led by the University of Bristol and published in PLOS Medicine, which analysed outcome data from over a million hip replacement procedures in the National Joint Registry, has highlighted the importance of considering the whole structure that is created when implants are put together to make up a hip replacement rather than focusing on individual components.
The research found that hip implants combining delta ceramic or oxidized zirconium heads with highly crosslinked polyethylene (HCLPE) liners or cups had the lowest risk of needing revision surgery over a 15-year period. These findings offer valuable guidance for surgeons and patients in selecting the most reliable implant materials for long-term outcomes. Using NJR data from hip replacements performed in England and Wales between 2003 and 2019, the study examined the relationship between implant materials and revision rates.
Out of the 1,026,481 patients reviewed, 2% required revision surgery and the type of bearing surface materials used was a key factor in this outcome. Implants made from the ceramic and HCLPE materials consistently showed better performance in terms of durability and reduced the likelihood of future surgeries, underscoring the need for a holistic approach to choosing implant systems. Although the research was not a randomized controlled trial, it is one of the largest studies of its kind.
Tim Wilton, Medical Director of the NJR, said, “We are always delighted when the data from the NJR can be used by researchers to produce important research of this kind which gives meaningful analysis to guide surgeons and patients in their decisions. An important value of the NJR data is that it allows researchers a unique insight to assess the long-term performance of different hip implant materials.
By tracking the combinations of materials used and subsequent revision rates, this research highlights the role of implant material choice in surgical outcomes. This ensures that the materials used can be optimised for longevity and patient health. Surgeons would be well advised to study these findings carefully in relation to the implant choices they make, and to use the information in pre-operative discussions with their patients. As the demand for joint replacements continues to rise, this insight can be invaluable in reducing revision surgery.”
By focusing on the whole structure of the hip replacement construct, this study provides critical insights for improving surgical planning and reducing the need for revision surgeries, ultimately enhancing patient outcomes. The findings also suggest that further research is needed to assess the cost-effectiveness, rehospitalization rates, and the broader health impacts of implant materials.
You can read more about the research here: ‘The association of bearing surface materials with the risk of revision following primary total hip replacement: a cohort analysis of 1,026,481 hip replacements from the National Joint Registry’ by Michael Richard Whitehouse, Erik Lenguerrand et al. in PLOS Medicine https://doi.org/10.1371/journal.pmed.1004478