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The incidence of implant fractures after total hip arthroplasty

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Abstract

Purpose

Implant fractures after total hip arthroplasty (THA) are considered as rare in clinical practice. Nevertheless they are relevant complications for patients, physicians, and the public health system leading to high socioeconomic burdens. The aim of this study was to assess the incidence of fractures after THAs in a comparative analysis of clinical studies and worldwide arthroplasty register datasets.

Methods

We calculated the pooled incidence of revision operations after fractures of THAs in a comparison of clinical studies published in Medline-listed journals and annual reports of worldwide arthroplasty registers in a structured literature analysis based on a standardised methodology.

Results

Included clinical studies (sample-based datasets) were mono-centre trials comprising a cumulative number of approximately 70,000 primary implantations whereas worldwide national arthroplasty register datasets referred to 733,000 primary implantations, i.e. approximately ten times as many as sample-based datasets. In general, sample-based datasets presented higher revision rates than register datasets with a maximum deviation of a 14.5 ratio for ceramic heads, respectively. The incidence of implant fractures in total hip arthroplasty in pooled worldwide arthroplasty register datasets is 304 fractures per 100,000 implants. In other words, one out of 323 patients has to undergo revision surgery due to an implant fracture after THA in their lifetime.

Conclusions

Implant fractures in total hip arthroplasty occur in a relevant number of patients. The authors believe that comprehensive arthroplasty register datasets allow more general evaluations and conclusions on that topic in contrast to clinical studies.

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Acknowledgement

This study was conducted in the course of an EU project and supported by a grant from the EU Commission’s Directorate General for Public Health and Consumer Protection (DG SANCO). No further financial support has been received from other stakeholders such as the industry. Apart from the general framework of the project task, the support on the part of a public health institution had no influence whatsoever on the results.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria

    Patrick Sadoghi & Andreas Leithner

  2. Department of Orthopaedic Surgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Wolfram Pawelka, Michael C. Liebensteiner, Alexandra Williams & Gerold Labek

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  1. Patrick Sadoghi
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  2. Wolfram Pawelka
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  3. Michael C. Liebensteiner
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  4. Alexandra Williams
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  5. Andreas Leithner
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  6. Gerold Labek
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Corresponding author

Correspondence to Patrick Sadoghi.

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Sadoghi, P., Pawelka, W., Liebensteiner, M.C. et al. The incidence of implant fractures after total hip arthroplasty. International Orthopaedics (SICOT) 38, 39–46 (2014). https://doi.org/10.1007/s00264-013-2110-3

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  • DOI: https://doi.org/10.1007/s00264-013-2110-3

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