Abstract
Introduction
The role of different femoral head materials for total hip arthroplasty (THA) has been widely studied in the context of wear properties and corrosion. Cobalt chrome (CoCr) femoral heads are commonly used as a standard of comparison to other materials such as ceramic and oxidized zirconium (OxZi). This study aims to evaluate the impact of femoral head material on clinical outcomes in elective primary THA patients.
Methods
Retrospective analysis of THA patients within the Medicare claims database between October 2017 and September 2020 using diagnosis-related group codes was conducted. Information collected included sex, age, Charlson Comorbidity Index, and femoral head type. Patients with CoCr femoral heads were compared against patients with either OxZi or ceramic femoral heads using 1:1 propensity score matching. Z-testing and Chi-square analysis were used to determine between-group significance.
Results
In total, 112,960 elective THA patients were included, with 56,480 in OxZi or ceramic and 56,480 in CoCr. Readmission rates were lower in patients that received OxZi or ceramic femoral heads at 30-day (p < 0.0001), 60-day (p < 0.0001), and 90-day postoperatively (p < 0.0001) compared to CoCr. Mortality rates were also lower in patients that received OxZi or ceramic femoral heads at 30-day (p = 0.004), 60-day (p = 0.018), and 90-day postoperatively (p = 0.009) compared to CoCr.
Conclusion
CoCr femoral heads had higher rates of readmissions and mortality compared to OxZi or ceramic. Further analysis of bearing surface combinations and sub-group analyses to determine significance between-group differences is needed.
Level III evidence
Retrospective analysis.
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Availability of data and materials
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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CS, NM, VS, PS, TN, and KH have nothing to disclose. RS reports being a paid consultant for Smith & Nephew, Intellijoint, and Zimmer; has stock options in Gauss Surgical and PSI, and receives IP royalties from Smith & Nephew, outside the submitted work.
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Sicat, C.S., Singh, V., Muthusamy, N. et al. Role of femoral head material on readmission and mortality rates following elective primary total hip arthroplasty in Medicare patients. Arch Orthop Trauma Surg 144, 459–464 (2024). https://doi.org/10.1007/s00402-023-05027-1
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DOI: https://doi.org/10.1007/s00402-023-05027-1