Complete Study Here:
Objectives To compare 10 year mortality rates
among patients undergoing metal-on-metal hip resurfacing and total hip
replacement in England.
Setting English hospital episode statistics
database linked to mortality records from the Office for National
Population All adults who underwent primary
elective hip replacement for osteoarthritis from April 1999 to March 2012.
The exposure of interest was prosthesis type: cemented total hip
replacement, uncemented total hip replacement, and metal-on-metal hip
resurfacing. Confounding variables included age, sex, Charlson comorbidity
index, rurality, area deprivation, surgical volume, and year of operation.
Results 7437 patients undergoing metal-on-metal
hip resurfacing were matched to 22 311 undergoing cemented total hip
replacement; 8101 patients undergoing metal-on-metal hip resurfacing were
matched to 24 303 undergoing uncemented total hip replacement. 10 year rates
of cumulative mortality were 271 (3.6%) for metal-on-metal hip resurfacing
versus 1363 (6.1%) for cemented total hip replacement, and 239 (3.0%) for
metal-on-metal hip resurfacing versus 999 (4.1%) for uncemented total hip
replacement. Patients undergoing metal-on-metal hip resurfacing had an
increased survival probability (hazard ratio 0.51 (95% confidence interval
0.45 to 0.59) for cemented hip replacement; 0.55 (0.47 to 0.65) for
uncemented hip replacement). There was no evidence for an interaction with
age or sex.