Study Shows Trends in Total Hip Arthroplasty Implant Usage

From 2001 to 2012, total hip arthroplasty implant usage trends favored cementless fixation, metal-on-polyethylene or ceramic-on-polyethylene bearings, modular acetabular cups and large diameter femoral heads, according to study results.

University of California-San Francisco researchers analyzed 105,291 total hip arthroplasty (THA) procedures to evaluate trends in implant utilization from 174 hospitals throughout the United States.

Study results showed an increase in cementless THA constructs from 46 percent in 2001 to 93 percent in 2012, with cementless stems used 94 percent of the time and cemented stems used 5.8 percent of the time. There was a decrease in the use of metal on highly cross-linked polyethylene bearings for primary THA from 63 percent in 2011 to 59 percent in 2012, as well as a decrease in ceramic-on-ceramic bearings from 11 percent in 2004 to 1 percent in 2012, according to the analysts.

Although researchers found a decline in use of metal-on-metal implants from 11 percent in 2010 to 1 percent in 2012, there was an increase in the use of ceramic heads and poly liners from 6 percent in 2001 to 38 percent in 2012. Of the acetabular cups used in 2012, modular two-piece cups accounted for 99 percent and one-piece acetabular cups accounted for 1 percent.

Among the acetabular liners used in 2012, 98 percent were highly cross-linked polyethylene. Additionally, 61 percent of the femoral heads used in primary THA were metal vs. 39 percent of ceramic heads, according to the researchers.

Fifty-one percent of femoral heads were 36 mm and 28 percent were 32 mm.