Clin Orthop Surg.  2016 Mar;8(1):29-37. 10.4055/cios.2016.8.1.29.

The Epidemiology and National Trends of Bearing Surface Usage in Primary Total Hip Arthroplasty in Korea

• Yoon PW
• Yoo JJ
• Kim Y
• Yoo S
• Lee S
• Kim HJ

• KMID: 2363942
• DOI: http://doi.org/10.4055/cios.2016.8.1.29

Abstract

BACKGROUND
We analyzed the data for primary total hip arthroplasty (THA) in the Korean nationwide database to assess (1) the epidemiology and national trends of bearing surface usage in THAs and (2) the prevalence of each type of bearing surface according to age, gender, hospital type, primary payer, and hospital procedure volume.
METHODS
A total of 30,881 THAs were analyzed using the Korean Health Insurance Review and Assessment Service database for 2007 through 2011. Bearing surfaces were sub-grouped according to device code for national health insurance claims and consisted of ceramic-on-ceramic (CoC), metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), and metal-on-metal (MoM). The prevalence of each type of bearing surface was calculated and stratified by age, gender, hospital type, primary payer, and procedure volume of each hospital.
RESULTS
CoC was the most frequently used bearing surface (76.7%), followed by MoP (11.9%), CoP (7.3%), and MoM (4.1%). The proportion of THAs using a CoC bearing surface increased steadily from 71.6% in 2007 to 81.4% in 2011, whereas the proportions using CoP, MoP, and MoM bearing surfaces decreased. The order of prevalence was identical to that in the general population regardless of age, gender, hospital type, primary payer, and hospital procedure volume.
CONCLUSIONS
The trends and epidemiology of bearing surface usage in THAs in Korea are different from those in other countries, and the CoC bearing surface is the most prevalent articulation. In future, the results of a large-scale study using nationwide data of THAs involving a CoC bearing surface will be reported in Korea.

Keyword

Epidemiology; Hip; Arthroplasty; Cross-sectional studies

MeSH Terms

Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip/methods/*statistics & numerical data/*trends
Ceramics/therapeutic use
Cross-Sectional Studies
Female
Hip Prosthesis/*statistics & numerical data
Humans
Male
Metals/therapeutic use
Middle Aged
Polyethylene/therapeutic use
Republic of Korea/epidemiology
Metals
Polyethylene

Figure

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  Fig. 1 Trends for bearing surface usage from 2007 to 2011. CoC: ceramic-on-ceramic, MoP: metal-on-polyethylene, CoP: ceramic-on-polyethylene, MoM: metal-on-metal.

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  Fig. 2 The proportion of women in patients that received different bearing surfaces. CoC: ceramic-on-ceramic, CoP: ceramic-on-polyethylene, MoP: metal-on-polyethylene, MoM: metal-on-metal.

Reference

1. Beaule PE, Campbell P, Mirra J, Hooper JC, Schmalzried TP. Osteolysis in a cementless, second generation metal-on-metal hip replacement. Clin Orthop Relat Res. 2001; (386):159–165.

2. Hwang KT, Kim YH, Kim YS, Choi IY. Is second generation metal-on-metal primary total hip arthroplasty with a 28 mm head a worthy option? A 12- to 18-year follow-up study. J Arthroplasty. 2013; 28(10):1828–1833.

3. Yoo JJ, Kim YM, Yoon KS, Koo KH, Song WS, Kim HJ. Alumina-on-alumina total hip arthroplasty: a five-year minimum follow-up study. J Bone Joint Surg Am. 2005; 87(3):530–535.

4. Ha YC, Kim SY, Kim HJ, Yoo JJ, Koo KH. Ceramic liner fracture after cementless alumina-on-alumina total hip arthroplasty. Clin Orthop Relat Res. 2007; 458:106–110.

5. Haddad FS, Thakrar RR, Hart AJ, et al. Metal-on-metal bearings: the evidence so far. J Bone Joint Surg Br. 2011; 93(5):572–579.

6. Bosker BH, Ettema HB, Boomsma MF, Kollen BJ, Maas M, Verheyen CC. High incidence of pseudotumour formation after large-diameter metal-on-metal total hip replacement: a prospective cohort study. J Bone Joint Surg Br. 2012; 94(6):755–761.

7. Walter WL, Kurtz SM, Esposito C, et al. Retrieval analysis of squeaking alumina ceramic-on-ceramic bearings. J Bone Joint Surg Br. 2011; 93(12):1597–1601.

8. Allain J, Roudot-Thoraval F, Delecrin J, Anract P, Migaud H, Goutallier D. Revision total hip arthroplasty performed after fracture of a ceramic femoral head: a multicenter survivorship study. J Bone Joint Surg Am. 2003; 85(5):825–830.

9. Rajaee SS, Trofa D, Matzkin E, Smith E. National trends in primary total hip arthroplasty in extremely young patients: a focus on bearing surface usage. J Arthroplasty. 2012; 27(10):1870–1878.

10. Lehil MS, Bozic KJ. Trends in total hip arthroplasty implant utilization in the United States. J Arthroplasty. 2014; 29(10):1915–1918.

11. Bozic KJ, Kurtz S, Lau E, et al. The epidemiology of bearing surface usage in total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009; 91(7):1614–1620.

12. Kobayashi S, Eftekhar NS, Terayama K, Iorio R, Takaoka K. Primary Charnley total hip arthroplasty: a comparison of American and Japanese cohorts followed for 10-20 years. J Arthroplasty. 2001; 16(3):340–350.

13. Hoaglund FT, Oishi CS, Gialamas GG. Extreme variations in racial rates of total hip arthroplasty for primary coxarthrosis: a population-based study in San Francisco. Ann Rheum Dis. 1995; 54(2):107–110.

14. Yoon PW, Lee YK, Ahn J, et al. Epidemiology of hip replacements in Korea from 2007 to 2011. J Korean Med Sci. 2014; 29(6):852–858.

15. Australian Orthopaedic Association National Joint Replacement Registry. Annual report 2014: hip and knee arthroplasty [Internet]. Adelaide: Australian Orthopaedic Association National Joint Replacement Registry;2014. cited 2015 Jun 2. Available from: https://aoanjrr.dmac.adelaide.edu.au/annual-reports-2014.

16. Malchau H, Herberts P, Eisler T, Garellick G, Soderman P. The Swedish total hip replacement register. J Bone Joint Surg Am. 2002; 84:Suppl 2. 2–20.

17. Zhan C, Kaczmarek R, Loyo-Berrios N, Sangl J, Bright RA. Incidence and short-term outcomes of primary and revision hip replacement in the United States. J Bone Joint Surg Am. 2007; 89(3):526–533.

18. Zahiri CA, Schmalzried TP, Ebramzadeh E, et al. Lessons learned from loosening of the McKee-Farrar metal-on-metal total hip replacement. J Arthroplasty. 1999; 14(3):326–332.

19. Rajpura A, Kendoff D, Board TN. The current state of bearing surfaces in total hip replacement. Bone Joint J. 2014; 96(2):147–156.

20. Kang BJ, Ha YC, Ham DW, Hwang SC, Lee YK, Koo KH. Third-generation alumina-on-alumina total hip arthroplasty: 14 to 16-year follow-up study. J Arthroplasty. 2015; 30(3):411–415.

21. Sugano N, Takao M, Sakai T, Nishii T, Miki H, Ohzono K. Eleven- to 14-year follow-up results of cementless total hip arthroplasty using a third-generation alumina ceramic-on-ceramic bearing. J Arthroplasty. 2012; 27(5):736–741.

22. Lee YK, Ha YC, Yoo JJ, Koo KH, Yoon KS, Kim HJ. Alumina-on-alumina total hip arthroplasty: a concise follow-up, at a minimum of ten years, of a previous report. J Bone Joint Surg Am. 2010; 92(8):1715–1719.

23. Willert HG, Buchhorn GH, Fayyazi A, et al. Metal-on-metal bearings and hypersensitivity in patients with artificial hip joints: a clinical and histomorphological study. J Bone Joint Surg Am. 2005; 87(1):28–36.

24. Witzleb WC, Hanisch U, Kolar N, Krummenauer F, Guenther KP. Neo-capsule tissue reactions in metal-on-metal hip arthroplasty. Acta Orthop. 2007; 78(2):211–220.

25. Davies AP, Willert HG, Campbell PA, Learmonth ID, Case CP. An unusual lymphocytic perivascular infiltration in tissues around contemporary metal-on-metal joint replacements. J Bone Joint Surg Am. 2005; 87(1):18–27.

26. Su EP. Ceramic-ceramic bearing: too unpredictable to use it regularly. HSS J. 2012; 8(3):287–290.