Risk of infection in joint replacement significantly reduced thanks to ceramic-on-ceramic bearing couple
The Heinz-Mittelmeier Research Award 2020/21 was awarded to Dr. Lisa Renner (Charité Universitätsmedizin, Berlin). The German Society for Orthopaedics and Orthopaedic Surgery (DGOOC) honors the special scientific achievement of Dr. med. Renner in the context of her work on the subject Ceramic-on-Ceramic Bearing in Total Hip Arthroplasty Reduces the Risk for Revision for Periprosthetic Joint Infection Compared to Ceramic-on-Polyethylene.1
Based on the German Arthroplasty Register (EPRD), Renner et al investigated the risk of revision for periprosthetic joint infection (PJI) in relation to bearing couples in total hip arthroplasty (THA). According to the registry, in Germany, over 87% of primary THA are performed with a ceramic head.
A total of 115,538 cases with patients of primary osteoarthritis and dysplastic hip in cementless THA were considered in the study:
100.954 cases, 87.1% CoP (Ceramic-on-Polyethylene);
14.954 cases, 12.9% CoC (Ceramic-on-Ceramic)
Among the observation cohort, 3027 revisions for any reason were performed, of which 977 hips were revised due to PJI.
After a 3-year follow-up period, the risk for patients to be revised for PJI was significantly lower for CoC (0.7%) compared to patients with CoP bearings (0.9%). In contrast, no difference in risk for revision for any other reason were found.
This study is the first register-based study in Germany of its kind that explicitly focuses on the influence of the bearing couple on the risk of revision due to PJI. These findings confirm the results of similar observational studies about the lower incidence of risk for revision for PJI with ceramic bearings.
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Reference:
1. Renner, L.; Perka, C.; Melsheimer, O.; Grimberg, A.; Jansson, V.; Steinbrück, A. Ceramic-on-Ceramic Bearing in Total Hip Arthroplasty Reduces the Risk for Revision for Periprosthetic Joint Infection Compared to Ceramic-on-Polyethylene. A Matched Analysis of 118,753 Cementless THA Based on the German Arthroplasty Registry. J. Clin. Med. 2021, 10, 1193. https://doi.org/10.3390/jcm10061193