The Epidemiology of Bearing Surface Usage in Total Hip Arthroplasty in the United States
The Epidemiology of Bearing Surface Usage in Total Hip Arthroplasty in the United States
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DOI：
10.2106/jbjs.h.01220
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发表时间：
2009-07-01
影响因子：
5.3
通讯作者：
Berry, Daniel J.
中科院分区：
文献类型：
--
作者：
Bozic, Kevin J.;Kurtz, Steven;Berry, Daniel J.
背景：硬对硬关节面有可能提高全髋关节置换术植入物的生存率。然而，使用这些先进技术的具体适应症仍存在争议。本研究的目的是从患者、医院、地理和支付者特征方面描述美国全髋关节置换术中关节面使用的流行病学特征。方法：使用全国住院患者样本数据库分析2005年10月1日至2010年12月30日期间在美国进行的112，095例初次全髋关节置换术相关的关节面类型和人口统计学特征，2006年12月31日。每种类型的全髋关节置换术轴承的患病率计算人口亚组作为一个功能的年龄，性别，人口普查地区，付款人类，和医院type.Results：最常见的报告轴承是金属对聚乙烯（51%），其次是金属对金属（35%）和陶瓷陶瓷（14%）。金属对聚乙烯关节面最常见于65 - 74岁的女性医疗保险患者，而金属对金属和陶瓷对陶瓷关节面最常见于65岁以下的私人保险男性患者。33%的65岁以上患者报告了硬对硬关节面。轴承的使用有很大的区域差异;最高的流行率的金属对聚乙烯轴承的报告在东北部和非教学医院，最高的流行率的金属对金属轴承的报告在南方和教学hospital.Conclusions：全髋关节置换术轴承的使用有很大的不同，患者的特点，医院类型，和整个美国的地理位置。尽管在老年患者中的优势不确定，但硬对硬关节面通常用于65岁以上的患者。需要进一步研究以确定这些先进技术在全髋关节置换术中的适当适应症。
Background: Hard-on-hard bearings offer the potential to improve the survivorship of total hip arthroplasty implants. However, the specific indications for the use of these advanced technologies remain controversial. The purpose of this study was to characterize the epidemiology of bearing surface utilization in total hip arthroplasty in the United States with respect to patient, hospital, geographic, and payer characteristics.Methods: The Nationwide Inpatient Sample database was used to analyze bearing type and demographic characteristics associated with 112,095 primary total hip arthroplasties performed in the United States between October 1, 2005, and December 31, 2006. The prevalence of each type of total hip arthroplasty bearing was calculated for population subgroups as a function of age, sex, census region, payer class, and hospital type.Results: The most commonly reported bearing was metal-on-polyethylene (51%) followed by metal-on-metal (35%) and ceramic-on-ceramic (14%). Metal-on-polyethylene bearings were most commonly reported in female Medicare patients who were sixty-five to seventy-four years old, while metal-on-metal and ceramic-on-ceramic bearings were most commonly reported in privately insured male patients who were less than sixty-five years old. Thirty-three percent of patients over sixty-five years old had a hard-on-hard bearing reported. There was substantial regional variation in bearing usage; the highest prevalence of metal-on-polyethylene bearings was reported in the Northeast and at nonteaching hospitals, and the highest prevalence of metal-on-metal bearings was reported in the South and at teaching hospitals.Conclusions: The usage of total hip arthroplasty bearings varies considerably by patient characteristics, hospital type, and geographic location throughout the United States. Despite uncertain advantages in older patients, hard-on-hard bearings are commonly used in patients over the age of sixty-five years. Further study is necessary to define the appropriate indications for these advanced technologies in total hip arthroplasty.