Table 2.
Reasons for revision by type of bearing (listed in decreasing frequency)
| Reason for revision (n = 2107) | Polyethylene bearing (n = 1721) number (%); reference group | Ceramic-on-ceramic (n = 238) number (%); OR (95% CI) | Metal-on-metal (n = 148) number (%); OR (95% CI) | p value |
|---|---|---|---|---|
| Cup aseptic loosening (n = 767) (cup or cup + stem) | 698 (41) | 41 (17); 0.31 (0.22–0.43) | 28 (19); 0.34 (0.22–0.52) | < 0.001* (ap < 0.001; bp < 0.001) |
| Periprosthetic fracture (n = 249) | 220 (13) | 21 (9); 0.66 (0.41–1.05) | 8 (5); 0.390 (0.19–0.81) | 0.0090* (ap < 0.0833; bp = 0.0110) |
| Infection (n = 240) | 185 (11) | 39 (16); 1.63 (1.12–2.37) | 16 (11); 1.01 (0.59–1.73) | 0.0362* (ap < 0.0111; bp = 0.9816) |
| Osteolysis (n = 230) | 213 (12) | 4 (2); 0.12 (0.05–0.33) | 13 (9); 0.68 (0.38–1.23) | < 0.001* (ap < 0.0001; bp = 0.2008) |
| Dislocation (n = 221) | 183 (11) | 23 (10); 0.90 (0.57–1.42) | 15 (10); 0.95 (0.54–1.65) | NS (0.89) |
| Stem aseptic loosening (n = 124) | 96 (6) | 20 (8); 1.55 (0.94–2.57) | 8 (5); 0.97 (0.46–2.03) | NS (0.21) |
| Surgical technical error (n = 64) (malposition, incorrect insert position, leg length discrepancy, femoral perforation) | 33 (2) | 22 (9); 5.21 (2.98–9.10) | 9 (6); 3.31 (1.55–7.06) | < 0.001* (ap < 0.001; bp = 0.0019) |
| Iliopsoas irritation (n = 51) | 28 (2) | 18 (8); 4.95 (2.69–9.09) | 5 (3); 2.11 (0.80–5.56) | < 0.001* (ap < 0.001; bp = 0.1291) |
| Miscellaneous (n = 48) (ossification, ARMD, impingement other than iliopsoas and prosthetic) | 20 (1) | 2 (1); 0.72 (0.17–3.10) | 26 (18); 18.12 (9.84–33.40) | < 0.001* (ap = 0.6603; bp < 0.001) |
| Stem or modular neck fracture (n = 33) | 23 (10 modular necks, 13 stems) (1) | 7 (modular necks) (3); 2.24 (0.9540–5.2743) |
3 (modular necks) (2); 1.53 (0.4543–5.15) |
NS (0.11) |
| Unexplained pain (n = 27) | 10 (1) | 5 (2); 3.67 (1.24–10.83) | 12 (8); 15.09 (6.41–35.57) | < 0.001* (ap = 0.0185; bp < 0.001) |
| Bulk ceramic fracture (n = 23) | 11 (1) | 12 (5); N/A | 0 (0); N/A | < 0.001* |
| Prosthetic impingement (n = 12) | 1 (0.06) | 7 (3); 52.12 (6.38–425.54) | 4 (3); 47.78 (5.31–430.29) | < 0.001* (ap < 0.001; bp < 0.001) |
| Ceramic sandwich fracture (n = 11) | 0 (0) | 11 (5); N/A | 0 (0); N/A | < 0.001* |
| Squeaking (n = 7) | 0 (0) | 6 (3); N/A | 1 (1); N/A | < 0.001* |
Polyethylene bearing is used as a reference to calculate odd ratios (ORs) with 95% confidence interval; results are presented as number (%); OR (95% confidence interval [CI]); ORs were calculated using polyethylene as the reference group; * p values = overall (ap values for ceramic-on-ceramic versus polyethylene; bp values for metal-on-metal versus polyethylene); ARMD = adverse reaction to metallic debris; N/A = not available; NS = nonsignificant.