Survivorship of modern total hip replacement to 30 years: systematic review, meta-analysis, and extrapolation of global joint registry data.

Knowing how long a total hip replacement might last is important for patients, surgeons, and health-care institutions for planning and resource allocation.

了解全髋关节置换术可能持续的时间对于患者、外科医生以及医疗保健机构在规划和资源分配方面都非常重要。

Over the past 20 years, the use of contemporary bearing surfaces for total hip replacement has substantially altered implant wear and, possibly, longevity.

在过去的20年里，当代轴承表面在全髋关节置换术中的应用显著改变了植入物的磨损情况，可能也影响了其使用寿命。

To date, there has been no large-scale study that examines survivorship of these modern implants.

迄今为止，还没有大规模的研究来检查这些现代植入物的存活率。

We aimed to determine the survivorship of contemporary total hip replacements and bearing materials.

我们的目标是确定当代全髋关节置换术及其承载材料的存活率。

Methods

We focused solely on the assessment of modern bearing surfaces: highly cross-linked polyethylene versus metal or third-generation and fourth-generation ceramic heads and ceramic-on-ceramic primary total hip replacement in adult patients.

我们仅专注于评估现代承载表面：高交联聚乙烯与金属或第三代和第四代陶瓷头，以及成人患者中陶瓷对陶瓷初次全髋关节置换术的评估。

We conducted a search of MEDLINE and Embase from database inception to June 13, 2024, including articles that reported a minimum of 10 years of survivorship, irrespective of fixation method or surgical approach.

我们对MEDLINE和Embase数据库从创建开始到2024年6月13日进行了检索，包括报告了至少10年生存期的文章，无论固定方法或手术方法如何。

We then conducted a meta-analysiscombining data from eight national joint registries assessing all-cause revision within the various bearing combinations.

然后我们进行了荟萃分析，结合了来自八个国家级关节注册处的数据，评估了各种轴承组合中的全因翻修率。

We extrapolated the extracted data to estimate survivorship to 30 years, using the multivariable random-effects model from the registry data.

我们使用登记数据中的多变量随机效应模型，推算出提取数据的生存率，估计至30年。

The primary outcome was survivorship of the hip replacement, defined as time from primary total hip replacement to first all-cause revision, expressed as a percentage of unrevised implants at specific timepoints.

主要结果是髋关节置换术的生存率，定义为从初次全髋关节置换术到首次因任何原因进行翻修的时间，以特定时间点未翻修植入物的百分比表示。

This study is registered with PROSPERO (CRD42024572518).

本研究已在PROSPERO注册（CRD42024572518）。

Results

We identified 1 904 237 total hip arthroplasties across 29 clinical studies (n=5203) and eight national joint registries (n=1 899 034).

我们在29项临床研究(n=5203)和八个国家级关节登记处(n=1 899 034)中确认了1 904 237例全髋关节置换术。

Pooled analysis of the included studies showed an all-cause implant survivorship of 0·97 (0·96-0·98) under the random-effects model.

纳入研究的汇总分析显示，在随机效应模型下，所有原因的植入物存活率为0.97（95%置信区间0.96-0.98）。

Survivorship estimate based on joint registry data was at 93·6% (95% CI 92·3-94·7) at 20 years.

基于联合登记数据的存活率估计在20年时为93.6%（95%置信区间92.3-94.7）。

Extrapolating these data indicates a predicted survivorship of 92·8% (91·2-94·2) at 25 years and 92·1% (90·1- 93·7) at 30 years.

根据这些数据推算，预计在25年时的存活率为92.8%（91.2-94.2），在30年时的存活率为92.1%（90.1-93.7）。

interpretation

The estimated 92% 30-year survivorship of contemporary total hip replacement suggests that advances in bearing surface technology have greatly improved the long-term durability of total hip replacements and might influence patient counselling, health-care planning, and device regulation.

估计的当代全髋关节置换术30年的存活率为92%，表明轴承表面技术的进步极大地提高了全髋关节置换术的长期耐用性，并可能影响患者咨询、医疗规划和设备监管。

funding

None.

无。