Cancer risk is not increased after conventional hip arthroplasty.
OBJECTIVE
Wear debris from conventional total hip arthroplasty (THA) induces chromosomal aberrations and DNA damage, which may promote cancerogenesis. A long latent period is required for solid tumors. We therefore re-analyzed a large THA cohort for cancer.


METHODS
We updated a cohort of 24,636 patients with primary osteoarthritis and metal-on-polyethylene THA who had been entered in the Finnish Arthroplasty Register between 1980 and 1995, and linked it to the Finnish Cancer Registry for cancer risk assessment up to 2005. The mean follow-up time was 13 years. The numbers of cancer cases observed were compared with expected rates based on incidence in the general population.


RESULTS
The standardized incidence ratio (SIR) for the whole follow-up period was 0.95 (95% confidence interval (CI): 0.92-0.97). After 10 years of follow-up, the SIR was equal to that in the normal population (SIR = 0.98, 95% CI: 0.94-1.03). Incidence of lung cancer was low throughout the follow-up time and that of prostate cancer was slightly elevated. The incidence rates for all other forms of cancer did not deviate significantly from those in the normal population.


CONCLUSIONS
We found no increased cancer risk in patients with conventional THA after an average of 13 years and up to 25 years of follow-up.
Visuri
Tuomo
T
Research Department, Centre for Military Medicine, Finland. tuomo.visuri@helsinki.fi
Pulkkinen
Pekka
P
Paavolainen
Pekka
P
Pukkala
Eero
E
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D015331:Cohort Studies; D003343:Corrosion; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008670:Metals / Q000009:adverse effects; D008689:Methacrylates / Q000009:adverse effects; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced / Q000209:etiology*; D015207:Osteoarthritis, Hip / Q000601:surgery; D011095:Polyethylenes / Q000009:adverse effects; D011475:Prosthesis Failure; D012042:Registries; D012307:Risk Factors
D008670:Metals; D008689:Methacrylates; D011095:Polyethylenes