title: Nationwide review of mixed and non-mixed components from different manufacturers in total hip arthroplasty.
abstract: Background and purpose - Combining components from different manufacturers in total hip arthroplasty (THA) is common practice worldwide. We determined the proportion of THAs used in the Netherlands that consist of components from different manufacturers, and compared the revision rates of these mixed THAs with those of non-mixed THAs. Patients and methods - Data on primary and revision hip arthroplasty are recorded in the LROI, the nationwide population-based arthroplasty register in the Netherlands. We selected all 163,360 primary THAs that were performed in the period 2007-2014. Based on the manufacturers of the components, 4 groups were discerned: non-mixed THAs with components from the same manufacturer (n = 142,964); mixed stem-head THAs with different manufacturers for the femoral stem and head (n = 3,663); mixed head-cup THAs with different head and cup manufacturers (n = 12,960), and mixed stem-head-cup THAs with different femoral stem, head, and cup manufacturers (n = 1,773). Mixed prostheses were defined as THAs (stem, head, and cup) composed of components made by different manufacturers. Results - 11% of THAs had mixed components (n = 18,396). The 6-year revision rates were similar for mixed and non-mixed THAs: 3.4% (95% CI: 3.1w-3.7) for mixed THAs and 3.5% (95% CI: 3.4-3.7) for non-mixed THAs. Revision of primary THAs due to loosening of the acetabulum was more common in mixed THAs (16% vs. 12%). Interpretation - Over an 8-year period in the Netherlands, 11% of THAs had mixed components-with similar medium-term revision rates to those of non-mixed THAs.
authors.affiliation: a Medical Center Leeuwarden , Leeuwarden ;
authors.forename: Rinne M
authors.initials: RM
authors.lastname: Peters
authors.affiliation: b Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Implantaten) , 's Hertogenbosch ;
authors.forename: Liza N
authors.initials: LN
authors.lastname: van Steenbergen
authors.affiliation: c University Medical Center Groningen, University of Groningen , Groningen ;
authors.forename: Sjoerd K
authors.initials: SK
authors.lastname: Bulstra
authors.affiliation: d Medisch Spectrum Twente , Enschede ;
authors.forename: Adelgunde V C M
authors.initials: AV
authors.lastname: Zeegers
authors.affiliation: c University Medical Center Groningen, University of Groningen , Groningen ;
authors.forename: Roy E
authors.initials: RE
authors.lastname: Stewart
authors.affiliation: e Onze Lieve Vrouwe Gasthuis , Amsterdam , the Netherlands.
authors.forename: Rudolf W
authors.initials: RW
authors.lastname: Poolman
authors.affiliation: c University Medical Center Groningen, University of Groningen , Groningen ;
authors.forename: Anton H
authors.initials: AH
authors.lastname: Hosman
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012042:Registries; D012086:Reoperation / Q000639:trends; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome