Finding the Right Implants for Young and Active THA Patients

    In perhaps the first application of network meta-analysis in the hip and knee literature, researchers at Mayo Clinic, Rochester, Minnesota, found that 3 types of bearing surfaces – ceramic-on-ceramic, ceramic-on-highly cross-linked polyethylene, and metal-on-highly cross-linked polyethylene – have comparable survivorship in young and active total hip arthroplasty patients.

    This finding, the researchers said, means that surgeons do not need to worry about implant longevity and can instead focus on costs and implant-specific complications when deciding which implants to use in these patients.

    Their review of randomized controlled trials (RCTs) involving these bearing surfaces was presented at the recent annual meeting of the Mid-America Orthopaedic Association.

    The included RCTs had to:

    • Be published after 2000
    • Report survivorship of 1 of the 3 bearing surface types
    • Have a minimum follow-up of 2 years
    • Have an average patient age less than 65 years

    The researchers were not surprised to find good survivorship for all 3 bearing surface types based on their clinical experience, according to Miguel Cabenela, MD, one of the study authors. What was significant about this study, Dr. Cabanela said, was the application of network meta-analysis to compare the data.

    According to the study abstract, “A network meta-analysis is a novel statistical method for analyzing more comprehensive datasets through indirect comparisons and provides a ranking system for interventions based on efficacy. The reported outcome for network meta-analysis is a probability of being ranked the most effective intervention with 95% credible intervals.”

    Dr. Cabanela spoke with ICJR about the review and the implication of using network meta-analysis. Click the image above to hear his comments.

    Producer and director: Michael Bugera; Post Production: Charles Maynard


    Wyles CC, Jimenez-Almonte JH, Norambuena-Morales GA, Cabanela Me, Sierra RJ, Trousdale RT. Mid-Term Survivorship of Modern Bearing Surface Options for Total Hip Arthroplasty in Young Patients: A Systematic Review and Meta-Analysis (Paper 170). Presented at the Mid-America Orthopaedic Association Annual Meeting, April 22-25, 2015, Hilton Head Island, South Carolina.