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Background

Total hip arthroplasty (THA) can be performed using either femoral and acetabular components provided by the same manufacturer (matched components) or components from different manufacturers (unmatched components). We hypothesized that there would be no difference in outcomes following the use of unmatched compared to matched components.

Methods

Data from a nationwide joint registry, the New Zealand Joint Registry (NZJR), were analyzed to assess long-term outcomes of using unmatched implants in THA.

Results

The NZJR has recorded a total of 108,613 primary THAs. We excluded combinations with less than 50 implantations, leaving 99,732 arthroplasties (90.5%). The unmatched group consisted of 24,537 (24.6%) THAs. Revision procedures were required in 3434 (4.6%) of the matched group, at a rate of 0.72/100 component years and 1078 (4.4%) of the unmatched group, a rate of 0.69/100 component years (P = .049). THAs with metal-on-metal or ceramic-on-metal bearings were overrepresented in the matched group. When analysis was repeated with these implants excluded, there was no longer a difference in revision rate between groups (4.0% revisions, 0.65/100 component years and 4.3% revisions, 0.67/100 component years [P = .742]).Survival analysis showed 17-year survival for matched components and unmatched to be within 95% confidence intervals at all time points.There was a small, statistically significant improvement in Oxford Hip Scores for the unmatched group compared with the matched group.

Conclusion

Data from the NZJR confirm that the use of unmatched components in THA has no adverse effect on outcomes.  相似文献   
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Singh  Simron  Dey  Chris  Kennecke  Hagen  Kocha  Walter  Maroun  Jean  Metrakos  Peter  Mukhtar  Tariq  Pasieka  Janice  Rayson  Daniel  Rowsell  Corwyn  Sideris  Lucas  Wong  Ralph  Law  Calvin 《Annals of surgical oncology》2015,22(8):2685-2699
Annals of Surgical Oncology - Pancreatic neuroendocrine tumors (pNETs) are rare heterogeneous tumors that have been steadily increasing in both incidence and prevalence during the past few decades....  相似文献   
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Pregnancy, birth and adjusting to a new baby is a potentially stressful time that can negatively affect the health of women. There is some evidence that expressive writing can have positive effects on psychological and physical health, particularly during stressful periods. The current study aimed to evaluate whether expressive writing would improve women’s postpartum health. A randomized controlled trial was conducted with three conditions: expressive writing (n?=?188), a control writing task (n?=?213), or normal care (n?=?163). Measures of psychological health, physical health and quality of life were measured at baseline (6–12 weeks postpartum), 1 and 6 months later. Ratings of stress were taken before and after the expressive writing task. Intent-to-treat analyses showed no significant differences between women in the expressive writing, control writing and normal care groups on measures of physical health, anxiety, depression, mood or quality of life at 1 and 6 months. Uptake and adherence to the writing tasks was low. However, women in the expressive writing group rated their stress as significantly reduced after completing the task. Cost analysis suggest women who did expressive writing had the lowest costs in terms of healthcare service use and lowest cost per unit of improvement in quality of life. Results suggest expressive writing is not effective as a universal intervention for all women 6–12 weeks postpartum. Future research should examine expressive writing as a targeted intervention for women in high-risk groups, such as those with mild or moderate depression, and further examine cost-effectiveness.Clinical trial registration number ISRCTN58399513 www.isrctn.com  相似文献   
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