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ArticleInternational orthopaedics2024

Concerns with alumina bipolar hemiarthroplasties compared to metal bipolar hemiarthroplasties when performed for nontraumatic osteonecrosis of the femoral head.

Seneki Kobayashi, Nobuhiko Sugano, Wataru Ando, Wakaba Fukushima, Kyoko Kondo, Takashi Sakai

Abstract readMulticenter StudyComparative Study
PubMed Publisher
In one paragraph

Article in International orthopaedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Seneki KobayashiThe Investigation Committee on Osteonecrosis of the Femoral Head under the Ministry of Health, Labour and Welfare of Japan, Tokyo, Japan. seneki@suwa.jrc.or.jp.ORCID 0009-0006-5649-534X
Nobuhiko SuganoThe Investigation Committee on Osteonecrosis of the Femoral Head under the Ministry of Health, Labour and Welfare of Japan, Tokyo, Japan.
Wataru AndoThe Investigation Committee on Osteonecrosis of the Femoral Head under the Ministry of Health, Labour and Welfare of Japan, Tokyo, Japan.
Wakaba FukushimaThe Investigation Committee on Osteonecrosis of the Femoral Head under the Ministry of Health, Labour and Welfare of Japan, Tokyo, Japan.
Kyoko KondoResearch support platform, Osaka Metropolitan University Graduate School of Medicine, Osaka-city, Osaka-prefecture, Japan.
Takashi SakaiThe Investigation Committee on Osteonecrosis of the Femoral Head under the Ministry of Health, Labour and Welfare of Japan, Tokyo, Japan.

Funding

Ministry of Health, Labour and Welfare 23FC0201
6 · The paper itself

Abstract

purposeA nationwide multicenter follow-up cohort study of hip replacement arthroplasties performed for nontraumatic osteonecrosis of the femoral head (ONFH) aimed to answer the following questions: What factors were associated with need for reoperation? Although many modifications were made in bipolar hemiarthroplasties (BPs) to improve their durability, could we find any evidence of their efficacy?

methodsExcluding 58 infected hips and 43 ABS THAs with very poor survivorship, we analyzed 7393 arthroplasties; 6284 total hip arthroplasties (THAs), 886 BPs, 188 total resurfacing arthroplasties, and 35 hemi-resurfacing arthroplasties (hRSs). In the 886 BPs, 440 hips had a smooth small-diameter prosthetic neck (nBPs), 667 hips had a smooth neck (sBPs), 116 hips had highly cross-linked polyethylene in the outer head (hBPs), and 238 hips had an outer head whose outer surface was alumina ceramic (aBPs) (648 hips had an outer head whose outer surface was metal [mBPs]). Multivariate analyses using a Cox proportional-hazard model analyzed risk factors.

resultsFollow-up ranged from 0.1 to 27 (average, 6.9) years, during which 265 hips (3.6%) needed reoperation. Combined systemic steroid use and excessive alcohol consumption and lateral approach were associated with higher risks, aBPs were less durable than THAs or mBPs, and hRSs were inferior to the others. Regarding BPs, the following divisions did not influence their survivorship; nBP or not, sBP or not, and hBP or not.

conclusionsFactors associated with reoperation risk were identified as described above. The modifications made in BPs did not improve their durability, but aBPs made it worse. LEVEL OF CLINICAL EVIDENCE: Level III, therapeutic cohort study.

Indexed as

Arthroplasty, Replacement, HipFemur Head NecrosisHemiarthroplastyHip ProsthesisProsthesis DesignReoperationAdultAgedAluminum OxideCohort StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedProsthesis FailureAluminum OxideBipolar hemiarthroplastyHip arthroplastyOsteonecrosis of the femoral head (ONFH)ResurfacingSurvival rate

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.