• Alexander Buckenham Boyle, Mark Zhu, Chris Frampton, Andrew Vane, and Vaughan Poutawera.
• Department of Orthopaedic Surgery, Tauranga Hospital, Private Bag 12024, Tauranga, 3143, New Zealand. alexander.boyle@bopdhb.govt.nz.
• Arch Orthop Trauma Surg. 2022 Sep 1; 142 (9): 2371-2380.

BackgroundDespite increasing use of uncemented implants in young patients undergoing total hip arthroplasty (THA), there is minimal evidence for specific implant combinations in this group. We analysed the most commonly used uncemented (Corail-Pinnacle), hybrid (Exeter-Trident/Tritanium), and fully cemented (Exeter) implant combinations in the New Zealand Joint Registry (NZJR) in patients aged under 40 and between 40 and 55 years.MethodsAll THAs recorded in the NZJR between 1999 and 2018 were included. The 40-55 and < 40 age groups were analysed separately. Demographic data, implant type, and outcome data including implant survival, reason for revision, and post-operative Oxford Hip Scores were obtained from the NZJR, and detailed survival analyses were performed. The primary outcome was revision for any reason.ResultsWe identified 4152 THAs in the 40-55 group and 422 in the < 40 group. In the 40-55 group, revision rates and patient-reported outcome measure scores were comparable between the uncemented implant combination (0.70/100 component years) and the hybrid implant combination (0.62/100 component years), whereas the cemented implant combination exhibited a statistically significant higher revision rate (1.75/100 component years) (p < 0.001). In the < 40 group, revision rate for the hybrid implant combination (0.46/100 component years) was significantly lower than the uncemented implant combination (1.54/100 component years).ConclusionThe most commonly used hybrid and uncemented implant combinations provided equivalent survival and functional outcomes in patients aged 40-55 years. More research is required to guide implant selection in patients aged < 40 years. The authors suggest a transition away from comparing classes of implants (cemented, uncemented, hybrid) given the diverse product range within these categories.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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