Hviding K, Aamodt A, Nordsletten L, Havelin LI, Indrekvam K; Health Technology Assessment International. Meeting (1st : 2004 : Krakow, Poland).
Proc One HTA Health Technol Assess Int Meet 1st 2004 Krakow Pol. 2004; 1: 14.
The Norwegian Centre for Health Technology Assessment, Oslo, Norway.
OBJECTIVE: To review available evidence on the comparative effectiveness of different prosthesis types used in Norway in 2000 in primary total hip replacement for adults. METHODS: A systematic literature review was undertaken. The reviewers could build upon results from two NHS HTA 1998 reports covering all prostheses used from 1980 - 1995. Additional searches were conducted in Medline, Embase, Cochrane, 1996-2000, using a similar search strategy. A total of 129 new articles were included (72 % observational studies, 9% RCT). RESULTS: Approximately 1/3 of the implants marketed in Norway in 2000 lacked peer-reviewed documentation. Cemented designs in general showed good survival results at about 10 years plus. Models with good published, comparable results (at 10 years or more) include the Charnley, Lubinus, Exeter, ITH, Spectron, Titan prostheses. Only the Charnley prostheses had documented better then 90 % implant survival at 10 years or more. Some uncemented stems showed promising medium-term outcome but no combinations of uncemented cups and stems could document 90 % implant survival at 10 years. DISCUSSION: The basic criteria in the selection of an implant should be the available survival data and cost. Documented 90 % implant survival at 10 years has been proposed as a minimum requirement in the selection of prostheses for routine use in primary THR. New models or prosthetic design should be introduced as a part of a clinical study. The arthroplasty registers allowed for early identification of malfunctioning implants and new trends. Improvements are needed in the design and reporting of research studies regarding inclusion of patients-derived quality of life measures.
Publication Types:
Keywords:
- Adult
- Arthroplasty
- Arthroplasty, Replacement, Hip
- Bone Cements
- Cementation
- Documentation
- Hip Prosthesis
- Humans
- Norway
- methods
- organization & administration
- surgery
- utilization
- hsrmtgs
UI: 103140645
From Meeting Abstracts