Association between cemented and uncemented cups and risk of revision in patients aged 65 years or older following primary total hip arthroplasty: a study of 310,515 patients from the Nordic Arthroplasty Register Association.
9 affiliations
- 1Department of Orthopedic Surgery, Aalborg University Hospital, Denmark. [email protected].
- 2Department of Orthopedic Surgery, Lillebaelt Hospital - Vejle, Denmark; Department of Regional Health Research, University of Southern Denmark, Denmark.
- 3Department of Orthopedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Orthopedics, Skåne University Hospital, Hässleholm, Sweden and Department of Clinical Sciences - Orthopedics, Lund University, Lund, Sweden; Unit of Orthopedics, Department of Clinical Sciences, Malmö, Lund University, Sweden.
- 4Unit of Orthopedics, Department of Clinical Sciences, Malmö, Lund University, Sweden.
- 5The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway.
- 6The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Norway.
- 7Coxa Hospital for Joint Replacement, and Faculty of Medicine and Health Technologies, University of Tampere, Tampere, Finland.
- 8Turku University Hospital and University of Turku, Finland, and the Finnish Arthroplasty Register, Finland.
- 9Copenhagen University Hospital Bispebjerg, Department of Orthopedic Surgery and Traumatology and Department of Clinical Medicine, University of Copenhagen, Denmark.
Abstract
Background and purpose
Cemented stem fixation in total hip arthroplasty (THA) reduces early femoral fracture risk in elderly patients, but the optimal method of cup fixation remains controversial. We aimed to compare cup revision risk between cemented and uncemented acetabular cups in patients aged 65 years or older undergoing primary THA.Methods
This registry-based cohort study used data from the Nordic Arthroplasty Register Association (NARA). We included patients aged 65 years or older who underwent primary THA for primary osteoarthritis or sequelae of childhood hip disorders between 1995 and 2018. The primary outcome was all-cause cup revision, with prespecified analyses stratified by age and sex. Cox regression adjusted for age, sex, femoral head size, time period, and nation was used. Follow-up was divided into 3 periods: 0-1, 1-6, and 6-26 years.Results
Among 310,515 patients, cemented cups were associated with a lower risk of all-cause cup revision during the first year (adjusted hazard ratio [aHR] 0.47, 95% confidence interval [CI] 0.41-0.53) and a higher risk at 6-26 years (aHR 1.91, CI 1.72-2.13). In patients aged 80 years or older, the sex-specific adjusted hazard ratios after the first year were close to 1, with wide confidence intervals.Conclusion
Cemented cups were associated with a lower risk of cup revision during the first year across all age groups and a higher risk at 6-26 years in the overall cohort. Among patients aged 80 years or older, we found no evidence of an association between fixation method and cup revision after the first year.
Related
- Prognosis of 1st time revision due to pain following primary total hip arthroplasty - a nationwide cohort study from the Danish Hip Arthroplasty Register
- Comparison of Mortality and Revision Rates between Cemented and Cementless Fixation in Bipolar Hemiarthroplasty: A Nationwide Cohort Study
- Association between prior corrective spinal alignment surgery and post-operative range of motion following reverse total shoulder arthroplasty
- Comparing Short-Term Clinical Outcomes and Survivorship of Complex Revision Total Hip Arthroplasty: Custom Triflange Acetabular Implants Vs Standard Cage Reconstruction
- Early Revision Rates and Clinical Outcomes of Two Cementless Cruciate-Retaining Total Knee Arthroplasty Designs at Two-Year Follow-Up: A Propensity Score-Adjusted Comparative Analysis
BibTeX
@article{latifi2026association,
title = {{Association between cemented and uncemented cups and risk of revision in patients aged 65 years or older following primary total hip arthroplasty: a study of 310,515 patients from the Nordic Arthroplasty Register Association.}},
author = {Roshan Latifi and Simon Kornvig and Maziar Mohaddes and Muhanned Ali and Torbjørn Berge Kristensen and Geir Hallan and Antti Eskelinen and Keijo Mäkelä and Claus Varnum and Søren Overgaard},
journal = {Acta orthopaedica},
year = {2026},
month = oct,
doi = {10.2340/17453674.2026.46937},
url = {https://europepmc.org/article/MED/42948963},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association between cemented and uncemented cups and risk of revision in patients aged 65 years or older following primary total hip arthroplasty: a study of 310,515 patients from the Nordic Arthroplasty Register Association.
AU - Roshan Latifi
AU - Simon Kornvig
AU - Maziar Mohaddes
AU - Muhanned Ali
AU - Torbjørn Berge Kristensen
AU - Geir Hallan
AU - Antti Eskelinen
AU - Keijo Mäkelä
AU - Claus Varnum
AU - Søren Overgaard
PY - 2026
DA - 2026/10/28
JO - Acta orthopaedica
DO - 10.2340/17453674.2026.46937
UR - https://europepmc.org/article/MED/42948963
AB - Background and purpose Cemented stem fixation in total hip arthroplasty (THA) reduces early femoral fracture risk in elderly patients, but the optimal method of cup fixation remains controversial. We aimed to compare cup revision risk between cemented and uncemented acetabular cups in patients aged 65 years or older undergoing primary THA.Methods This registry-based cohort study used data from the Nordic Arthroplasty Register Association (NARA). We included patients aged 65 years or older who underwent primary THA for primary osteoarthritis or sequelae of childhood hip disorders between 1995 and 2018. The primary outcome was all-cause cup revision, with prespecified analyses stratified by age and sex. Cox regression adjusted for age, sex, femoral head size, time period, and nation was used. Follow-up was divided into 3 periods: 0-1, 1-6, and 6-26 years.Results Among 310,515 patients, cemented cups were associated with a lower risk of all-cause cup revision during the first year (adjusted hazard ratio [aHR] 0.47, 95% confidence interval [CI] 0.41-0.53) and a higher risk at 6-26 years (aHR 1.91, CI 1.72-2.13). In patients aged 80 years or older, the sex-specific adjusted hazard ratios after the first year were close to 1, with wide confidence intervals.Conclusion Cemented cups were associated with a lower risk of cup revision during the first year across all age groups and a higher risk at 6-26 years in the overall cohort. Among patients aged 80 years or older, we found no evidence of an association between fixation method and cup revision after the first year.
SN - 1745-3674
SN - 1745-3682
ER -