Un estudio publicado en JAMA Internal Medicine (doi:10.1001/jamainternmed.2013.3271.) sugiere que las mujeres tienen mayor riesgo de sufrir fallos en un implante de cadera respecto a los hombres.

La artroplastia total de cadera (ATC) afecta más a mujeres que a hombres. Maria C.S. Inacio, del Southern California Permanente Medical Group  de San Diego (Estados Unidos),  y sus colegas estudiaron la asociación entre el género y el riesgo a corto plazo de una revisión de artroplastia total de cadera. Se analizaron un total de 35 140 ATC con un seguimiento de tres años y medio en el que el el 57,5 % de los pacientes eran mujeres con 66 años de edad aproximadamente.

«De nuestros análisis de una cohorte extensa de ATC, incluyendo diversos casos de 46 hospitales con una media de tres años de seguimiento, se concluye que las mujeres tienen un riesgo más alto de padecer todas las causas de revisión y la revisión aséptica, pero no la revisión séptica.

Según estos científicos «el papel del género en una relación tras el fracaso del implante después de la artroplastia total de cadera es importante para el manejo del paciente y para la innovación del dispositivo.»
febrero 18/2013 (Diario Médico)

Maria C. S. Inacio, Christopher F. Ake, Elizabeth W. Paxton, Monti Khatod, Cunlin Wang, Thomas P. Gross.Sex and Risk of Hip Implant Failure: Assessing Total Hip Arthroplasty Outcomes in the United States.JAMA Intern Med. 2013;():1-7. Feb 18, 2013

Resumen

Importance  The role of sex in relationship to implant failure after total hip arthroplasty (THA) is important for patient management and device innovation.

Objective  To evaluate the association of sex with short-term risk of THA revision after adjusting for patient, implant, surgery, surgeon, and hospital confounders.

Design and Setting  A prospective cohort of patients enrolled in a total joint replacement registry from April 1, 2001, through December 31, 2010.

Participants  Patients undergoing primary, elective, unilateral THA.

Main Outcome Measures  Failure of THA, defined as revision procedure for (1) any reason, (2) septic reason, or (3) aseptic reason after the index procedure.

Results  A total of 35 140 THAs with 3.0 years of median follow-up were identified. Women constituted 57.5% of the study sample, and the mean (SD) patient age was 65.7 (11.6) years. A higher proportion of women received 28-mm femoral heads (28.2% vs 13.1%) and had metal on highly cross-linked polyethylene-bearing surfaces (60.6% vs 53.7%) than men. Men had a higher proportion of 36-mm or larger heads (55.4% vs 32.8%) and metal on metal-bearing surfaces (19.4% vs 9.6%). At 5-year follow-up, implant survival was 97.4% (95% CI, 97.2%-97.6%). Device survival for men (97.7%; 95% CI, 97.4%-98.0%) vs women (97.1%; 95% CI, 96.8%-97.4%) was significantly different (P = .01). After adjustments, the hazards ratios for women were 1.29 (95% CI, 1.11-1.51) for all-cause revision, 1.32 (95% CI, 1.10-1.58) for aseptic revision, and 1.17 (95% CI, 0.81-1.68) for septic revision.

Conclusions  After considering patient-, surgery-, surgeon-, volume-, and implant-specific risk factors, women had a 29% higher risk of implant failure than men after THA in this community-based sample.

Comments

Comments are closed.

Name

Email

Web

Speak your mind

Código CAPTCHA*