February 19, 2013
Hip implants in women have a 29 percent higher failure rate than in men, Medpage Today reported. Researchers at the Permanente Research Group in San Diego published the study in the February 2013 issue of JAMA Internal Medicine.
In the study, funded by the Food and Drug Administration (FDA), researchers gathered data over an average of three years from 35,140 patients who had a primary total hip replacement. Scientists found that the failure rate for women was 2.3 percent, compared with 1.9 percent for men, and there was a higher risk of aseptic failure than septic failure – failure that results from an infection.
According to researchers, one of the contributing factors for the higher failure rate may be the large size of most hip implants. Women had more trouble with femoral head sizes of 36mm or more, compared with men. Metal-on-metal implants also failed more often in women, and the risk of failure in women was double the risk for men. Higher device failures also mean higher rates of revision surgery.
Some critics of the study suggest that the findings are trivial, while others found the data helpful.
Doctors Weigh in On Study Results
Diana Zuckerman, PhD, of the National Research Center for Women and Families in Washington, told MedPage Today that women have few other options if they are already suffering from pain and limited mobility. What is needed, said Zuckerman, is “long-term comparative effectiveness research based on large sample sizes, indicating which total hip arthroplasty devices are less likely to fail in women and in men, with subgroup analyses based on age and other key patient traits, as well as key surgeon and hospital factors.”
Others like Dr. Glenn Don Wera of UH Medical Center in Cleveland say the study provides valuable data that helps doctors understand more about why hip implants fail in women. Factors like women’s smaller stature may figure into the results.
Aside from risk factor such as gender, studies were done on the risk of failure with certain types of implants. Overall, Johnson and Johnson’s DePuy ASR had the highest rate of failure of all implants in both men and women.