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The purpose of this study was to describe actual usage patterns for metal-on-metal (MOM) bearings in the United States using a nationally representative database. The 2005–2009 nationwide inpatient sample (NIS), in combination with the 2009–2010 state inpatient databases (SIDs), was employed to identify primary total hip arthroplasty (THA), revision THA, and resurfacing hip arthroplasty (RHA) patients implanted with a MOM bearing using ICD-9-CM codes. The MOM patient population was characterized by gender, age, race, U.S. Census region, hospital characteristics, and insurance coverage. The prevalence of MOM bearing usage was estimated between 2000 and 2010. Between 2005 and 2010, MOM bearing usage in the United States ranged between from 32 % and 40 % of primary THAs and from 26 % and 32 % of revision THAs. Utilization of MOM bearing types in primary/revision THA and RHA peaked in 2008. By 2010, 755 000 patients were estimated to be implanted with MOM bearings in the United States between 2000 and 2010, we estimated that 83.7 % of MOM bearings in the United States were implanted during primary THA procedures, 11.7 % during revision THA, and the remaining 4.6 % during RHA. Our research demonstrates that the prevalence of MOM increased substantially up to a high water mark in 2008. Despite uncertain indications for use, MOM bearings were used extensively in female and elderly patients.
metal-on-metal, THA, hip resurfacing, RHA, primary, revision, MOM, epidemiology, incidence, prevalence, propensity
Kurtz, Steven M.
Corporate Vice President and Principal, Exponent, Inc., Philadelphia, PA
Ong, Kevin L.
Senior Managing Engineer, Exponent, Inc., Philadelphia, PA
Senior Managing Scientist, Exponent, Inc., Menlo Park, CA
Greenwald, A. Seth
Director, Orthopedic Research Laboratories, Cleveland, OH
Associate Professor and Vice Chair, Dept. of Orthpaedic Surgery, Phillip R. Lee Institute for Health Policy Studies, Univ. of California, San Francisco, San Francisco, CA