Clinical Results of the Pinnacle Acetabular System: Data from the UK Joint Replacement Registry
The Pinnacle Acetabular System has been available on the market for nearly two decades. Since then, it has been implanted in numerous healthcare facilities worldwide. Clinical outcomes of the acetabular system were evaluated by analyzing data from the National Joint Replacement Registry of England, Wales, Northern Ireland, and the Isle of Man.
Introduction
The Pinnacle Acetabular System was launched in 2000 in the United States and subsequently in 2003 on the international market (1). Since then, it has become one of the most widely used and most successful modular acetabular systems (2, 3); it has been implanted in more than 2 million patients worldwide (4). The Pinnacle system allows for the implantation of all currently used contact types, including metal−polyethylene, ceramic−polyethylene, and ceramic−ceramic (1).
National joint replacement registries provide valuable information on survival rates and the number of revision surgeries, which can be used to assess the clinical success of total hip replacement systems. The Pinnacle system was evaluated in the National Joint Replacement Registry of England, Wales, Northern Ireland, and the Isle of Man (1).
Data from the UK Joint Replacement Registry
As part of the clinical outcome assessment of the Pinnacle system, a Kaplan-Meier analysis was conducted on a large set of 77,009 primary hip replacement implantations (1). The goal was to evaluate the number of revision surgeries for metal−polyethylene and ceramic−polyethylene implants in combination with all cemented and cementless stems from the same manufacturer (2).
The cumulative revision rate was 3.02% after 10 years (95% confidence interval [CI] 2.70–3.39; n = 1717) and 3.35% after 12 years (95% CI 2.81–3.99; n = 107). For the ceramic−polyethylene system (n = 23313), the 10-year cumulative revision rate was 2.81% (95% CI 2.20–3.58; n = 215). For the metal−polyethylene system (n = 53,696), the 10-year cumulative revision rate was 3.07% (95% CI 2.71–3.48; n = 1502). A higher revision rate was observed in patients suffering from obesity and in surgeons with initial experience in implanting this system (2).
Conclusion
The results of the National Joint Replacement Registry of England, Wales, Northern Ireland, and the Isle of Man indicate that the implantation of the Pinnacle acetabular system is associated with high durability and a low revision rate over medium-term follow-up (10 and 12 years).
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CZ-2020-04-83
Sources:
1. Hanes M. D., Voorhorst P. E. Clinical Results of the PINNACLE® Acetabular Cup System Polyethylene Bearings in National Joint Replacement Registries. Available at: www.corailpinnacle.net/sites/default/files/DSUSJRC10140529_Poly Survivorship WP.pdf
2. National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. NJR Data from 1st April 2003 – 10th Sep 2016 on DePuy products supplied for post-marketing surveillance. NJR Centre, 2016.
3. Australian Orthopaedic Association National Joint Replacement Registry. Annual Report. HT14 from 2016 AOA NJR. AOA, Adelaide, 2016. Available at: https://aoanjrr.sahmri.com/annual-reports-201
4. Sales Data. 2000-2015 Pinnacle Unit Sales-Worldwide. DePuy Orthopaedics, Inc., Warsaw.
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