OBJECTIVES: Total hip replacement (THR) procedures are generally successful. The medial collared, triple tapered (MCTT) ACTIS primary hip stem was shown in early research to be associated with lower revision rates following THR compared to other implants. This study evaluates 2-year survivorship of matched cohorts of patients treated with MCTT vs comparators.

METHODS: Patients with THR from 2016 to most recent (12/2020) within the Mercy Healthcare Systems database were identified and categorized based on implant (MCTT (brand: ACTIS®) vs other (non-MCTT)). The primary outcome was 2-year revision. Secondary outcomes included operating room time (ORT), length of hospital stay (LOS) and discharge disposition. Variables were patient demographics and comorbidities (Elixhauser Index (EI), and each individual disease domain included in the EI), surgery and provider characteristics and implant used. Patients with MCTT vs non-MCTT were matched using propensity scores on surgery year, patient age, gender and comorbidities (R package: MatchIT, nearest neighbor method, glm distance). Kaplan-Meier survival analyses and Cox models were developed. Chi-square significance tests were performed for all other outcomes.

RESULTS: 2,298 matched patients (1,149 MCTT vs 1,149 control; In each group: 54% female, mean age: 66.0 years (standard deviation (SD): 10.9), mean EI: 2.6 (SD: 1.8), 43% obese) were included in the analysis. Two-year revision rates for MCTT and non-MTCC were 1.39% (95%CI: 0.51%-2.26%) and 1.81% (95%CI: 0.95%-2.66%), respectively. (Hazard ratio: 0.67 (0.31-1.42)). ORT decreased from 127.65 min (SD: 32.07) with non-MTCC to 112.30 min (SD: 22.41) with MTCC. LOS decreased from 2.17 days (SD: 1.32) with non-MTCC to 1.96 days (SD: 1.02) with MTCC; 87.2% non-MTCC vs 93.2% MTCC patients were discharged to home or home health. (For all secondary outcomes, p < 0.001).