DOS 2018

264 · DOS Abstracts Lack of evidence for the implementation of New well-documented implants to experienced surgeons A systematic review on total hip arthroplasty Patrick Nyborg Butler, Josef Gorgis, Søren Overgaard, Bjarke Viberg Syddansk Universitet SDU, Syddansk Universitet SDU; Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark; Department of Orthopaedic Surgery and Traumatology, Kolding Hospital – part of Hospital , Department of Clinical Research, University of Southern Denmark Background: When introducing new implants, surgeons undergo steep learn- ing curves, leading to increased revision frequency. Stepwise introduction (SI) revolutionized introductions of new implants, but lacked a last step. No guide- lines exist for introductions of new well- documented implants not previously used in a department. This is a problem according to the EU legislated tendering process, potentially leading to disasters such as metal-on-metal cases in total hip arthroplasty (THA). In this systematic review, the introduction of new, well- documented THA implants to experienced surgeons are investigated concerning higher revision frequency. Purpose / Aim of Study: Are the introductions of new, well-documented im- plants to experienced surgeons associated with higher revision frequency for patients with OA undergoing primary THA? Materials and Methods: A systematic literature search was conducted in Embase & Medline. Covidence software was then used by two reviewers to screen title/abstract and subsequently full text for inclusion. Findings / Results: No articles were found fulfilling our eligibility criteria. A post hoc analysis retrieved two national register- based studies only missing information of the surgeon’s knowledge of the introduced implant. None of the introduced implants decreased revision frequency and around 30% of the intro- duced implants were associated with a higher revision frequency. Conclusions: The current management of learning curve, in relation to these introductions, need guidelines to minimize revision frequency. An expansion of (SI) with a fourth clinical step might decrease revision frequency. This would be possible by avoiding the continuation use of worse performing implants than the ones already used. Finally, EU Legislation concerning introductions would need to move more towards the regulations of the pharmacological regime. 205.