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The MITCH TRH System is a metal-on-metal hip replacement system consisting of components that can be used in different combinations to carry out either hip resurfacing arthroplasty or total hip replacement. The system was manufactured by Finsbury Orthopaedics and was distributed in the UK by Stryker Orthopaedics between May 2006 and October 2011.*

Analysis of data from the England and Wales National Joint Registry (NJR) up to 10 March 2012 has shown that the cumulative revision rate for MITCH TRH System used in hip resurfacing arthroplasty (revision rate of 3.1 % at 4 years based on 769 patients recorded by the NJR) is in line with relevant guidance from the National Institute for Health and Clinical Excellence (NICE) guidance,1,2 but that the cumulative revision rate for MITCH TRH System total hip replacements (revision rate of 8.8% at 4 years based on 445 patients recorded by the NJR) is higher than indicated as acceptable by NICE. MITCH TRH total hip replacements consist of MITCH TRH acetabular cups used with MITCH TRH modular femoral heads and also an appropriate Stryker femoral stem with a V40 taper including Exeter V40 or uncemented Accolade or ABG II.

Further analysis of NJR data by DePuy has now determined that the cumulative revision rate of MITCH TRH System total hip replacements varies considerably depending upon which femoral stem is used:

  • MITCH TRH with Exeter V40 – revision rate of 3.7% at 4 years based on 120 patients recorded by the NJR
  • MITCH TRH with uncemented Accolade – revision rate of 10.7% at 4 years based on 271 patients recorded by the NJR
  • MITCH TRH with ABG II – rate of usage too low to estimate revision rate

*Note: DePuy International acquired Finsbury Orthopaedics in 2009 and they are now responsible for the safety and monitoring of the MITCH TRH hip system.

References:
1. Guidance on the selection of prostheses for primary total hip replacement. National Institute for Health and Clinical Excellence (NICE), 2000. Technology appraisal guidance No. 2
2. Guidance on the use of metal on metal hip resurfacing arthroplasty. National Institute for Health and
Clinical Excellence (NICE), 2002. Technology Appraisal Guidance No. 44.

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