Solid Cup vs Cluster Hole in Total Hip Arthroplasty: A 10-Year Randomized Control Trial |
| |
Authors: | Rory A Gallen Riaz JK Khan Samantha J Haebich Sharon H Karamfiles Humza Khan |
| |
Institution: | 1. University College Dublin, Dublin, Ireland;2. Department of Orthopaedics, Hollywood Private Hospital, Nedlands, Western Australia, Australia;3. The Joint Studio, Hollywood Medical Centre, Nedlands, Western Australia, Australia;4. University of Notre Dame, Fremantle, Western Australia, Australia;5. Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia;6. Perth Radiological Clinic, Mirrabooka, Western Australia, Australia |
| |
Abstract: | BackgroundAcetabular osteolysis is a major complication of total hip arthroplasty. It is caused in part by wear debris. It has been suggested that this debris can migrate through screw holes in the acetabular component. Solid-backed components have been used to prevent this migration and reduce osteolysis. Newer materials, however, have reduced wear debris. This study aimed to evaluate whether using solid-backed instead of cluster-hole components actually reduces osteolysis. This could open up the possibility of screws being used for greater stability where required.MethodsThis prospective trial randomized 100 patients undergoing cementless total hip arthroplasty to receive either cluster-hole or solid-backed acetabular components. A cementless cup and highly cross-linked polyethylene was used in all patients. Computed tomography, performed at 5 and 10 years after surgery, was assessed by a blinded radiologist for the presence of osteolysis.ResultsOf the 100 patients, 14 required screws for stability, and so were moved into a third “screw” group for per-protocol analysis. At 10 years after surgery, osteolytic lesions were discovered in 18.2% of patients. There was no difference in incidence or volume of osteolysis between patients with cluster-hole acetabular components and those with solid-backed components.ConclusionThis study reveals a low number of patients with osteolytic lesions 10 years after total hip arthroplasty performed with a modern cup design and highly cross-linked polyethylene liner. There was no clear benefit to using solid-backed acetabular components. Cluster-hole components, however, offer the option of screw augmentation when required. |
| |
Keywords: | hip arthroplasty cup solid cluster osteolysis |
本文献已被 ScienceDirect 等数据库收录! |
|