Anatomic placement of the acetabular implant in cementless total hip arthroplasty does not adversely affect the implant survival and patient satisfaction |
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Institution: | 1. The Royal Orthopaedic Hospital Birmingham, UK;2. Worcester Royal Hospital, UK;3. Sandwell and West Birmingham Hospital, UK;1. Centura Orthopaedics & Spine, 9949 South Oswego Stree, Suite 200 Parker, CO, 80134, USA;2. Inova Fairfax Medical Campus, 3300 Gallows Road, Falls Church, VA, 22042, USA;3. Indiana University School of Medicine, Department of Orthopaedic Surgery, 1801 North Senate Blvd, MPC 1, Suite 535, Indianapolis, IN, 46202, USA;1. Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India;2. Department of Radiology, All India Institute of Medical Sciences, New Delhi, India;1. Division of Neurosurgery, National University Health System, Singapore;2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore;3. Department of Diagnostic Imaging, National University Health System, Singapore;4. Department of Orthopedic Surgery, National University Health System, Singapore;1. General Hospital of Heraklion “Venizeleio and Pananio”, Leoforos Knossou 44, 71409, Heraklion Crete, Greece;2. Creta Interclinic Hospital, Leoforos Minoos 63, 71304, Greece |
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Abstract: | ObjectiveThis study aimed to evaluate if the acetabulum's conservative reaming with preservation of the medial acetabular bone and anatomic placement of the acetabular implant in cementless total hip arthroplasty (THA) has any adverse effect on the radiological outcome, long term implant survival and patient satisfaction.Methods106 consecutive patients were identified from a single surgeon practice who underwent cementless THA from 2005 to 2010. Twenty-one were lost to follow up, and five patients died unrelated to THA. Eighty patients were available for the study. The mean follow-up was 8.6 years (range 5.7–11.6). The mean age was 61.9 years. Immediate pre- and postoperative radiographs were reviewed to calculate combined offset (Acetabular offset – AO, plus Femoral offset – FO). Implant failure, aseptic loosening, revision surgery, patient satisfaction and complications were assessed on long-term follow-up.ResultsAcetabular component survival was 100% with no aseptic failure. None of the patients had revision surgery for any cause. The mean difference in the acetabular offset and combined offset postoperatively was within 3 mm. One patient had a dislocation, and one had a prosthetic joint infection (PJI). 95% of the patients in this series would recommend the hip replacement procedure to others, with a mean satisfaction score of 8.7 (range; 1–10).ConclusionConservative acetabular reaming with preservation of medial acetabulum bone with the anatomic placement of the acetabular implant in cementless THA is safe with no adverse effects on implant survival and patient satisfaction. It offers the advantage of preserving the patient's bone stock, which would potentially be of significant advantage to the patient and the surgeon in case of revision arthroplasty. |
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Keywords: | Total hip arthroplasty (THA) Acetabular offset Femoral offset |
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