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Erschienen in: Clinical Orthopaedics and Related Research® 11/2012

01.11.2012 | Symposium: Papers Presented at the 2011 Meeting of the International Hip Society

Cup Press Fit in Uncemented THA Depends on Sex, Acetabular Shape, and Surgical Technique

verfasst von: Eduardo García-Rey, MD, PhD, Eduardo García-Cimbrelo, MD, PhD, Ana Cruz-Pardos, MD, PhD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 11/2012

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Abstract

Background

Uncemented press-fit cups provide bone fixation in primary THA, but the use of screws is sometimes necessary to achieve primary stability of the socket. However, it is unclear whether and when screws should be used.

Question/Purposes

We analyzed the factors related to screw use with a press-fit uncemented cup and assessed whether screw use is associated with the same rates of loosening and revision as a press-fit technique.

Methods

We retrospectively reviewed 248 patients who underwent THA using the same prosthetic design. Eighty-eight hips had screws to achieve primary cup fixation (Group 1), and 189 did not (Group 2). Mean age was 50 years (range, 14–73 years). We analyzed factors related to the patient, acetabular type, and reconstruction of the rotation center of the hip. Minimum followup was 5 years (mean, 8.9 years; range, 5–12 years).

Results

We found higher screw use in women, patients with less physical activity, Acetabular Types A or C, and a distance from the center of the prosthetic femoral head to the normal center of rotation of more than 3 mm. There were four revisions in Group 1 and five in Group 2. Eight hips had radiographic loosening in Group 1 and nine in Group 2. Cups with a postoperative abduction angle of more than 50° had a higher risk for loosening.

Conclusions

Press fit was achieved less frequently in women and patients with Acetabular Types A or C and less physical activity; a closer distance to the normal center of rotation decreased screw use. Screw use to augment fixation achieved survival similar to that of a press-fit cup.

Level of Evidence

Level II, prognostic study. See Instructions for Authors for a complete description of levels of evidence
Literatur
1.
Zurück zum Zitat Barrack RL. Neurovascular injury: avoiding catastrophe. J Arthroplasty. 2004;19(suppl 1):104–107.PubMedCrossRef Barrack RL. Neurovascular injury: avoiding catastrophe. J Arthroplasty. 2004;19(suppl 1):104–107.PubMedCrossRef
2.
Zurück zum Zitat Bizot P, Nizard R, Hamadouche M, Hannouche D, Sedel L. Prevention of wear and osteolysis: alumina-on-alumina bearing. Clin Orthop Relat Res. 2001;393:85–93.PubMedCrossRef Bizot P, Nizard R, Hamadouche M, Hannouche D, Sedel L. Prevention of wear and osteolysis: alumina-on-alumina bearing. Clin Orthop Relat Res. 2001;393:85–93.PubMedCrossRef
3.
Zurück zum Zitat Clohisy JC, Harris WH. The Harris-Galante porous-coated acetabular component with screw fixation: an average ten-year follow-up study. J Bone Joint Surg Am. 1999;81:66–73.PubMed Clohisy JC, Harris WH. The Harris-Galante porous-coated acetabular component with screw fixation: an average ten-year follow-up study. J Bone Joint Surg Am. 1999;81:66–73.PubMed
4.
Zurück zum Zitat DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976;121:20–32.PubMed DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976;121:20–32.PubMed
5.
Zurück zum Zitat Devane PA, Home JG, Martin K, Coldham G, Krause B. Three-dimensional polyethylene wear of a press-fit titanium prosthesis: factors influencing generation of polyethylene debris. J Arthroplasty. 1997;12:256–266.PubMedCrossRef Devane PA, Home JG, Martin K, Coldham G, Krause B. Three-dimensional polyethylene wear of a press-fit titanium prosthesis: factors influencing generation of polyethylene debris. J Arthroplasty. 1997;12:256–266.PubMedCrossRef
6.
Zurück zum Zitat Dorr LD, Bechtol CO, Watkins RG, Wan Z. Radiographic anatomic structure of the arthritic acetabulum and its influence on total hip arthroplasty. J Arthroplasty. 2000;15:890–900.PubMedCrossRef Dorr LD, Bechtol CO, Watkins RG, Wan Z. Radiographic anatomic structure of the arthritic acetabulum and its influence on total hip arthroplasty. J Arthroplasty. 2000;15:890–900.PubMedCrossRef
7.
Zurück zum Zitat Dorr LD, Faugere MC, Mackel AM, Gruen TA, Bognar B, Malluche HH. Structural and cellular assessment of bone quality of proximal femur. Bone. 1993;14:231–242PubMedCrossRef Dorr LD, Faugere MC, Mackel AM, Gruen TA, Bognar B, Malluche HH. Structural and cellular assessment of bone quality of proximal femur. Bone. 1993;14:231–242PubMedCrossRef
8.
Zurück zum Zitat Dorr LD, Wan Z, Cohen J. Hemispheric titanium porous coated acetabular component without screw fixation. Clin Orthop Relat Res. 1998;351:158–168.PubMedCrossRef Dorr LD, Wan Z, Cohen J. Hemispheric titanium porous coated acetabular component without screw fixation. Clin Orthop Relat Res. 1998;351:158–168.PubMedCrossRef
9.
Zurück zum Zitat Engh CA, Hopper RH Jr, Engh CA Jr. Long-term porous-coated cup survivorship using spikes, screws, and press-fitting for initial fixation. J Arthroplasty. 2004;19(suppl 2):54–60.PubMedCrossRef Engh CA, Hopper RH Jr, Engh CA Jr. Long-term porous-coated cup survivorship using spikes, screws, and press-fitting for initial fixation. J Arthroplasty. 2004;19(suppl 2):54–60.PubMedCrossRef
10.
Zurück zum Zitat García-Cimbrelo E, Cruz-Pardos A, Cordero J, Sanchez-Sotelo J. Low-friction arthroplasty in patients younger than 40 years old: 20- to 25-year results. J Arthroplasty. 2000;15:825–832.PubMedCrossRef García-Cimbrelo E, Cruz-Pardos A, Cordero J, Sanchez-Sotelo J. Low-friction arthroplasty in patients younger than 40 years old: 20- to 25-year results. J Arthroplasty. 2000;15:825–832.PubMedCrossRef
11.
Zurück zum Zitat García-Rey E, Cruz-Pardos A, García-Cimbrelo E. Alumina-on-alumina total hip arthroplasty in young patients: diagnosis is more important than age. Clin Orthop Relat Res. 2009;467:2281–2289.PubMedCrossRef García-Rey E, Cruz-Pardos A, García-Cimbrelo E. Alumina-on-alumina total hip arthroplasty in young patients: diagnosis is more important than age. Clin Orthop Relat Res. 2009;467:2281–2289.PubMedCrossRef
12.
Zurück zum Zitat García-Rey E, García-Cimbrelo E, Cordero-Ampuero J. Outcome of hemispherical porous-coated acetabular component with a proximally hydroxyapatite-coated anatomical femoral component: a 12- to 15-year follow-up study. J Bone Joint Surg Br. 2009;91:327–322. García-Rey E, García-Cimbrelo E, Cordero-Ampuero J. Outcome of hemispherical porous-coated acetabular component with a proximally hydroxyapatite-coated anatomical femoral component: a 12- to 15-year follow-up study. J Bone Joint Surg Br. 2009;91:327–322.
13.
Zurück zum Zitat Hailer NP, Garellick G, Kärrlholm J. Uncemented and cemented primary total hip arthroplasty in the Swedish Hip Arthroplasty Register: evaluation of 170,413 operations. Acta Orthop. 2010;81:34–41.PubMedCrossRef Hailer NP, Garellick G, Kärrlholm J. Uncemented and cemented primary total hip arthroplasty in the Swedish Hip Arthroplasty Register: evaluation of 170,413 operations. Acta Orthop. 2010;81:34–41.PubMedCrossRef
14.
Zurück zum Zitat Hallan G, Dybvik E, Furnes O, Havelin LI. Metal-backed acetabular components with conventional polyethylene: a review of 9113 primary components with a follow-up of 20 years. J Bone Joint Surg Br. 2010;92:196–201.PubMed Hallan G, Dybvik E, Furnes O, Havelin LI. Metal-backed acetabular components with conventional polyethylene: a review of 9113 primary components with a follow-up of 20 years. J Bone Joint Surg Br. 2010;92:196–201.PubMed
15.
Zurück zum Zitat Johnston RC, Fitzgerald RH, Harris WH, Poss R, Müller ME, Sledge CB. Clinical and radiographic evaluation of total hip arthroplasty: a standard system of terminology for reporting results. J Bone Joint Surg Am. 1990;72:161–168.PubMed Johnston RC, Fitzgerald RH, Harris WH, Poss R, Müller ME, Sledge CB. Clinical and radiographic evaluation of total hip arthroplasty: a standard system of terminology for reporting results. J Bone Joint Surg Am. 1990;72:161–168.PubMed
16.
Zurück zum Zitat Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481.CrossRef Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481.CrossRef
17.
Zurück zum Zitat Kress AM, Schmidt R, Vogel T, Nowak TE, Forts R, Mueller LA. Quantitative computed tomography-assisted osteodensitometry of the pelvis after press-fit cup fixation: a prospective ten-year follow-up. J Bone Joint Surg Am. 2011;93:1152–1157.PubMedCrossRef Kress AM, Schmidt R, Vogel T, Nowak TE, Forts R, Mueller LA. Quantitative computed tomography-assisted osteodensitometry of the pelvis after press-fit cup fixation: a prospective ten-year follow-up. J Bone Joint Surg Am. 2011;93:1152–1157.PubMedCrossRef
18.
Zurück zum Zitat Kwong LM, O’Connor DO, Sedlacek RC, Krushell RJ, Maloney WJ, Harris WH. A quantitative in vitro assessment of fit and screw fixation on the stability of a cementless hemispherical acetabular component. J Arthroplasty. 1994;9:163–170.PubMedCrossRef Kwong LM, O’Connor DO, Sedlacek RC, Krushell RJ, Maloney WJ, Harris WH. A quantitative in vitro assessment of fit and screw fixation on the stability of a cementless hemispherical acetabular component. J Arthroplasty. 1994;9:163–170.PubMedCrossRef
19.
Zurück zum Zitat Manning DW, Chiang PP, Martell JM, Galante JO, Harris WH. In vivo comparative wear study of traditional and highly cross-linked polyethylene in total hip arthroplasty. J Arthroplasty. 2005;20:880–886.PubMedCrossRef Manning DW, Chiang PP, Martell JM, Galante JO, Harris WH. In vivo comparative wear study of traditional and highly cross-linked polyethylene in total hip arthroplasty. J Arthroplasty. 2005;20:880–886.PubMedCrossRef
20.
Zurück zum Zitat Merle d’Aubigné R, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am. 1954;36:451–475. Merle d’Aubigné R, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am. 1954;36:451–475.
21.
Zurück zum Zitat Moore MS, McAuley JP, Young AM, Engh CA Sr. Radiographic signs of osseointegration in porous-coated acetabular components. Clin Orthop Relat Res. 2006;444:176–183.PubMedCrossRef Moore MS, McAuley JP, Young AM, Engh CA Sr. Radiographic signs of osseointegration in porous-coated acetabular components. Clin Orthop Relat Res. 2006;444:176–183.PubMedCrossRef
22.
Zurück zum Zitat Morscher EW. Current status of acetabular fixation in primary total hip arthroplasty. Clin Orthop Relat Res. 1992;274:172–193.PubMed Morscher EW. Current status of acetabular fixation in primary total hip arthroplasty. Clin Orthop Relat Res. 1992;274:172–193.PubMed
23.
Zurück zum Zitat Önsten I, Carlsson AS, Sanzén L, Besjakov J. Migration and wear of a hydroxyapatite-coated hip prosthesis: a controlled of a roentgen stereophotogrammetric study. J Bone Joint Surg Br. 1996;78:85–91.PubMed Önsten I, Carlsson AS, Sanzén L, Besjakov J. Migration and wear of a hydroxyapatite-coated hip prosthesis: a controlled of a roentgen stereophotogrammetric study. J Bone Joint Surg Br. 1996;78:85–91.PubMed
24.
Zurück zum Zitat Pagnano MW, Hanssen AD, Lewallen DG, Shaughnessy WJ. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty: long-term results in patients who have Crowe type-II congenital dysplasia of the hip. J Bone Joint Surg Am. 1996;78:1004–1014.PubMed Pagnano MW, Hanssen AD, Lewallen DG, Shaughnessy WJ. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty: long-term results in patients who have Crowe type-II congenital dysplasia of the hip. J Bone Joint Surg Am. 1996;78:1004–1014.PubMed
25.
Zurück zum Zitat Parvizi J, Sullivan T, Duffy G, Cabanela ME. Fifteen-year clinical survivorship of Harris-Galante total hip arthroplasty. J Arthroplasty. 2004;19:672–677.PubMedCrossRef Parvizi J, Sullivan T, Duffy G, Cabanela ME. Fifteen-year clinical survivorship of Harris-Galante total hip arthroplasty. J Arthroplasty. 2004;19:672–677.PubMedCrossRef
26.
Zurück zum Zitat Ranawat CS, Dorr LD, Inglis AE. Total hip arthroplasty in protrusio acetabuli of rheumatoid arthritis. J Bone Joint Surg Am. 1980;62:1059–1065.PubMed Ranawat CS, Dorr LD, Inglis AE. Total hip arthroplasty in protrusio acetabuli of rheumatoid arthritis. J Bone Joint Surg Am. 1980;62:1059–1065.PubMed
27.
Zurück zum Zitat Ries M, Harbaugh M. Acetabular strains produced by oversized press fit cups. Clin Orthop Relat Res. 1997;334:276–281.PubMedCrossRef Ries M, Harbaugh M. Acetabular strains produced by oversized press fit cups. Clin Orthop Relat Res. 1997;334:276–281.PubMedCrossRef
28.
Zurück zum Zitat Röhrl SM, Nivbrant B, Snorrason F, Kärrholm J, Nilsson KG. Porous-coated cups fixed with screws: a 12-year clinical and radiostereometric follow-up study of 50 hips. Acta Orthop. 2006;77:393–401.PubMedCrossRef Röhrl SM, Nivbrant B, Snorrason F, Kärrholm J, Nilsson KG. Porous-coated cups fixed with screws: a 12-year clinical and radiostereometric follow-up study of 50 hips. Acta Orthop. 2006;77:393–401.PubMedCrossRef
29.
Zurück zum Zitat Roth A, Winzer T, Sander K, Anders JO, Venbrocks RA. Press fit fixation of cementless cups: how much stability do we need indeed? Arch Orthop Trauma Surg. 2006;126:77–81.PubMedCrossRef Roth A, Winzer T, Sander K, Anders JO, Venbrocks RA. Press fit fixation of cementless cups: how much stability do we need indeed? Arch Orthop Trauma Surg. 2006;126:77–81.PubMedCrossRef
30.
Zurück zum Zitat Schmalzried TP, Harris WH. The Harris-Galante porous-coated acetabular component with screw fixation: radiographic analysis of eighty-three primary hip replacements at a minimum of five years. J Bone Joint Surg Am. 1992;74:1130–1139.PubMed Schmalzried TP, Harris WH. The Harris-Galante porous-coated acetabular component with screw fixation: radiographic analysis of eighty-three primary hip replacements at a minimum of five years. J Bone Joint Surg Am. 1992;74:1130–1139.PubMed
31.
Zurück zum Zitat Schmalzried TP, Wessinger SJ, Hill GE, Harris WH. The Harris-Galante porous acetabular component press-fit without screw fixation: five-year radiographic analysis of primary cases. J Arthroplasty. 1994;9:235–242.PubMedCrossRef Schmalzried TP, Wessinger SJ, Hill GE, Harris WH. The Harris-Galante porous acetabular component press-fit without screw fixation: five-year radiographic analysis of primary cases. J Arthroplasty. 1994;9:235–242.PubMedCrossRef
32.
Zurück zum Zitat Sedel L, Kerboull L, Christel P. Alumina on alumina hip replacement results and survivorship in young patients. J Bone Joint Surg Br. 1990;72:658–663.PubMed Sedel L, Kerboull L, Christel P. Alumina on alumina hip replacement results and survivorship in young patients. J Bone Joint Surg Br. 1990;72:658–663.PubMed
33.
Zurück zum Zitat Takao M, Nakamura N, Ohzono K, Sakai T, Nishii T, Sugano N. The results of a press-fit-only technique for acetabular fixation in hip dysplasia. J Arthroplasty. 2011;26:562–568.PubMedCrossRef Takao M, Nakamura N, Ohzono K, Sakai T, Nishii T, Sugano N. The results of a press-fit-only technique for acetabular fixation in hip dysplasia. J Arthroplasty. 2011;26:562–568.PubMedCrossRef
34.
Zurück zum Zitat Teinturier P, Terver S, Jaramillo CV, Besse JP. [Biomechanics of the acetabulum] [in French]. Rev Chir Orthop Reparatrice Appar Mot. 1984;70(suppl 2):41–46.PubMed Teinturier P, Terver S, Jaramillo CV, Besse JP. [Biomechanics of the acetabulum] [in French]. Rev Chir Orthop Reparatrice Appar Mot. 1984;70(suppl 2):41–46.PubMed
35.
Zurück zum Zitat Udomkiat P, Dorr LD, Wan Z. Cementless hemispheric porous-coated sockets implanted with press-fit technique without screws: average ten-year follow-up. J Bone Joint Surg Am. 2002;84:1195–2000.PubMed Udomkiat P, Dorr LD, Wan Z. Cementless hemispheric porous-coated sockets implanted with press-fit technique without screws: average ten-year follow-up. J Bone Joint Surg Am. 2002;84:1195–2000.PubMed
36.
Zurück zum Zitat Utting MR, Raghuvanshi M, Amirfeyz R, Blom AW, Learmonth ID, Bannister GC. The Harris-Galante porous-coated, hemispherical, polyethylene-lined acetabular component in patients under 50 year of age: a 12- to 16-year review. J Bone Joint Surg Br. 2008;90:1422–1427.PubMedCrossRef Utting MR, Raghuvanshi M, Amirfeyz R, Blom AW, Learmonth ID, Bannister GC. The Harris-Galante porous-coated, hemispherical, polyethylene-lined acetabular component in patients under 50 year of age: a 12- to 16-year review. J Bone Joint Surg Br. 2008;90:1422–1427.PubMedCrossRef
37.
Zurück zum Zitat Vasu R, Carter DR, Harris WH. Stress distribution in the acetabular region. Part I. Before and after total joint replacement. J Biomech. 1982;15:155–164.PubMedCrossRef Vasu R, Carter DR, Harris WH. Stress distribution in the acetabular region. Part I. Before and after total joint replacement. J Biomech. 1982;15:155–164.PubMedCrossRef
38.
Zurück zum Zitat Wasielewski RC, Cooperstein LA, Kruger MP, Rubash HE. Acetabular anatomy and the transacetabular fixation of screws in total hip arthroplasty. J Bone Joint Surg Am. 1990;72:501–508.PubMed Wasielewski RC, Cooperstein LA, Kruger MP, Rubash HE. Acetabular anatomy and the transacetabular fixation of screws in total hip arthroplasty. J Bone Joint Surg Am. 1990;72:501–508.PubMed
39.
Zurück zum Zitat Widmer KH, Zurfluh B, Morscher EW. Load transfer and fixation mode of press-fit acetabular sockets. J Arthroplasty. 2002;17:926–935.PubMedCrossRef Widmer KH, Zurfluh B, Morscher EW. Load transfer and fixation mode of press-fit acetabular sockets. J Arthroplasty. 2002;17:926–935.PubMedCrossRef
40.
Zurück zum Zitat Won CH, Hearn TC, Tile M. Micromotion of cementless hemispherical acetabular components: does press-fit need adjunctive screw fixation? J Bone Joint Surg Br. 1995;77:484–489.PubMed Won CH, Hearn TC, Tile M. Micromotion of cementless hemispherical acetabular components: does press-fit need adjunctive screw fixation? J Bone Joint Surg Br. 1995;77:484–489.PubMed
41.
Zurück zum Zitat Yoder SA, Brand RA, Pedersen DR, O’Gorman TW. Total hip acetabular component position affects component loosening rates. Clin Orthop Relat Res. 1988;228:79–87.PubMed Yoder SA, Brand RA, Pedersen DR, O’Gorman TW. Total hip acetabular component position affects component loosening rates. Clin Orthop Relat Res. 1988;228:79–87.PubMed
42.
Zurück zum Zitat Zenz P, Stiehl JB, Knechtel H, Titzer-Hochmaier G, Schwagerl W. Ten-year follow-up of the non-porous Allofit cementless acetabular component. J Bone Joint Surg Br. 2009;91:1443–1447.PubMedCrossRef Zenz P, Stiehl JB, Knechtel H, Titzer-Hochmaier G, Schwagerl W. Ten-year follow-up of the non-porous Allofit cementless acetabular component. J Bone Joint Surg Br. 2009;91:1443–1447.PubMedCrossRef
Metadaten
Titel
Cup Press Fit in Uncemented THA Depends on Sex, Acetabular Shape, and Surgical Technique
verfasst von
Eduardo García-Rey, MD, PhD
Eduardo García-Cimbrelo, MD, PhD
Ana Cruz-Pardos, MD, PhD
Publikationsdatum
01.11.2012
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 11/2012
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2381-9

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