Comparison of 5-year cup and stem migration between ceramic-on-ceramic and ceramic-on-polyethylene bearing in press-fit total hip arthroplasty: a randomised controlled trial using radiostereometric analysis.

IF 1.3 4区医学 Q3 ORTHOPEDICS

HIP International Pub Date : 2024-11-01 Epub Date: 2024-08-19 DOI:10.1177/11207000241265653

Amanda D Klaassen, Justin van Loon, Nienke W Willigenburg, Lennard A Koster, Bart L Kaptein, Victor P M van der Hulst, Daniel Haverkamp, Dirk Jan F Moojen, Rudolf W Poolman

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引用次数: 0

Abstract

Introduction: The inelasticity of ceramic bearings might affect primary stability and migration of implants in press-fit total hip arthroplasty (THA). This randomised controlled trial compares migration patterns of the uncemented Delta-TT cup and H-MAX S stem between ceramic and polyethylene liners, up to 5 years follow-up.

Methods: Patients receiving primary press-fit THA were randomly allocated to a ceramic (n = 28) or polyethylene (n = 25) liner. Migration was measured using model-based radiostereometric analysis (RSA) at baseline and 1.5, 3, 6, 12, 24 and 60 months postoperatively and compared between groups using mixed models statistical analysis. The focus of this study is on the 2- to 5-year migration of the Delta-TT cup and migration during complete follow-up of the H-MAX S stem up to 5-years.

Results: At 5-year follow-up, mean (95% CI) proximal cup translation was 0.56 (0.37-0.74) mm in ceramic and 0.58 (0.25-0.90) mm in polyethylene (p = 0.729). The mean change in adduction was 1.05° (0.27-1.82°) in ceramic and 0.78° (-0.16-1.71°) in polyethylene. Mixed modelling showed that all between-group effects were ⩽0.20 mm for translation and ⩽0.22° for rotation at 5 years postoperatively (p ⩾ 0.23). Mean cup migration between 2 and 5 years was limited (all parameters <0.17 mm and <0.30°). At 5-year follow-up, mean stem subsidence was 2.09 mm (0.89-3.29 mm) in ceramic and 2.55 (0.97-4.12) mm in polyethylene. The mean change in internal rotation was 3.69° (1.98-5.40°) in ceramic and 4.01° (2.20-5.81°) in polyethylene. Most stem migration occurred up to 1.5 months, stabilising afterwards. All between-group effects were ⩽0.75 mm for translations and ⩽1.41° for rotations (p ⩾ 0.26).

Conclusions: 5-year migration patterns of press-fit cups and stems were similar between ceramic and polyethylene liners. The Delta-TT cup and H-MAX S stem showed secondary stabilisation and remained stable up to 5 years in both groups, which is promising for long-term survival with both liner types.

Clinical trial registration: ClinicalTrials.gov (NCT03093038).

查看原文本刊更多论文

压入式全髋关节置换术中陶瓷基底与聚乙烯基底陶瓷基底轴承 5 年髋臼杯和髋臼柄移位的比较：采用放射性立体计量分析的随机对照试验。

导言：陶瓷轴承的非弹性可能会影响压入式全髋关节置换术（THA）中植入物的初次稳定性和移位。这项随机对照试验比较了非骨水泥Delta-TT髋臼杯和H-MAX S柄在陶瓷衬垫和聚乙烯衬垫之间长达5年的迁移模式：方法：接受初次压入式THA的患者被随机分配到陶瓷衬垫（28人）或聚乙烯衬垫（25人）。在基线和术后1.5、3、6、12、24和60个月时，使用基于模型的放射性立体计量分析（RSA）测量迁移情况，并使用混合模型统计分析对不同组间的迁移情况进行比较。本研究的重点是Delta-TT杯2至5年的移位情况，以及H-MAX S骨干5年完全随访期间的移位情况：随访5年时，陶瓷近端杯移位的平均值（95% CI）为0.56（0.37-0.74）毫米，聚乙烯为0.58（0.25-0.90）毫米（P = 0.729）。陶瓷内收的平均变化为 1.05°（0.27-1.82°），聚乙烯内收的平均变化为 0.78°（-0.16-1.71°）。混合建模显示，术后 5 年时，所有组间效应均为：平移 ⩽0.20 mm，旋转 ⩽0.22° (p ⩾0.23)。2至5年的平均髋臼杯移位有限（所有参数p ⩾0.26）：结论：陶瓷内衬和聚乙烯内衬的压合杯和牙杆的5年移位模式相似。Delta-TT杯和H-MAX S柄显示出二次稳定，在两组中均保持稳定达5年之久，这对两种衬垫的长期存活是有希望的：临床试验注册：ClinicalTrials.gov (NCT03093038)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIP International 医学-整形外科

CiteScore

4.20

自引率

0.00%

发文量

审稿时长

2 months

期刊介绍： HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology