Acetabular components with or without screws in total hip arthroplasty

Abstract

AIMTo compare the operation time, blood loss, and early outcomes of acetabular components with and without the screw.METHODSThirty patients who underwent cementless acetabular component with or without screw and whose follow-up exceeded one year period in total hip arthroplasty were evaluated. A posterior approach was used in all surgical procedures by one experienced surgeon. Demographic data, operation time, intra- and postoperative blood loss volume, follow-up clinical score, cup migration, and osteolysis were recorded. The Kolmogorov-Smirnov test was performed for testing the normality of study data. Mann-Whitney U test was used to analyze the inter-group differences. A P-value of ≤ 0.05 was considered statistically significant.RESULTSAcetabular components were used in 16 (53.3%) patients with screw and 14 (46.7%) without screw. After one year of follow-up, an osteolytic lesion of 3 mm was found in only one patient in the screw group. No cup migration was encountered. Intra-group mean Harris hip score significantly increased, but there was no significant inter-group difference. While the mean operation time of the screw group was 121.8 min (range; 95-140), it was 102.7 min (range; 80-120) in the no-screw group, and this difference was statistically significant (P = 0.002). The mean intraoperative/postoperative, and total blood loss were 556.6 mL (range: 350-800)/423.3 mL (range: 250-600), and 983.3 mL (range: 600-1350), respectively in the screw group; and 527 mL (range: 400-700)/456 mL (range: 230-600), and 983 mL (range: 630-1250), respectively in the no-screw group. The blood loss difference between the two groups was not significant. In the screw group, the operation time was 19.1 min longer than the no-screw group, and this difference was statistically significant.CONCLUSIONAcetabular components with or without screw have similar results, but the use of screw increases the operation time significantly, while not changing the blood loss volume.

Incorporation of screwless press-fit acetabular cups and disappearance of polar gaps

“…No significant difference was seen in the HHS between the two groups. The six week HHS seen in this study was better than that seen in the series published by Pepe M et al 14 who have reported a six week mean HHS for screwless uncemented acetabulum of 60. The scores seen in the study by Schmalzried et al 8 were comparable to the current study.…”

“…Table 4 compares the HHS of both groups in this study and the HHS seen in the study by Schmalzried at al 8 and Pepe M et al 14 . The evaluation of the pre-operative and the post-operative HHS demonstrated a significant improvement (p value-0.001) in the HHS post-operatively in both the groups.…”

Are additional screws required for press-fit fixation of cementless acetabular cups? A systematic review and meta-analysis

“…These studies suggested that osteolysis was closely related to screw holes and screws. Additionally, fixation with screws was associated with a risk of increased surgical time [ 4 , 5 ]. So far, there is no definitive guide on whether to add screws on the cementless acetabular cup, and the screw addition is widely debated.…”

“…Their study revealed no significant differences in osteolysis, prosthesis loosening, or revision rates with or without the addition of screws. This was the first evidence-based study in this field and after being published, this matter received wide attention from peers and more relevant clinical studies were published [ 4 , 7 – 11 ]. Nonetheless, the aforementioned study had some limitations.…”

Uncemented cups with and without screw holes in primary THA: a Swedish Hip Arthroplasty Register study with 22,725 hips

“…Both prolonged operation time (Pepe et al. 2017) and increased likelihood of receiving a blood transfusion (Colacchio et al. 2017) have been reported in recent studies.…”