Early aseptic loosening of cementless monoblock acetabular components

Miettinen, Simo; Mäkinen, Tuula; Laaksonen, Inari; Mäkelä, Keijo; Kettunen, Jukka; Remes, Ville

doi:10.1007/s00264-016-3254-8

Cited by 15 publications

(6 citation statements)

References 27 publications

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“…The association between aseptic failure and implant position has been investigated in a limited fashion. Miyakawa et al 29 demonstrated that both gritbasted and hydroxyapatite-coated cups had a higher chance of aseptic failure if implanted in an excessively horizontal position, while Miettinen et al 30 noted that components placed more vertically and less anteverted had higher tendencies to loosen in the short term. Taken together, these findings could suggest that malposition limits boneimplant contact, and the resulting shear forces prevent osseointegration and produce radiolucencies.…”

Section: Discussionmentioning

confidence: 99%

Radiographic assessment of the dynasty biofoam acetabular component with a minimum 2 years follow-up

et al. 2020

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Introduction: Acetabular components utilising novel ultraporous metal matrices have been recently introduced into clinical practice with improved interference fit, decreased stress shielding, and hope for more reliable osseointegration. 1 such example is the Dynasty Biofoam cup, which has been in clinical use for over a decade but has few reports documenting its clinical and radiographic performance. Methods: A single-centre retrospective study was performed evaluating 96 Dynasty Biofoam acetabular components implanted between March 2010 and August 2014 with minimum 2-year radiographic follow-up. Patients that received components for revision surgery or that had early complications postoperatively (femur fracture, prosthetic infection) were excluded. Biofoam patients were compared to 96 patients that received the Trident PSL acetabular component and were matched for age, gender, and BMI. Patient reported outcomes, component position and radiographic features of cup loosening, including radiolucent lines and sclerosis were compared among groups. Results: Patient-reported outcomes at 2 years were similar among groups. Cup anteversion was similar but inclination was significantly greater in the Biofoam group ( p = 0.006). A significantly greater number of Biofoam components exhibited 2-zone (27.2%) and 3-zone (12.0%) radiolucencies compared to 0% of the Trident shells ( p < 0.05). 2 Biofoam cups were revised for aseptic loosening compared to no Trident cups ( p = 0.49). Discussion: Despite adequate implant survivorship, over a quarter of Biofoam cups had 2 or more radiolucent zones in early follow-up. Longer follow-up is needed to determine if the aseptic revision rate for this cup will increase.

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Section: Discussionmentioning

confidence: 99%

Radiographic assessment of the dynasty biofoam acetabular component with a minimum 2 years follow-up

et al. 2020

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“…For smaller defects, good results could be achieved with standard implants or jumbo cups that give good stability and osteointegration but require a significant bone contact. In case of osteolysis of both the anterior and posterior column, this is hard to obtain and the primary stability often results impaired; moreover, a suboptimal positioning of the cup rise the risk for an early loosening [6,7,15,16,17,18]. Cages and rings have the peculiarity of bridging the defect respectively with or without osteointegrative qualities and can be positioned independently from the final cup, which is usually cemented into the device after stability is achieved.…”

Section: Discussionmentioning

confidence: 99%

Management of Paprosky type three B acetabular defects by custom-made components: early results

Aprato

Giachino

Bedino

et al. 2018

International Orthopaedics (SICOT)

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Our study aims at the evaluation of the recently introduced Lima Promade custom-made acetabular device for the treatment of complex acetabular Paprosky 3B defects. MethodsBetween 2016 and 2018, eight patients with major acetabular osteolysis and multiple revisions history were treated with a custom-made implant in a single centre and by a single surgeon. We assessed patients' demographics, peri-operative data, and complications and a specific questionnaire was submitted to the surgeon after each procedure. ResultsAll the devices were correctly positioned. In two over eight cases, a post-operative dislocation occurred, where extensive soft tissue impairment was present. The questionnaire showed a good pre-operative and intra-operative experience of the surgeon. ConclusionsThe Promade custom-made acetabular system showed encouraging results for complex defects and the entire procedure was positively rated. Further analysis with a higher number of cases and a longer follow-up should be performed for a complete clinical and cost-effective evaluation.

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“…Only the usage of self-locking cups was identified as relevant risk factor; however, gender did not influence the rate of periprosthetic fractures [ 9 ]. Sharkey et al suggested that oversizing of the cup may be associated with an increased rate of periprosthetic acetabular fractures [ 22 ] whereas undersizing may be associated with early loosening as a result of insufficient press-fit [ 18 ]. Additional benefits of accurate preoperative planning include shortened surgical time, and reduced complications with equipment and an improved reconstruction of individual joint geometry [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Quantitative and individualized assessment of the learning curve in preoperative planning of the acetabular cup size in primary total hip arthroplasty

Waldstein

Bouché

Pottmann

et al. 2021

Arch Orthop Trauma Surg

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Introduction The aim of the present study was to investigate the learning curves of 2 trainees with different experience levels to reach proficiency in preoperative planning of the cup size based on learning curve cumulative summation (LC-CUSUM) statistics and a cumulative summation (CUSUM) test. Materials and methods One-hundred-twenty patients who had undergone primary total hip arthroplasty with a cementless cup were selected. Preoperative planning was performed by an experienced orthopedic surgeon. Trainee 1 (student) and trainee 2 (resident) planned the cup size. The trainees were blinded to the preoperative plan and the definitive cup size. Only after a cup size was chosen, the trainees were unblinded to the preoperative plan of the surgeon. LC-CUSUM was applied to both trainees to determine when proficiency in determining the appropriate cup size was reached. A CUSUM test was applied to ensure retention of proficiency. Results With reference to the preoperative plan of the surgeon, LC-CUSUM indicated proficiency after 94 planning attempts for trainee 1 and proficiency after 66 attempts for trainee 2, respectively. Trainee 1 and 2 maintained proficiency thereafter. With reference to the definitive cup size, LC-CUSUM did not signal competency within the first 120 planning attempts for trainee 1. Trainee 2 was declared competent after 103 attempts and retained competency thereafter. Conclusions LC-CUSUM/CUSUM allow for an individualized, quantitative and continuous assessment of planning quality. Based on LC-CUSUM statistics, the two trainees of this study gain proficiency in planning of the acetabular cup size after 50–100 attempts when an immediate feedback is provided. Previous experience positively influences the performance. The study serves as basis for the medical education of students and residents in joint replacement procedures.

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Early aseptic loosening of cementless monoblock acetabular components

Cited by 15 publications

References 27 publications

Radiographic assessment of the dynasty biofoam acetabular component with a minimum 2 years follow-up

Radiographic assessment of the dynasty biofoam acetabular component with a minimum 2 years follow-up

Management of Paprosky type three B acetabular defects by custom-made components: early results

Quantitative and individualized assessment of the learning curve in preoperative planning of the acetabular cup size in primary total hip arthroplasty

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