Flanged acetabular components in cemented Charnley hip arthroplasty. Ten-year follow-up of 350 patients

Abstract

A flanged socket was introduced by Sir John Charnley for use in his low-friction hip arthroplasty in 1976. Experimental evidence has suggested that the flange offers an advantage in terms of cement pressurisation at the time of implantation. We have reviewed 302 primary Charnley arthroplasties followed for 9 to 11 years to determine the effect of the flanged socket on the radiological appearance. The incidence of radiological demarcation at the cement-bone interface is significantly reduced in early radiographs after the use of a flanged socket, and the advantage is maintained in the long-term results.

Cementless primary total hip replacement

“…Such an improvement has never been described around the more commonly used cemented polyethylene cups [15], metal backed cemented cups [23,24], or cementless cups [22,26].…”

The influence of initial pressurization and cup introduction time on the depth of cement penetration in an acetabular model

“…In the acetabulum, a suboptimal cementationas shown by even minor radiological demarcation in the cement-bone interface during the first year-has been reported to lead to 35-45% radiographic loosening at 10 years (Hodgkinson et al 1993, Ranawat et al 1995, Garcia-Cimbrelo et al 1997, Ritter et al 1999. Improved cementation technique with cement pressurization in the acetabulum has been shown to improve the longevity of acetabular components (Hodgkinson et al 1993, Malchau et al 1993, Ranawat et al 1997.…”

“…Improved cementation technique with cement pressurization in the acetabulum has been shown to improve the longevity of acetabular components (Hodgkinson et al 1993, Malchau et al 1993, Ranawat et al 1997. Late aseptic loosening of the acetabular component remains a problem, however (Mulroy et al 1995, Ranawat et al 1995, and is thought to be partly due to the difficulty in achieving adequate cementation pressure in the acetabulum given its anatomy.…”

The Influence of a Suction Device on Fixation of a Cemented Cup using RSA

“…It also is known a radiolucent line at the biologic interface of the cup is an important prognostic sign for later loosening [12,16,26]. The presence of a radiolucent line around the periphery of the cup implies there is inadequate penetration of bone by cement and in these cases, there may be easier ingress of pressure and debris around the implant to erode bone and compromise fixation.…”