Inferior stabilization of cementless compared with cemented dual-mobility cups in elderly osteoarthrosis patients: a randomized controlled radiostereometry study on 60 patients with 2 years’ follow-up

Abstract

Background and purpose — Elderly patients may benefit from a dislocation low-risk dual-mobility (DM) articulation in total hip arthroplasty, but the best cup fixation method is unknown. We compared cup migration for cemented and cementless DM cups using radiostereometry. Patients and methods — In a patient-blinded randomized trial, 60 patients (33 female) with osteoarthritis were allocated to cemented (n = 30) or cementless (n = 30) Avantage DM cup fixation. Criteria were age above 70 years, and T-score above –4. We investigated cup migration, periprosthetic bone mineral density (BMD), and patient-reported outcome measures (PROMs) until 24 months postoperative follow-up. Results — At 24 months mean proximal cup migration was 0.11 mm (95% CI 0.00–0.23) for cemented cups and 0.09 mm (CI –0.09 to 0.28) for cementless cups. However, cementless cups generally migrated more than cemented cups at 12 and 24 months. Cemented cups had no measurable migration from 3 months’ follow-up, while cementless cups had not yet stabilized at 24 months in all rotations. Cementless cups showed statistically significantly more maximum total point motion (MTPM) at 12- and 24-month follow-up compared with cemented cups in patients with low systemic BMD (p = 0.01). Periprosthetic BMD changes did not statisticially significantly correlate to proximal migration in either cup fixation group (p > 0.05). PROMs improved similarly in both groups. Interpretation — Cemented cups were well fixed at 3 months. The cementless cups migrated more in patients with low BMD, showed an inconsistent pattern of migration, and migrated in different directions during the first and second year without tendency to stabilization. Cemented fixation of the Avantage DM cup seems safer in elderly patients

Model-Based Roentgen Stereophotogrammetric Analysis Using Elementary Geometrical Shape Models: Reliability of Migration Measurements for an Anatomically Shaped Femoral Stem Component

“…A uniplanar RSA set up was used. This presents the common set up for hip implant migration measurement [34][35][36]. The results of this study showed the reliability of out-of-plane migration measurements was inferior to in-plane migration measurements, which can be a common limitation of the uniplanar calibration set up [14].…”

Diagnostic significance of magnetic resonance imaging in distinguishing temporomandibular disorders: a retrospective chart review

“…Osteoarthritis and internal disorders coexist in only one-third of cases, which means that the view that subclinical osteoarthritis leads to the pathological tissue response to internal disorders should be reexamined [ 13 ]. Temporomandibular joint-related pain can be predicted by temporomandibular joint MRI [ 14 – 17 ]. In this study, we used MRI to assess bone changes in the TMJ and studied bone changes caused by disc position.…”

Cemented and cementless dual mobility cups show similar fixation, low polyethylene wear, and low serum cobalt-chromium in elderly patients: a randomized radiostereometry study with 6 years’ follow-up

“…The sample size was fixed at 30 patients per group to investigate the primary outcome of 2-year proximal cup migration with a clinically important difference of 0.2 mm (SD 0.27) ( 20 ). Here, we present the pre-specified secondary outcomes of 6-year cup migration, polyethylene wear, and activity.…”

“…Cementing was performed using Palacos R+G cement (Heraeus Medical Gmbh, Wehrheim, Germany) with removal of the subchondral bone and over-reaming of 4 mm. The cementless cup was coated with titanium and hydroxyapatite (150 ± 50 μm) and implanted size to size ( 20 ). All patients received cemented Exeter highly polished stems combined with a 28-mm chrome-cobalt femoral head (Stryker Corporation, Kalamazoo, MI, USA) and a highly cross-linked polyethylene liner (E1, ZimmerBiomet, Warsaw, IN, USA) machined from compression-molded GUR 1050 rods.…”

“…PE wear precision, i.e., femoral head translations relative to the cup, was 0.4, 0.2, and 0.3 mm along the x-, y-, and z-axes, respectively. Migration precision has been published previously ( 20 ).…”