Poor Survival of Abg I Hip Prosthesis in Younger Patients

Abstract

Background: Hydroxyapatite coated (HAC) hip implants have been used in clinical practice for more than two decades. However, the majority of studies have reported only intermediate term outcomes that are not reliable for predicting long-term behavior in all implants. The aim of this study was to determine the performance of HAC total hip arthroplasty in younger patients over a 10-year follow-up period. Methods and Results:This was an observational retrospective study of a 137 consecutive hips with the ABG I prosthesis. Of these, 128 were available for the last investigation. Median duration of follow-up was 10.9 years. The mean age at time of index surgery was 46±6.7 years. Probability of implant survival was estimated using the Kaplan-Meier method. The overall 12-year cumulative survival was 0.55 (95% CI, 0.443-0.659). Periprosthetic osteolysis (57 %) was the most frequent reason for failure followed by aseptic loosening (28 %). When only aseptic loosening was included in the analysis, the same fi gures for cup and stem were 0.873 (95% CI, 0.808-0.938) and 0.992 (95% CI, 0.976-1.0), respectively. Patients with a smaller cup size were those at high risk for revision due to wear-related complications (odds ratio, OR=4.3; 95% CI, 1.734-10.555).Conclusion: This study reports one of the poorest 12-year survivorship data for cementless acetabular component in the literature. The main reason for premature failure was osteolysis, strongly related to high wear rate of polyethylene.

Risk factors for accelerated polyethylene wear and osteolysis in ABG I total hip arthroplasty

“…The overall 12-year survival for ABG I prostheses, found in our previous study, was 55% [10], which is in agreement with several studies [39][40][41][42] but contrasts with others [11,43,44]. The reasons for the disparity are still not clear, but this issue is discussed elsewhere [10]. Briefly, it has been disclosed that PE liners made from GUR 415HP resins possess greater biological activity compared to PE made from GUR 1120 [45].…”

“…The revised cases belonged to a group of patients with ABG I prostheses operated upon at the author's institution between September 1994 and January 2000 (n=506). We previously reported on the poor 12-year survival of the ABG I prosthesis [10]. Information was collected on the indication for the original arthroplasty, the time since the arthroplasty, and indication for revision.…”

Inferior Survival of Hydroxyapatite versus Titanium-coated Cups at 15 Years

“…For some cups, there is a plausible explanation of failure, eg, in cases of HA coating applied to smooth surfaces [13,29,42], very thick coatings [33,42], the presence of screw holes [7,25], a poor locking mechanism [32], and conventional PE. However, for other HA-coated cup designs, the reasons for the wear rate, osteolysis, and revision are not entirely transparent [7,21,25,34] and raise concern regarding continued use of HA coating for acetabular cups. Generalizability of our results based on discontinued components is unclear.…”

Assessment of Haemoglobin A1c Evolution Using Two Statistical Approaches (Survival Analysis and Linear Regression) in Persons With Diabetes Mellitus

“…Survival analysis was first described by Kaplan and Meier in 1958 14, 15 and was used to evaluate the survival time of oncological patients. This statistical method has been mostly used in epidemiological studies 3,4,16,22,28 . In the present study, in order to describe the therapeutic effects of continuous glucose monitoring on metabolic control (i.e.…”