Radiographic assessment of cup migration and wear after hip replacement

Ilchmann, Thomas

doi:10.1080/17453674.1997.11744768

Cited by 26 publications

(31 citation statements)

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“…EBRA accepts only pelvic radiographs within a range of 9° tilting in the ydirection and 6° in the x-direction. Using these parameters, a measurement accuracy of better than ± 1 mm has been reported (Ilchmann et al 1992, Ilchmann 1997, Phillips et al 2002. Thus, implant migration was defined as a change in implant position of more than 1 mm in the horizontal or vertical direction.…”

Section: Ein-bild-roentgen-analyse (Ebra)mentioning

confidence: 99%

High long-term loosening rate of conical screw cups

et al. 2006

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Background Acetabular screw cups seem to give high primary stability. We analyzed the migration and loosening behavior of a first-generation screw cup in a longterm follow-up.Patients and methods We examined 92 uncemented titanium alloy conical screw cups prospectively. Implant migration was assessed with a digital high-precision method (EBRA) with an accuracy of 1.0 mm.Results After mean 11 (0.5-18) years, 87 patients were available for examination and 5 patients had died. 32 implants had been revised and 7 cases showed radiographic evidence of loosening. The 10-year survival rate was 71%. Migration of more than 1 mm occurred in 53 hips. Implant survival was strongly associated with an annual migration of greater than 0.2 mm.Interpretation The long-term behavior of this cup is not satisfactory. In spite of extraordinarily high primary implant stability, secondary osseointegration of this cup often fails. The annual migration rate represents a valid parameter for prediction of implant survival.

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Section: Ein-bild-roentgen-analyse (Ebra)mentioning

confidence: 99%

High long-term loosening rate of conical screw cups

et al. 2006

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“…Using special software for contrast enhancement, the contour of all components could be defined in a satisfactory way. As in previous EBRA investigations, migration of more than 1 mm and wear of more than 0.5 mm were regarded as significant (Ilchmann 1997). Bettin and Katthagen (1997).…”

Section: Methodsmentioning

confidence: 85%

“…Measurements were made with the EBRA method, which has been shown previously to be more accurate than standard methods (Ilchmann 1997, Stockl et al 1997.…”

mentioning

confidence: 99%

Acetabular reconstruction with the Burch-Schneider ring: An EBRA analysis of 40 cup revisions

et al. 2006

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Background Reconstruction of the bone stock and fixation of the implant remain challenging problems in revision surgery. In this retrospective study, we wanted to gain information on initial stability and wear after revision with the Burch-Schneider ring.Patients and methods Between 1994 and 1998, we performed 70 reconstructions of the acetabulum with a Burch-Schneider ring in revision arthroplasty. 63 patients could be followed up clinically and radiographically. 40 cups were suitable for EBRA measurements whereas migration and wear could not be assessed by this method in 23 cases due to lack of comparability of pelvic radiographs. The mean follow-up time was 4.7 years.Results 2 cups were re-revised and 14 cups had breakage or changes of position of the screws. 30 cups showed detectable migration and 18 cups detectable wear. The mean migration was 2.8 mm and the mean wear rate was 0.12 mm/year. 16 cups had detectable migration after 1 year; 11 of these 16 continued to migrate and 9 of them had screw breakage. Both re-revisions showed early migration. Early migration correlated with later screw breakage and the overall migration correlated with wear. The only risk factor found for early migration was the wear rate.Interpretation The Burch-Schneider ring is an established and reliable implant for cup revision with good clinical results, but it seems to be difficult to maintain intraoperative stability. The implants with continuous migration may lead to late clinical failure and require further observation. Wear may contribute to migration and resorption of the bone graft.

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“…We did not systematically gather patient information to calculate performance status or other oncologic variables that might influence outcome. Our technique of assessing component migration and radiolucent lines has known limitations [11]. It is possible that subtle migration occurred and was not detected.…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique: Porous Tantalum Reconstruction for Destructive Nonprimary Periacetabular Tumors

Khan

Rose

Yanagisawa

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Large bone loss and frequently irradiated existing bone make reconstructing metastatic and other nonprimary periacetabular tumors challenging. Although existing methods are initially successful, they may fail with time. Given the low failure rates of porous tantalum acetabular implants in other conditions with large bone loss or irradiated bone, we developed a technique to use these implants in these neoplastic cases where others might fail. Description of Technique After local tumor curettage, a large uncemented tantalum shell (sometimes with tantalum augments) was fixed to remaining bone using numerous screws. When substantial medial bone loss was present, an antiprotrusio cage was placed over the top of the cup and secured to remaining ilium and ischium. Patients and Methods We retrospectively reviewed 20 patients who underwent THAs for neoplastic bone destruction with the described technique. Their mean age was 60 years (range, 22-80 years). We recorded pain and ambulatory status, pain medication use, and Harris hip scores. We assessed for progressive radiolucent lines and component migration on followup radiographs. Eleven of the 20 patients died at a mean of 17 months after surgery. The minimum followup for surviving patients was 26 months (mean, 56 months; range, 26-85 months).

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Radiographic assessment of cup migration and wear after hip replacement

Cited by 26 publications

References 0 publications

High long-term loosening rate of conical screw cups

High long-term loosening rate of conical screw cups

Acetabular reconstruction with the Burch-Schneider ring: An EBRA analysis of 40 cup revisions

Surgical Technique: Porous Tantalum Reconstruction for Destructive Nonprimary Periacetabular Tumors

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