Survival of Hydroxy Apatite-Coated Cups: Acetabular Screws Involve a Lower Rate of Revision Surgery due to Aseptic Loosening

Natera, Luis; Valera, M.; Gómez, E. Martínez; Ibañez, Natalia; Crusi, X.; Sancho, R.

doi:10.5301/hipint.5000435

Cited by 8 publications

(8 citation statements)

References 46 publications

(47 reference statements)

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“…3 In a THA with an HA-coated cup, the use of acetabular screws is associated with a lower rate of revision surgery due to aseptic loosening. 16 These experimental results indicate that acetabular screws lead to positive outcomes in primary cup fixation.…”

Section: Discussionmentioning

confidence: 84%

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Changes in acetabular component alignment due to screw fixation in patients with hip dysplasia

et al. 2019

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Introduction: Adequate initial stability of the acetabular cup is essential for total hip arthroplasty (THA). However, changes in the alignment of the acetabular component caused by screw fixation are concerning in patients with inadequate bone stock. This study aimed to investigate the effects of screw fixation on the alignment of the acetabular component in THA patients with hip dysplasia. Methods: We retrospectively examined 256 hips (range 28–87 years) that underwent THA using a navigation system. Patients were divided into 2 groups based on the presence or absence of changes in the alignment of the intraoperative acetabular cup, and univariate and multivariate analyses were performed to identify factors that were predictive of changes in acetabular component alignment after screw fixation in 2 dimensions: inclination and anteversion. Results: Screw fixation led to a mean change in inclination of 1.6° (range 0–10°) and a mean change in anteversion of 1.4° (range 0–14°). The Crowe classification, the presence of bone cysts, and the use of an inferior quadrant screw were identified as factors that correlated with acetabular cup alignment changes in inclination (odds ratios, 6.01, 5.94 and 0.03, respectively). Only the Crowe classification was identified as a factor that correlated with intraoperative alignment changes in anteversion (odds ratio, 2.08). Conclusions: Screw fixation altered the acetabular cup alignment. The inclination changes were related to the extent of the dysplasia, and the risk was reduced when the inferior quadrant screw was used. Surgeons should use caution during screw fixation in THAs performed on severely dysplastic hips.

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Section: Discussionmentioning

confidence: 84%

“…On the navigation system screen, cup angle was displayed in the operative definition. 16 The total number of screws that were required for fixation, including the inferior quadrant screw, was documented.…”

Section: Intraoperative Measurementsmentioning

confidence: 99%

Changes in acetabular component alignment due to screw fixation in patients with hip dysplasia

et al. 2019

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“…Early full weight-bearing has not been shown to affect the bone mineral density around the implant at 5 years postoperatively, as compared to partial weight-bearing [41]. Nevertheless, high-impact activities have an odds ratio of 4.24 to develop aseptic loosening, compared to a patient with medium or low activity levels [65].…”

Section: Postoperative Protocolmentioning

confidence: 97%

“…Regarding the use of acetabular screws, they can lower the risk of revision surgery as shown by Natera et al on 749 cases of primary THAs [41].…”

Section: Acetabular Screwsmentioning

confidence: 99%

How to Prevent Aseptic Loosening in Cementless Arthroplasty: A Review

et al. 2022

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Aseptic loosening is the main late postoperative complication of cementless total hip arthroplasties (THAs), leading to pain and functional impairment. This article aims to update the orthopedic surgeon on the various methods by which the aseptic loosening rate can be reduced. We performed a systematic review by searching the PubMed database for hip aseptic loosening. We included meta-analysis, randomized controlled trials, reviews, and systematic reviews in the last 10 years, which provided information on techniques that can prevent aseptic loosening in total hip arthroplasty. From a total of 3205 articles identified, 69 articles (2%) met the inclusion criteria, leading to a total of 36 recommendations. A lot of research has been conducted in terms of septic loosening in the last decade. Currently, we have various techniques by which we can reduce the rate of aseptic loosening. Nevertheless, further randomized clinical trials are needed to expand the recommendations for aseptic loosening prevention.

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“…The treatment of periprosthetic osteolysis and offsetting its impact on arthroplasty have become novel problems, which have perturbed surgeons. It was well documented that subsequent aseptic loosening resulting from periprosthetic osteolysis was one of the leading cause of joint revision surgery after artificial joint replacement (Natera et al, ). With the increasing cases of artificial arthroplasty, it was critical to prevent or inhibit the occurrence of periprosthetic osteolysis.…”

Section: Introductionmentioning

confidence: 99%

MiR‐377 inhibits wear particle‐induced osteolysis via targeting RANKL

Xiaomeng

et al. 2019

Cell Biology International

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Periprosthetic osteolysis caused by wear particles is the main factor that affects the long‐term efficacy of artificial joint replacement, and macrophages play a vital role in the pathogenesis of periprosthetic osteolysis, while the potential mechanism underlying this is still unclear. To investigate the underlying role of miR‐377 in wear particle‐induced osteolysis (PIO), blood samples from patients undergoing arthroplasty were collected for analyzing the correlation between miR‐377 expression and the clinicopathological parameters of PIO. Peripheral blood macrophages were obtained to compare the miR‐377 and receptor activator of NF‐κB ligand (RANKL) expressions. Bone marrow macrophages (BMMs) following titanium (Ti) particle treatment and/or miR‐377 mimic transfection were used. The expressions of RANKL, pro‐inflammatory cytokines interleukin 6 (IL‐6) and tumor necrosis factor‐α (TNF‐α) and the osteoclast‐related molecules tartrate‐resistant acid phosphatase (TRAP) and cathepsin K (CTSK) were determined using real‐time polymerase chain reaction or western blotting or enzyme‐linked immunosorbent assay or TRAP staining, when appropriate. The interaction between miR‐377 and RANKL was assessed by luciferase reporter assay. The in vivo role of miR‐377 in PIO was evaluated using a mouse calvarial osteolysis model. There were significant differences in downregulated miR‐377 expression between the different numbers of particles in the joint prostheses. The Ti particle treatment increased pro‐inflammatory cytokine levels, downregulated RANKL and increased osteoclast activity in BMMs, while miR‐377 overexpression led to the opposite effect. Taken together, miR‐377 downregulated the target gene RANKL, resulting in PIO inhibition. MiR‐377 relieved PIO by negatively regulating RANKL.

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Survival of Hydroxy Apatite-Coated Cups: Acetabular Screws Involve a Lower Rate of Revision Surgery due to Aseptic Loosening

Abstract: In THA with the stem and cup HA-coated, the use of acetabular screws is associated with a lower rate of revision surgery.

Cited by 8 publications

References 46 publications

Changes in acetabular component alignment due to screw fixation in patients with hip dysplasia

Changes in acetabular component alignment due to screw fixation in patients with hip dysplasia

How to Prevent Aseptic Loosening in Cementless Arthroplasty: A Review

MiR‐377 inhibits wear particle‐induced osteolysis via targeting RANKL

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