To cement or not to cement acetabular cups in total hip arthroplasty: a systematic review and re-evaluation

Praet, Frank Van; Mulier, Michiel

doi:10.1051/sicotj/2019032

Cited by 18 publications

(11 citation statements)

References 43 publications

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“…To the best of our knowledge, a study that supports the superiority in survival of uncemented acetabular components over cemented components has not previously been reported in the literature. Therefore, at present, there is a lack of sufficient evidence for superior survivorship of cementless acetabular components [ 29 ]. Current clinical studies show a wide range of heterogeneity regarding patient characteristics, materials, and bearing surfaces used, and also a wide range of study designs.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Risk of Wear on Cemented and Uncemented Polyethylene Liners According to Different Variables in Hip Arthroplasty

Bravo¹

2021

Materials

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Wear debris in total hip arthroplasty is one of the main causes of loosening and failure, and the optimal acetabular fixation for primary total hip arthroplasty is still controversial because there is no significant difference between cemented and uncemented types for long-term clinical and functional outcome. To assess and predict, from a theoretical viewpoint, the risk of wear with two types of polyethylene liners, cemented and uncemented, a simulation using the finite element (FE) method was carried out. The risk of wear was analyzed according to different variables: the polyethylene acetabular component’s position with respect to the center of rotation of the hip; the thickness of the polyethylene insert; the material of the femoral head; and the relationship of the cervical–diaphyseal morphology of the proximal end of the femur to the restoration of the femoral offset. In all 72 simulations studied, a difference was observed in favour of a cemented solution with respect to the risk of wear. With regard to the other variables, the acetabular fixation, the thickness of the polyethylene, and the acetabular component positioning were statistically significant. The highest values for the risk of wear corresponded to a smaller thickness (5.3 mm), and super-lateral positioning at 25 mm reached the highest value of the von Mises stress. According to our results, for the reconstruction of the acetabular side, a cemented insert with a thickness of at least 5 mm should be used at the center of rotation.

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Section: Discussionmentioning

confidence: 99%

Analysis of the Risk of Wear on Cemented and Uncemented Polyethylene Liners According to Different Variables in Hip Arthroplasty

Bravo¹

2021

Materials

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“…In this situation, if we had fixed with an uncemented cup, it would have had a significantly higher chance of failure due to poor bone quality and less bony growth. Van Praet F and Mulier [ 9 ] showed the 15-year survivorship of cemented acetabular cup fixation in young and old individuals.…”

Section: Discussionmentioning

confidence: 99%

Primary Complex Total Hip Arthroplasty in Neglected Anterior Hip Dislocation With Comminuted Pertrochanteric Femur Fracture

Singh¹,

Kumar²,

Singh³

et al. 2021

Arthroplasty Today

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Neglected anterior hip dislocation combined with comminuted pertrochanteric ipsilateral fracture of the femur is rare, with few reports in the literature. The present report describes the case of a 7-month-old neglected anterior hip dislocation with a pertrochanteric femoral fracture in a 45-year-old male patient. The patient was treated with total hip arthroplasty with proximal femoral reconstruction. The 2-year follow-up showed good clinical and radiological outcomes with a painless and mobile hip joint. The Harris-Hip score improved from 10 (preoperatively) to 89 (postoperatively) after 2 years. The patient was satisfied with the intervention and showed minimal lurch with ambulation with no leg-length discrepancy. However, long-term results from periodic follow-up are warranted.

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“…This is now up to nearly 35% in 2018 and is set to continue to rise 61 . Despite its increase in popularity, hybrid THA has a reduced implant survival and increased risk of infection compared with cemented THA 62,63 . Cost of treatment is another dimension that needs to be considered in this discussion.…”

Section: Discussionmentioning

confidence: 99%

“…61 Despite its increase in popularity, hybrid THA has a reduced implant survival and increased risk of infection compared with cemented THA. 62,63 Cost of treatment is another dimension that needs to be considered in this discussion. CEA studies were conducted to determine which method has the greatest cost utility.…”

Section: Ta B L E 2 (Continued)mentioning

confidence: 99%

Cost effectiveness analyses of total hip arthroplasty for hip osteoarthritis: A PRISMA systematic review

Agarwal

Khan

2020

Int J Clin Pract

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Background Healthcare services are facing economic constraints globally with an increasingly elderly population, and greater burdens of osteoarthritis. Because of the chronic nature of osteoarthritis and the costs associated with surgery, arthroplasty is seen as potentially cost saving. There have been no systematic reviews conducted on cost effectiveness analysis (CEA) studies of total hip arthroplasty (THA) in the management of osteoarthritis. The aim of this systematic review was to evaluate CEAs conducted on THA for osteoarthritis to determine if THA is a cost‐effective intervention. Materials and methods A systematic review was conducted using five databases to identify all clinical CEAs of THA for osteoarthritis conducted after 1 January 1997. Twenty‐eight studies were identified that met the inclusion criteria. The Quality of Health Economic Analysis (QHES) checklist was employed to assess the quality of the studies. Results The average QHES score was 86 indicating high quality studies. All studies reviewed concluded that THA was a cost‐effective intervention. In younger patients, cementless THA and ceramic on polyethylene implants were found to be most cost effective. Hybrid THA and metal on polyethylene implants had the greatest cost utility in older patients. In patients with acetabular defects, cemented cup with impaction bone grafting was most cost effective, while dual mobility THA was most cost effective in patients with high risk of dislocation. Conclusion We have shown that THA is a cost‐effective treatment for hip osteoarthritis. These findings should be implemented into clinical practice to improve cost utility in health services across the world.

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To cement or not to cement acetabular cups in total hip arthroplasty: a systematic review and re-evaluation

Cited by 18 publications

References 43 publications

Analysis of the Risk of Wear on Cemented and Uncemented Polyethylene Liners According to Different Variables in Hip Arthroplasty

Analysis of the Risk of Wear on Cemented and Uncemented Polyethylene Liners According to Different Variables in Hip Arthroplasty

Primary Complex Total Hip Arthroplasty in Neglected Anterior Hip Dislocation With Comminuted Pertrochanteric Femur Fracture

Cost effectiveness analyses of total hip arthroplasty for hip osteoarthritis: A PRISMA systematic review

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