Ceramic-Ceramic Bearing Decreases Osteolysis: A 20-year Study versus Ceramic-Polyethylene on the Contralateral Hip

Yoo

et al. 2012

Background THA in patients younger than 30 years presents challenges because of uncertainties regarding the long-term survivorship of prostheses. Alumina-on-alumina bearings, which exhibit little long-term wear, may be a reasonable option but the long-term survivorship is unknown. Questions/Purposes We determined (1) the survival rate of alumina-on-alumina bearings in patients younger than 30 years after a 10-year followup, (2) the incidence of audible hip clicking and squeaking, (3) radiographic evidence of osteolysis, and (4) the effects on pregnancy, childbirth, and career choice. Methods We retrospectively reviewed 62 patients who had 75 THAs with alumina-on-alumina bearings followed more than 10 years (average, 11.5; range, 10-13.5 years). Mean patient age at the time of surgery was 24 years (range, 18-30 years). All operations were performed using the same cementless implant at a single center. We determined survival, presence of osteolysis, and function (Harris hip score, WOMAC).

Section: Discussionmentioning

confidence: 80%

Alumina-on-alumina THA Performed in Patients Younger Than 30 Years: A 10-year Minimum Followup Study

Yoo

et al. 2012

“…Osteolytic lesions around femoral component worsen over time [10], although the rate is highly variable. Patients with a THA that requires cup revision for loosening or osteolysis may have a stable stem component without loosening.…”

Section: Introductionmentioning

confidence: 99%

Alumina Heads Minimize Wear and Femoral Osteolysis Progression After Isolated Simple Acetabular Revision

Hernigou

Dupuy

Pidet

et al. 2012

Self Cite

Background Patients with THA requiring cup revision for acetabular osteolysis may have a stable stem component without loosening. However, it is unclear whether isolated cup revision halts femoral osteolysis progression. Question/purposes We asked (1) whether and to what degree osteolysis progresses after isolated acetabular revision with a change of the femoral head and (2) whether an alumina or metal bearing better reduces osteolysis progression and wear with a polyethylene (PE) cup. Methods We retrospectively evaluated 150 patients who underwent 165 acetabular revisions but no treatment for proximal femoral osteolysis in hips with stable femoral components. Mean age at revision was 63 years (range, 48-74 years). All hips received a new PE cup; 83 hips received new alumina heads and 82 new metal heads. Radiographs (mean followup, 15 years; range, 10-25 years) were assessed to measure osteolysis, loosening, and PE wear. Revisions of the femoral stem were recorded.

“…In radiographic assessment of hip arthroplasty, 2 mm is commonly used as a critical measurement of width of radiolucency [29]. Numerous authors consider linear radiolucencies greater than 2 mm a definite indication of loosening of the prosthesis [6,8,17,34]. Therefore, a grid was developed and printed on transparency film with 2 mm between each point, which was a small cross at the intersection of grid lines.…”

Section: Methodsmentioning

confidence: 99%

“…This requires more precise measurement to quantify progressive changes. The area of a lesion has been measured in numerous ways, including geometric formulae and computer software [15,17,31], but these techniques are not readily applied in routine clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Use of Morphometry to Quantify Osteolysis after Total Hip Arthroplasty

Smith

Cramp

Palmer

et al. 2010

Background Progressive osteolysis threatens the longevity of hip arthroplasties and radiographic review is recommended. Measurement of osteolytic lesions in a clinical setting has not been achieved easily in the past. Other radiologic investigations provide accurate information but cost and risk to the patient prohibit their use in routine review. Questions/purposes We developed a simple, reliable tool to be used in hip arthroplasty review to quantify osteolytic changes seen on plain film radiographs. Methods A morphometric grid was developed and tested on simulated and actual osteolytic lesions. Four health professionals measured lesions on each of two occasions. Intraclass correlation coefficients (ICC) for interobserver and intraobserver reliabilities were calculated and BlandAltman plots were constructed for graphic analysis. ResultsThe ICCs for interobserver reliability on the simulated and actual osteolytic lesions were in the range 0.90 to 0.96. The values for intraobserver (test-retest) reliability were 0.97 to 0.98. The Bland-Altman plots confirmed agreement and in each case, proximity of the mean to zero indicated no significant bias. Conclusions The data show a morphometric grid is reliable for measuring osteolytic changes after hip arthroplasty. Clinical Relevance This tool has potential to improve monitoring processes for hip arthroplasty and to be useful in future research studies. Additional work is needed to test for validity and clinical importance of the measurements obtained.