Eight- to Ten-Year Clinical and Radiographic Outcome of a Porous Tantalum Monoblock Acetabular Component

Background Aseptic osteolysis has been the single most important factor limiting the longevity of a THA. A great deal of attention has been focused on the development of implants and materials that minimize the development of osteolysis. The monoblock porous tantalum acetabular cup was designed to minimize osteolysis, but whether it does so is unclear. Questions/purposes We evaluated the incidence of osteolytic lesions after THA using a monoblock porous tantalum acetabular component. Methods We retrospectively reviewed 51 patients who had a THA using a monoblock porous tantalum acetabular cup. At a minimum of 9.6 years postoperatively (average, 10.3 years; SD, 0.2 years; range, 9.6-10.8 years), a helical CT scan of the pelvis using a metal suppression protocol was obtained. This scan was evaluated for the presence of osteolysis.

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Monoblock Porous Tantalum Acetabular Cup Has No Osteolysis on CT at 10 Years

Moen

Ghate²,

Salaz

et al. 2011

“…Therefore, it is not feasible to draw conclusions on the difference in frequency of osteolysis between monoblock and modular cups. Moreover, substantially different rates of osteolysis were reported on different monoblock cups in noncomparative case series, ranging from 0% to 15% reported for monoblock cups with 10 to 20 years of followup [4,7,9,11,12,21,24,27]. As noted earlier, the different designs and material properties of monoblock cups from different brands could be confounding factors, having different degrees of radiodensity, different mechanical properties, and different ways of osseointergration (osseous in-or ongrowth).…”

Section: Discussionmentioning

confidence: 97%

“…The Swedish Hip Arthroplasty Register Annual Report 2010 indicates that the 10-year survival of all uncemented implants is 97.7% with revision for aseptic loosening as the end point [33]. Long-term results from uncontrolled (noncomparative) case series that have been published on several monoblock cups of the current generation (ie, the titanium-coated RM cup, the Morscher cup, and the Trabecular Metal cup) show a 10-year survival for aseptic loosening within the range or higher than the survival reported in the Swedish Hip Arthroplasty Register [4,7,9,11,12,14,21,24,27,33]. Those studies represent the potentially good clinical results with the use monoblock cups in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Do Monoblock Cups Improve Survivorship, Decrease Wear, or Reduce Osteolysis in Uncemented Total Hip Arthroplasty?

Halma

Charles

Dhert

et al. 2013

Background Monoblock acetabular components used in uncemented total hip arthroplasty (THA) have certain mechanical characteristics that potentially reduce acetabular osteolysis and polyethylene wear. However, the degree to which they achieve this goal is not well documented. Questions/purposes The purpose of this study was to use a systematic review of controlled trials to test the hypothesis that monoblock cups have superior (1) polyethylene wear rate; (2) frequency of cup migration; (3) frequency of acetabular osteolysis; and (4) frequency of aseptic loosening compared with modular components used in uncemented THA.Methods A systematic search was conducted in the Medline, Embase, and Cochrane electronic databases to assemble all controlled trials comparing monoblock with modular uncemented acetabular components in primary THA. Included studies were considered ''best evidence'' if the quality score was either C 50% on the Cochrane Back Review Group checklist or C 75% the Newcastle-Ottawa quality assessment scale. A total of seven publications met our inclusion criteria. Results Best evidence analysis showed no difference in polyethylene wear rate, the frequency of cup migration, and aseptic loosening between monoblock and modular acetabular components. No convincing evidence was found for the claim that lower frequencies of acetabular osteolysis are observed with the use of monoblock cups compared with modular uncemented cups. Conclusions The purported benefits of monoblock cups were not substantiated by this systematic review of controlled studies in that polyethylene wear rates and frequencies of cup failure and acetabular osteolysis were similar to those observed with modular implants. Other factors should therefore drive implant selection in cementless THA. Level of Evidence Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

“…With similar clinical outcomes at 5-years minimum followup, comparable metal ion concentrations, and 7-year survivorship, there is no reason to abstain from using the 3.5-mm thick acetabular component. Excellent results of ultraporous trabecular-like acetabular component backing (made of titanium or tantalum) have been reported [7,20] for conventional THAs and open the way for additional improvement of cementless fixation of hip resurfacing devices.…”

Section: Discussionmentioning

confidence: 99%

Acetabular Component Thickness Does Not Affect Mid-term Clinical Results in Hip Resurfacing

Al-Hamad

Duff

Takamura

et al. 2014

Background The benefits of using thin acetabular components for hip resurfacing have been shown in terms of bone conservation, but there currently are little data available in the literature addressing the mid-term clinical results of these devices. Questions/purposes We aimed to determine whether thinner acetabular components altered mid-term postoperative clinical scores, complication rates, survivorship, radiographic appearance, and metal ion levels. Methods Two hundred eighty-one patients with unilateral disease received a 5-mm thick acetabular shell and 223 received a 3.5-mm shell. The femoral component implanted in both groups was identical. We compared clinical scores, complication rates, survivorship, radiographic results, and ion levels between these two groups. Results UCLA hip scores were similar (pain, p = 0.0976; walking, p = 0.9571; function, p = 0.9316; activity, p = 0.2085). Complications were higher in the 5-mm group (6.4% versus 1.8%, p = 0.0431). Both groups were similar regarding survivorship (p = 0.3181), cup radiolucency at 5 years (p = 0.107), and metal ion levels (cobalt p = 0.404, chromium p = 0.250). Conclusions With comparable mid-term clinical results,