Is there evidence for a superior method of socket fixation in hip arthroplasty? A systematic review

Pakvis, D.F.M.; Hellemondt, Gijs van; Visser, Enrico de; Jacobs, Wilco C. H.; Spruit, Maarten

doi:10.1007/s00264-011-1234-6

Cited by 36 publications

(30 citation statements)

References 51 publications

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“…Two recent systematic reviews [33,34] comparing cemented and uncemented THA addressed acetabular fixation types in a broader perspective than our review. Pakvis and van Hellemondt reviewed both the clinical and radiological outcome and postulated that the surgeon should choose an established cemented or uncemented acetabular component based on patient characteristics, knowledge, experience and preference [33].…”

Section: Discussionmentioning

confidence: 99%

“…Pakvis and van Hellemondt reviewed both the clinical and radiological outcome and postulated that the surgeon should choose an established cemented or uncemented acetabular component based on patient characteristics, knowledge, experience and preference [33]. However, Clement and Biant concluded that cemented acetabular fixation may be the gold standard in total hip arthroplasty, based primarily on the lower overall re-operation risk for cemented fixation [34].…”

Section: Discussionmentioning

confidence: 99%

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Is there evidence for accelerated polyethylene wear in uncemented compared to cemented acetabular components? A systematic review of the literature

Veen

Jonbergen

Poolman

et al. 2012

International Orthopaedics (SICOT)

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Joint arthroplasty registries show an increased rate of aseptic loosening in uncemented acetabular components as compared to cemented acetabular components. Since loosening is associated with particulate wear debris, we postulated that uncemented acetabular components demonstrate a higher polyethylene wear rate than cemented acetabular components in total hip arthroplasty. We performed a systematic review of the peer-reviewed literature, comparing the wear rate in uncemented and cemented acetabular components in total hip arthroplasty. Studies were identified using MEDLINE (PubMed), EMBASE and the Cochrane Central Register of Controlled Trials. Study quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The search resulted in 425 papers. After excluding duplicates and selection based on title and abstracts, nine studies were found eligible for further analysis: two randomised controlled trials, and seven observational studies. One randomised controlled trial found a higher polyethylene wear rate in uncemented acetabular components, while the other found no differences. Three out of seven observational studies showed a higher polyethylene wear in uncemented acetabular component fixation; the other four studies did not show any differences in wear rates. The available evidence suggests that a higher annual wear rate may be encountered in uncemented acetabular components as compared to cemented components.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is there evidence for accelerated polyethylene wear in uncemented compared to cemented acetabular components? A systematic review of the literature

Veen

Jonbergen

Poolman

et al. 2012

International Orthopaedics (SICOT)

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“…However, in a systematic review of the literature conducted by Pakvis et al [28], the authors concluded that there is no evidence for the superiority of either cemented or uncemented acetabular component fixation.…”

Section: Introductionmentioning

confidence: 99%

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

Halma

Charles

Dhert

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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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.

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“…Secondly, we aimed to assess whether there is any association between the reoperation of the THA with Balgrist cup and a set of patient-, surgery-, and implant-related factors. Thirdly, we believe that a report on the long-term outcomes related to a particular uncemented THA could contribute to a current discussion on which fixation for THA [3,17].…”

Section: Introductionmentioning

confidence: 99%

Long-term survival of the uncemented Balgrist total hip replacement cup

Gallo

Lošťák

Langová

2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate the longterm clinical and radiographic outcomes of the Balgrist total hip replacement cup. Methods We report the results of a retrospective review of 195 total hip prostheses with Balgrist cup implanted in 178 patients. There were 59 men and 119 women with a mean age at surgery of 52.3 years (range, 19-72). Cox regression was used to determine the influence of independent variables on the survivorship of the prosthesis. Results There were 117 (66 %) of 178 patients, and 131 (67 %) of 195 hips available for assessment at a mean follow-up of 17.4 years. A total of 21 patients (22 hips) were lost from follow-up (12 %). A total of 25 patients (27 hips) required some type of re-operation during the follow-up period. Eight of 27 re-operations (30 %) were directly caused by the Balgrist cup failure due to fatigue fracture of the metallic shell (n=5; 19 %), polyethylene wear (n=2; 7 %) and aseptic loosening (n=1; 4 %). The mean polyethylene wear rate was 0.068 mm/year (range, 0.008-0.230; SD=0.043). The risk of re-operation for any reason was decreased with dysplastic hip as a primary diagnosis (hazard ratio; HR=0.250; 95 % CI 0.086-0.725) and with greater age at the time of surgery (HR =0.923; 95 % CI 0.880-0.969). The 19-year survivorship with re-operation for any reason was 75.6 % (95 % CI 67.0-84.2). The 19-year survivorship with re-operation for the Balgrist cup failure was 90.5 % (95 % CI 83.4-97.6).Conclusions The Balgrist cup continues to provide excellent clinical and radiological outcomes. This is associated at least in part with a low polyethylene wear rate. The main reason for the Balgrist cup failure is fatigue fracture of the metallic shell.

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Is there evidence for a superior method of socket fixation in hip arthroplasty? A systematic review

Abstract: We recommend that an orthopaedic surgeon should choose an established cemented or cementless socket for hip replacement based on patient characteristics, knowledge, experience and preference.

Cited by 36 publications

References 51 publications

Is there evidence for accelerated polyethylene wear in uncemented compared to cemented acetabular components? A systematic review of the literature

Is there evidence for accelerated polyethylene wear in uncemented compared to cemented acetabular components? A systematic review of the literature

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

Long-term survival of the uncemented Balgrist total hip replacement cup

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