Long-term results of the threaded Weill cup in primary total hip arthroplasty

Abstract

Uncemented, threaded acetabular components with smooth surface treatment were widely used in continental Europe in the 1970s and 1980s for primary total hip arthroplasty (THA). Previously published studies showed high failure rates in the mid-term. In a consecutive series of 116 patients, 127 threaded cups with smooth surface treatment (Weill cup; Zimmer, Winterthur, Switzerland) were implanted in combination with one type of uncemented stem. Patients were followed up clinically and radiographically. Mean time of follow-up was 17 years (range [15][16][17][18][19][20]. At the time of follow-up, the acetabular component had been revised or was awaiting revision in 30 hips (24%). Two hips were revised for infection and 23 for aseptic loosening. Four polyethylene liners were exchanged because of excessive wear. One hip was awaiting revision. The survival rate for all acetabular revisions including one hip awaiting revision was 75% (95%CI: 65-85%) at 17 years. These results support the view that smooth, threaded acetabular components do not provide satisfactory long-term fixation and should be abandoned. It is important to closely monitor patients with these components as the failure rate remains high in the long-term.

The Bicontact cementless primary total hip arthroplasty: long-term results

“…There have been concerns with early polyethylene wear and osteolysis with the first generation ABG cups [5] and also the threaded Weill and the Mercon cups [6], but Philippot et al [18] demonstrated good results using the dual articulation acetabular cup with 95% survival at 18 years, which is more consistent with our study with the Bicontact cup.…”

“…The medium term results of the Bicontact total hip arthroplasty with a minimum follow-up of 6.5 years have been encouraging [4]. There are however concerns of osteolysis and loosening as a consequence of polyethylene particle wear [4][5][6] or early aseptic loosening due to reduced primary stability [1].…”

Acetabular Components in Total Hip Arthroplasty: Is There Evidence That Cementless Fixation Is Better?

“…Although initial acetabular components were cemented, cementless acetabular components have gained popularity over the years and have become the primary components of choice in North America. This is despite the availability of ample literature supporting the use of cemented acetabular components [2][3][4][5][6] and suggesting a less optimal survivorship for cementless components [7][8][9][10][11][12][13][14] . However, there is a lack of long-term studies on the improved cementless implants that may have the potential for better survivorship and durability.…”

Early Migration Predicts Aseptic Loosening of Cementless Femoral Stems: A Long-term Study

“…In addition, when compared with other migration analysis studies using EBRA-FCA [9,19,38], our dropout rate was lower. We also recognize a possible bias because the acetabular components used in this cohort showed a high rate of aseptic loosening [7,8], as patients with cup loosening might reduce their activity which could influence wear and aseptic loosening of the stem; surgery for cup loosening also might have an influence on stem revision rate. Further, the migration threshold of 2.7 mm in this study using a single stem design might not apply to other stem designs, since such thresholds are almost certainly implant-specific.…”

“…However, prediction of longterm implant performance is difficult and definitive results regarding aseptic loosening are available only after lengthy followup [24,32,33]. Widespread use of poor-performing implants might occur before these results are available [7,8]. Therefore, reliable methods are needed to predict aseptic loosening and allow early evaluation of long-term implant performance during the first years after implantation.…”