Male gender, Charnley class C, and severity of bone defects predict the risk for aseptic loosening in the cup of ABG I hip arthroplasty

Abstract

BackgroundWe studied which factor could predict aseptic loosening in ABG I hip prosthesis with hydroxyapatite coating. Aseptic loosening and periprosthetic osteolysis are believed to be caused, at least in part, by increased polyethylene (PE) wear rate via particle disease. Based on it, increased PE wear rate should be associated with aseptic loosening regardless of the type of implant.MethodsWe analyzed data from 155 revisions of ABG I hip prostheses to examine the influence of patient, implant, surgery, and wear related factors on the rate of aseptic loosening at the site of the cup. This was calculated by stepwise logistic regression analysis. The stability of the implant and severity of bone defects were evaluated intraoperatively.ResultsWe found that men (odds ratio, OR = 5.6; p = 0.004), patients with Charnley class C (OR = 6.71; p = 0.013), those having more severe acetabular bone defects (OR = 4 for each degree of severity; p = 0.002), and longer time to revision surgery (OR = 1.51 for each additional year; p = 0.012) had a greater chance of aseptic loosening of the cup. However, aseptic loosening was not directly predicted by polyethylene wear rate in our patients.ConclusionSeverity of bone defects predicts the risk for aseptic loosening in ABG I cup. Factors potentially associated with the quality of bone bed and biomechanics of the hip might influence on the risk of aseptic loosening in this implant.

Facteurs prédictifs de descellement aseptique des prothèses totales cimentées de la hanche

“…Le sexe: Plusieurs études ont étudié l’influence du sexe sur la survie des prothèses totales de hanche [ 14 – 17 ]. Le sexe masculin est incriminé dans le descellement précoce de deux façons: Les hommes sont généralement plus lourds et plus actifs que les femmes du même âge [ 18 ].…”

Untitled

“…However, there is still insufficient evidence regarding the long term outcomes of this technique, as well as the overall cost implications of using navigational tools. Therefore, more research is needed to support these findings (Beckmann et al, 2009) 59,60,61 .…”

Review of periprosthetic osteolysis in total joint arthroplasty: An emphasis on host factors and future directions

“…49 Having a Charnley classification rating of C (multiple joints affected with arthritis) as well as possessing more pronounced acetabular boney defects each yield a higher risk for developing aseptic loosening of the cup. 50 The revelation that global joint involvement of arthritis predisposes an individual to develop periprosthetic osteolysis confounds the already complex understanding of the pathogenesis behind aseptic loosening by implicating inflammatory cascades outside the multiple currently accepted pathways. Immune modulators that have previously been implicated in an individual's susceptibility of chronic arthritis, such as IL-17 which increases the expression of synoviolin, an E3 ubiquitin ligase that has been identified due to its principal involvement in the pathogenesis of arthritis, may also play a pivotal role in one's predisposition to aseptic loosening.…”