Radiostereoanalysis of Press-Fit Cups with Alumina Liner. A Randomized Clinical Trial

Abstract

The purpose of the present study was to assess the in-vivo migration of a press-fit acetabular component in total hip arthroplasty using alumina or polyethylene liners. The measurements were performed using radiostereometric analysis (RSA). Fifty patients (50 hips) with degenerative hip osteoarthritis were randomized in two groups. All received a modular press-fit cup and an alumina head. In 27 cases we used a polyethylene, in 23 an alumina liner. RSA was performed for a followup of 2 years after surgery. The mean preoperative Harris hip score was rated 48.9 points in the alumina, and 47.7 points in the polyethylene group. The mean Harris hip score after one year of the alumina group was rated 94.1 points, 93.7 points in the polyethylene group. There were no clinical and radiological signs of aseptic loosening at follow-up. Radiostereoanalysis of the alumina group of cups showed a median axial migration of 0.034 mm (max. 0.382mm). The median axial migration of the polyethylene group was 0.094 mm. The median rotational displacement was 0.03° in the alumina group, -0.07° in the polyethylene group. Overall rotational displacement ranged between -5.59° to 1.72°. Median tilting of the cup was 0.06° in the alumina group, and 0.43° in the polyethylene group. At an average of one year postoperatively, the cups inserted with an alumina liner showed limited displacement, and results did not contrast with those achieved using the same implant with a polyethylene liner.

Is a Ceramic-on-Ceramic Bearing Really Superior to Ceramic-on-Polyethylene for Primary Total Hip Arthroplasty? A Systematic Review and Meta-Analysis of Randomised Controlled Trials

“…A study flow diagram depicting the identification of the studies is shown in Figure 1. We identified a total of 1697 potential articles (450 from PubMed; 546 from Embase; 52 from CENTRAL; 631 from Web of Science; and 18 from the reference lists), of which 13 studies including a total of 2,488 THAs fulfilled the inclusion criteria for final review (9, 15-16-17, 19-20-21-22-23-24-25-26-27). The characteristics of the included studies are shown in Tables I and II.…”

“…The most commonly reported functional outcome of primary THA was the Harris Hip Score (HHS). A total of 10 studies reported the preoperative, postoperative HHS or the improvement of HHS (9, 16, 19-20-21-22-23-24, 26, 27). All of these studies had observed no significant difference in HHS between CoC and CoP THAs.…”