The Morscher Press Fit acetabular component

Gwynne‐Jones, David; Garneti, N.; Wainwright, Chris; Matheson, J.A.; King, Richard J.

doi:10.1302/0301-620x.91b7.22013

Cited by 18 publications

(13 citation statements)

References 43 publications

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“…In that study, no radiolucencies were seen around the cups, whereas osteolytic defects were found around 8% of the stems investigated. Similarly encouraging results were described after a minimum of 9 years follow-up of 125 THAs using the Morscher cup, where none of the cups were revised because of aseptic loosening or osteolysis, and 3 were revised for other reasons (Gwynne-Jones et al 2009). Berli et al (2007) reported the 15-year results of 280 hips implanted with the Morscher cup, quoting a survival of 98% for aseptic loosening and 95% overall.…”

Section: Discussionsupporting

confidence: 55%

Survival of uncemented acetabular monoblock cups

Weiss¹,

Hailer²,

Stark³

et al. 2012

Acta Orthopaedica

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Background and purposeMonoblock acetabular cups represent a subtype of uncemented cups with the polyethylene liner molded into a metal shell, thus eliminating—or at least minimizing—potential backside wear. We hypothesized that the use of monoâ€‹block cups could reduce the incidence of osteolysis and aseptic loosening, and thus improve survival compared to modular designs.Patients and methodsWe identified all 210 primary total hip arthroplasty (THA) procedures in the Swedish Hip Arthroplasty Register that used uncemented monoblock cups during the period 1999–2010. Kaplan-Meier and Cox regression analyses with adjustment for age, sex, and other variables were used to calculate survival rates and adjusted hazard ratios (HRs) of the revision risk for any reason. 1,130 modular cups, inserted during the same time period, were used as a control group.ResultsThere was a nearly equal sex distribution in both groups. Median age at the index operation was 47 years in the monoblock group and 56 years in the control group (p < 0.001). The cumulative 5-year survival with any revision as the endpoint was 95% (95% CI: 91–98) for monoblock cups and 97% (CI: 96–98) for modular cups (p = 0.6). The adjusted HR for revision of monoblock cups compared to modular cups was 2 (CI: 0.8–6; p = 0.1). The use of 28-mm prosthesis heads rather than 22-mm heads reduced the risk of cup revision (HR = 0.2, CI: 0.1–0.5; p = 0.001).InterpretationBoth cups showed good medium-term survival rates. There was no statistically significant difference in revision risk between the cup designs. Further review of the current patient population is warranted to determine the long-term durability and risk of revision of monoblock cup designs.

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Section: Discussionsupporting

confidence: 55%

Survival of uncemented acetabular monoblock cups

Weiss¹,

Hailer²,

Stark³

et al. 2012

Acta Orthopaedica

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“…As for many other contemporary designs and articulations, mostly medium-term results are available for monobloc cups (Hinrichs et al 2001, Unger et al 2005, Malizos et al 2008, Gwynne-Jones et al 2009). However, problems due to osteolysis and wear rarely result in revision surgery until 6–8 years have elapsed; thus, optimistic reports on the survival of monobloc cups must be regarded with some caution.…”

Section: Discussionmentioning

confidence: 99%

“…Even today, the focus is on the articulating surfaces and materials with the hope that recent technology will solve these problems. Numerous uncemented implants with different appearances have indeed shown excellent results in small or medium-sized cohorts (Badhe et al 2002, Gabbar et al 2008, Reigstad et al 2008, Aldinger et al 2009, Gwynne-Jones et al 2009), in contrast to older designs with unacceptable failure rates (Puolakka et al 1999, Thanner et al 1999, Lai et al 2002). …”

Section: Introductionmentioning

confidence: 99%

Uncemented and cemented primary total hip arthroplasty in the Swedish Hip Arthroplasty Register

2010

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Background and purposeSince the introduction of total hip arthroplasty (THA) in Sweden, both components have most commonly been cemented. A decade ago the frequency of uncemented fixation started to increase, and this change in practice has continued. We therefore analyzed implant survival of cemented and uncemented THA, and whether the modes of failure differ between the two methods of fixation.Patients and methodsAll patients registered in the Swedish Hip Arthroplasty Register between 1992 and 2007 who received either totally cemented or totally uncemented THA were identified (n = 170,413). Kaplan-Meier survival analysis with revision of any component, and for any reason, as the endpoints was performed. Cox regression models were used to calculate risk ratios (RRs) for revision for various reasons, adjusted for sex, age, and primary diagnosis.ResultsRevision-free 10-year survival of uncemented THA was lower than that of cemented THA (85% vs. 94%, p < 0.001). No age or diagnosis groups benefited from the use of uncemented fixation. Cox regression analysis confirmed that uncemented THA had a higher risk of revision for any reason (RR = 1.5, 95% CI: 1.4–1.6) and for aseptic loosening (RR = 1.5, CI: 1.3–1.6). Uncemented cup components had a higher risk of cup revision due to aseptic loosening (RR = 1.8, CI: 1.6–2.0), whereas uncemented stem components had a lower risk of stem revision due to aseptic loosening (RR = 0.4, CI: 0.3–0.5) when compared to cemented components. Uncemented stems were more frequently revised due to periprosthetic fracture during the first 2 postoperative years than cemented stems (RR = 8, CI: 5–14). The 5 most common uncemented cups had no increased risk of revision for any reason when compared with the 5 most commonly used cemented cups (RR = 0.9, CI: 0.6–1.1). There was no significant difference in the risk of revision due to infection between cemented and uncemented THA.InterpretationSurvival of uncemented THA is inferior to that of cemented THA, and this appears to be mainly related to poorer performance of uncemented cups. Uncemented stems perform better than cemented stems; however, unrecognized intraoperative femoral fractures may be an important reason for early failure of uncemented stems. The risk of revision of the most common uncemented cup designs is similar to that of cemented cups, indicating that some of the problems with uncemented cup fixation may have been solved.

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“…Finally, osteolysis around the acetabulum was intentionally not addressed in this study for two reasons. One, it was systematically looked for and not found in a single patient, and two, osteolysis has rarely been reported with the use of the Morscher cup 31–33…”

Section: Discussionmentioning

confidence: 99%

Statins may reduce femoral osteolysis in patients with total Hip arthroplasty

Lübbeke

Garavaglia

Rothman

et al. 2012

Journal Orthopaedic Research

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ABSTRACT:In experimental studies, statin use has been associated with reduction of osteoclastic activity and promotion of bone formation around implants. Moreover, a large clinical study recently reported a substantially reduced risk of revision for aseptic loosening among statin users with THA. Our objective was to evaluate the influence of statin use on the development of femoral osteolysis within 5 years after THA. We conducted a case-cohort study including all THAs presenting with femoral osteolysis at the 5 year visit (cases) and compared them with those without osteolysis (controls). Cases and controls were identified from a cohort of primary THAs operated between 2001 and 2005. Seven hundred thirty-five THAs were included, mean age 68 years. Five years after surgery osteolysis had developed around the femoral component of 40 THAs (5.4%). Ever-use of statins was much less frequent among cases (5 of 40, 12.5%) than among controls (199 of 695, 28.6%). The crude risk ratio of femoral osteolysis among statin users was 0.36 (95% CI 0.14; 0.92). After adjusting for age, sex, activity level, BMI, diagnosis, bearing surface, and type of stem, the adjusted risk ratio was 0.38 (95% CI 0.15; 0.99). In conclusion, statin use was associated with a reduced risk of developing femoral osteolysis 5 years after THA. Statins may be useful for reducing the risk of implant failure following THA. ß

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The Morscher Press Fit acetabular component

Cited by 18 publications

References 43 publications

Survival of uncemented acetabular monoblock cups

Survival of uncemented acetabular monoblock cups

Uncemented and cemented primary total hip arthroplasty in the Swedish Hip Arthroplasty Register

Statins may reduce femoral osteolysis in patients with total Hip arthroplasty

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