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題名 | Results of Revision Total Hip Arthroplasty with Cementless Cups with Different Coating= |
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作者 | Cheng, Yen-wen; Chen, Wei-ming; Chen, Cheng-fong; Chiang, Chao-ching; Huang, Ching-kuei; Liu, Chien-lin; Chen, Tain-hsiung; |
期刊 | Formosan Journal of Musculoskeletal Disorders |
出版日期 | 20120800 |
卷期 | 3:3 2012.08[民101.08] |
頁次 | 頁83-87 |
分類號 | 416.61 |
語文 | eng |
關鍵詞 | Aseptic loosening; Fiber-metal-coated cups; Hydroxyapatite-coated cup; Porous-coated cup; Revision total hip arthroplasty; |
英文摘要 | Background/Purpose Revision total hip arthroplasty has become more and more challenging in recent years due to the lengthened lifespan of the patients and greater number of revision total hip surgeries. The hydroxyapatite (HA)-coated cup was reported to reduce the radiolucent line after total hip arthroplasty. However, it was also reported that HA particles increased the risk of polyethylene (PE) liner wear, resulting in osteolysis. Therefore, we wanted to know which cup coating would result in a lower loosening rate and better longevity after revision total hip surgery. Methods We reviewed a series of revision total hip arthroplasties in our department from 2000 to 2009. A total of 321 patients underwent 374 revision hip arthroplasties with cup replacement. Cases of revision total hip arthroplasty with cup revision caused by aseptic loosening were included in our study. In all, 148 cases fulfilled our criteria and were enrolled into our study. Revision due to aseptic loosening after prior revision surgery was defined as [[lifespan of revision implant??]]<comment>Compuscript: This appears to be a comment left from Elsevier. </comment>. We checked the revision rate and implant longevity of HA-coated TRIDENT (Stryker, Mahwah, NJ, USA), porous-coated DURALOC (Depuy, Warsaw, IN, USA) and fiber-metal–coated TRILOGY (Zimmer, Warsaw, IN, USA) cups after revision hip arthroplasty. Results Of the 148 cases, 73 were revised with HA-coated, 32 with porous-coated and 43 with fiber-metal–coated cups. Fiber-metal coating, to a significant extent, had the highest incidence rate and shortest implant survival of the three groups. In terms of high degrees of pre-operative acetabular defects, HA-coating and porous coating preserved more bone stock than fiber-metal coating. Conclusion HA-coated implants were regarded as beneficial to bone ingrowth after hip arthroplasty, especially with regard to the cup and stem components. Porous-coated cups had similar results. Fiber-metal–coated cups had a significantly higher loosening rate and lower implant survival, especially with large pre-operative acetabular bone defects with Paprosky classifications IIIA and IIIB. Revision total hip arthroplasty with HA-coated or porous-coated cup components revealed better results, greater longevity, and a low incidence of repeated revision, especially in cases with large bone defects. |
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