What factors predict ceramic liner malseating after ceramic-on-ceramic total hip arthroplasty?
Adult
Aged
Arthroplasty, Replacement, Hip
/ adverse effects
Ceramics
Female
Hip Joint
/ physiopathology
Hip Prosthesis
/ adverse effects
Humans
Male
Middle Aged
Osteoarthritis, Hip
/ physiopathology
Prosthesis Design
Prosthesis Failure
Radiography
Range of Motion, Articular
/ physiology
Retrospective Studies
Risk Factors
Young Adult
Ceramic liner with a metal-back titanium sleeve
Ceramic on ceramic bearings
Liner malseating
Risk factor
Total hip arthroplasty
Journal
Orthopaedics & traumatology, surgery & research : OTSR
ISSN: 1877-0568
Titre abrégé: Orthop Traumatol Surg Res
Pays: France
ID NLM: 101494830
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
16
07
2018
revised:
07
01
2019
accepted:
14
01
2019
pubmed:
12
3
2019
medline:
3
3
2020
entrez:
12
3
2019
Statut:
ppublish
Résumé
There is a lack of evidence about the risk factors associated with the malseating of the acetabular liner after ceramic-on-ceramic (CoC) total hip arthroplasty (THA). Therefore, we performed a complementary retrospective case-control study to determine the factors predicting the malseating of the acetabular liner after CoC THA and to evaluate the relationship between malseating and (1) osteoarthritis, (2) particularly in terms of the new radiographic parameter "bone sclerotic length" of the acetabular bone. Osteoarthritis, particularly bone sclerotic length, was an independent risk factor for malseating of ceramic liners. In total, 219 CoC THAs (174 women and 45 men) were evaluated to determine the risk factors influencing the malseating of the acetabular ceramic liner. An average patient age at the time of surgery was 55.9±9.5 years (range, 23 to 75 years). Data on patient background and preoperative radiographs, such as Tönnis grades; Crowe classification; and indices of acetabular osteoarthritis change; including bone cyst, osteophyte and bone sclerosis, were assessed. The bone sclerotic length in patients with osteoarthritis was measured as the slant distance between the bilateral edges of the sclerosis lesion of the acetabulum on the anteroposterior view. Preoperative less hip flexion (hazard ratio [HR]: 0.98; 95% CI: 0.97-0.99), osteoarthritis (HR: 3.15; 95% CI: 1.02-9.70) and the bone sclerotic length (HR: 1.83; 95% CI: 1.35-2.48) were independent risk factors determining the malseating of ceramic liners. Receiver operating characteristic curve analysis showed that a bone sclerotic length of 24.6mm was defined as the cut-off point for the malseating of the ceramic liner. Age, preoperative less flextion, osteoarthritis, and the bone sclerotic were independent risk factors determining malseating of ceramic liners. The acetabular shell can also deform upon insertion of the cup with sclerotic bone of the acetabulum and prevent correct seating of liners. Therefore, these factors must be taken into consideration when seating the ceramic liner. Case control study III, case control retrospective design.
Sections du résumé
BACKGROUND
There is a lack of evidence about the risk factors associated with the malseating of the acetabular liner after ceramic-on-ceramic (CoC) total hip arthroplasty (THA). Therefore, we performed a complementary retrospective case-control study to determine the factors predicting the malseating of the acetabular liner after CoC THA and to evaluate the relationship between malseating and (1) osteoarthritis, (2) particularly in terms of the new radiographic parameter "bone sclerotic length" of the acetabular bone.
HYPOTHESIS
Osteoarthritis, particularly bone sclerotic length, was an independent risk factor for malseating of ceramic liners.
PATIENTS AND METHODS
In total, 219 CoC THAs (174 women and 45 men) were evaluated to determine the risk factors influencing the malseating of the acetabular ceramic liner. An average patient age at the time of surgery was 55.9±9.5 years (range, 23 to 75 years). Data on patient background and preoperative radiographs, such as Tönnis grades; Crowe classification; and indices of acetabular osteoarthritis change; including bone cyst, osteophyte and bone sclerosis, were assessed. The bone sclerotic length in patients with osteoarthritis was measured as the slant distance between the bilateral edges of the sclerosis lesion of the acetabulum on the anteroposterior view.
RESULTS
Preoperative less hip flexion (hazard ratio [HR]: 0.98; 95% CI: 0.97-0.99), osteoarthritis (HR: 3.15; 95% CI: 1.02-9.70) and the bone sclerotic length (HR: 1.83; 95% CI: 1.35-2.48) were independent risk factors determining the malseating of ceramic liners. Receiver operating characteristic curve analysis showed that a bone sclerotic length of 24.6mm was defined as the cut-off point for the malseating of the ceramic liner.
DISCUSSION
Age, preoperative less flextion, osteoarthritis, and the bone sclerotic were independent risk factors determining malseating of ceramic liners. The acetabular shell can also deform upon insertion of the cup with sclerotic bone of the acetabulum and prevent correct seating of liners. Therefore, these factors must be taken into consideration when seating the ceramic liner.
LEVEL OF EVIDENCE
Case control study III, case control retrospective design.
Identifiants
pubmed: 30853457
pii: S1877-0568(19)30056-8
doi: 10.1016/j.otsr.2019.01.009
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
453-459Informations de copyright
Copyright © 2019 Elsevier Masson SAS. All rights reserved.