| Ceramic-on-ceramic Bearing Decreases the Cumulative Long-term Risk of Dislocation. | |
| | |
MedLine Citation:
|
PMID: 23423622 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: It is unclear whether late THA dislocations are related to mechanical impingement or to a biological mechanism that decreases the stability provided by the capsule (eg, inflammation secondary to osteolysis). It is also unknown if alumina-on-alumina bearing couples decrease the risk of late dislocation as a result of the absence of wear and osteolysis. QUESTION/PURPOSES: We asked (1) whether the cumulative number of dislocations differed with alumina-on-alumina (AL/AL) or alumina-on-polyethylene bearings (AL/PE); (2) whether patient factors (age, sex, and diseases) affect risk of late dislocation; (3) whether mechanical factors (component malposition, penetration resulting from creep and wear) or (4) biologic hip factors at revision (thickness of the capsule, volume of joint fluid removed at surgery, histology) differed with the two bearing couples. METHODS: One hundred twenty-six patients (252 hips) with bilateral THA (one AL/AL and the contralateral AL/PE) received the same cemented implants except for the cup PE cup or an AL cup. The cumulative risk of dislocation (first-time and recurrent dislocation) was calculated at a minimum of 27 years. We measured cup position, creep and wear, and capsular thickness in the hips that had revision. RESULTS: AL/PE and AL/AL hips differed by the cumulative number of dislocation (31 with AL/PE versus four with AL/AL) and by the number of late dislocations (none with AL/AL, 28 with AL/PE). Cause of osteonecrosis, age, and sex affected the number of dislocations. The frequency of component malposition did not differ between the two bearing couples. The risk of late dislocation appeared less in AL/AL hips with increased capsular thickness (mean, 4.5 mm; range, 3-7 mm) compared with the thinnest (mean, 1.2 mm; range, 0.2-2 mm) capsule of AL/PE hips. CONCLUSIONS: AL/AL bearing couples decreased the cumulative risk of dislocation as compared with AL/PE bearing couples. LEVEL OF EVIDENCE: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence. |
| | |
Authors:
|
Philippe Hernigou; Yasuhiro Homma; Olivier Pidet; Isaac Guissou; Jacques Hernigou |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2013-2-20 |
Journal Detail:
|
Title: Clinical orthopaedics and related research Volume: - ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2013 Feb |
Date Detail:
|
Created Date: 2013-2-20 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Department of Orthopaedic Surgery, University Paris East (UPEC), Hôpital Henri Mondor, 94010, Creteil, France, philippe.hernigou@wanadoo.fr. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Treatment Solutions Are Unclear for Perimegaprosthetic Infections.
Next Document: Acetabular Liner With Focal Constraint to Prevent Dislocation After THA.