The Journal of Bone and Joint Surgery, Vol 76, Issue 2 185-194, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Migration of acetabular components, inserted with and without cement, in one-stage bilateral hip arthroplasty. A controlled, randomized study using roentgenstereophotogrammetric analysis
I Onsten, AS Carlsson, A Ohlin and JA Nilsson
Department of Orthopaedics, Malmo General Hospital, Lund University, Sweden.
Twenty-one patients who had primary osteoarthrosis were managed with a
bilateral total hip arthroplasty with insertion of a Charnley femoral
component. In each patient, one hip was randomly allocated to have a
Harris-Galante acetabular component inserted without cement, and the
contralateral hip was treated with an all-polyethylene Charnley acetabular
component fixed with cement. The clinical result was satisfactory in all
patients. All forty-two hips were followed, with respect to migration of
the acetabular component, with use of roentgenstereophotogrammetric
analysis for a median of twenty-seven months (range, twenty-three to
forty-nine months). Each patient served as his or her own control. Maximum
migration in any direction was 1.7 and 2.1 millimeters, and maximum
rotation was 2.2 and 2.0 degrees for the Harris-Galante and Charnley
acetabular components, respectively. There was no significant difference in
migration between the two designs of acetabular components (p = 0.98, p =
0.75, and p = 0.06 for the transverse, longitudinal, and sagittal axes,
respectively). However, the Harris-Galante acetabular components rotated
significantly more than the Charnley acetabular components around two of
the three axes (p = 0.008, p = 0.08, and p = 0.03 for the transverse,
longitudinal, and sagittal axes, respectively). The Charnley hip implant
has been used clinically for a long time, with successful results.
Comparison of new designs of implants with the Charnley prosthesis is
therefore important. Roentgenstereophotogrammetric analysis provides a
potential for detection of problems with fixation at an early stage rather
than after long-term follow-up. No major difference in terms of skeletal
fixation was found between the two designs of components after short to
medium-term follow-up.