This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the activities for this article:
 Adult Hip Reconstruction Test 9: Topics of Interest in Hip Arthroplasty
Adult Hip Reconstruction Test 8: Total Hip Arthroplasty Results
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Valle, A. G. D.
Right arrow Articles by Salvati, E. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Valle, A. G. D.
Right arrow Articles by Salvati, E. A.
Related Collections
Right arrow Adult Hip
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?
The Journal of Bone and Joint Surgery (American) 86:1998-2003 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

Clinical and Radiographic Results Associated with a Modern, Cementless Modular Cup Design in Total Hip Arthroplasty

Alejandro González Della Valle, MD1, Adriana Zoppi, MD2, Margaret G.E. Peterson, PhD1 and Eduardo A. Salvati, MD1

1 The Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. E-mail address for E.A. Salvati: salvatie{at}hss.edu
2 Department of Orthopaedics, Civil Hospital of Velletri-RMH, Rome, Italy

Investigation performed at the Hospital for Special Surgery, New York, NY

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from Zimmer. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: First-generation cementless modular cups reproducibly achieved fixation to bone but were associated with unacceptable rates of pelvic osteolysis and mechanical failure. Consequently, second-generation cups were developed with shells that had a limited number of holes (or no holes) as well as improved locking mechanisms, a polished inner surface, and increased conformity with the liner. The purpose of the present study was to evaluate the clinical and radiographic results associated with the use of a second-generation acetabular component for primary total hip arthroplasty.

Methods: Two hundred and ninety-seven patients underwent 335 consecutive primary total hip arthroplasties that were performed by a single surgeon with a second-generation modular acetabular component. All cups were implanted with a press-fit technique. Ten patients were lost to follow-up, and sixteen died from unrelated causes. The remaining 271 patients (308 hips) were followed clinically (with the Hospital for Special Surgery hip-scoring system) and radiographically for four to seven years.

Results: One cup was revised because of aseptic loosening. There were seven additional revisions: five were performed because of aseptic loosening of the stem with a well-fixed cup, and two were performed because of deep infection. Among the 271 patients who were alive at the time of the last follow-up, 266 (98%) had retention of the cup and 264 (97%) had retention of both components with a good or excellent clinical result. In the group of 229 patients (262 hips) with complete radiographic follow-up, 259 cups were well fixed and the average wear rate (for the 246 hips for which this rate could be calculated) was 0.09 mm/yr. Osteolysis was detected in twelve hips (5%) and was associated with male gender (p = 0.001) and the annual wear rate (p = 0.004). The extent of calcar resorption was also associated with the annual wear rate (p < 0.001).

Conclusions: This second-generation acetabular cup design predictably achieved bone fixation and was associated with low rates of revision for loosening and osteolysis after intermediate-term follow-up.

Level of Evidence: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 J Bone Joint Surg BrHome page
R. Raman, R. P. Kamath, A. Parikh, and P. D. Angus
Revision of cemented hip arthroplasty using a hydroxyapatite-ceramic-coated femoral component
J Bone Joint Surg Br, August 1, 2005; 87-B(8): 1061 - 1067.
[Abstract] [Full Text] [PDF]