Abstract
BackgroundPress-fit cementless acetabular cup is widely used in total hip arthroplasty (THA). However, the use of additional screws for the acetabular cup has been extensively debated. The purpose of this review is to compare the stability, revision rate, wear rate, and clinical scores of cementless acetabular cups with and without screws in THA.Materials and MethodsComprehensive literature searches of the following databases were performed: Cochrane Library, Pubmed, Web of Science, OVID, Elsevier ClinicalKey, Clinicaltrials.gov, and EMBASE. We searched for trials that compared cementless acetabular cups with screws or without screws, and were published in the English language. We evaluated the stability of the prosthesis by osteolysis and migration. The clinical scores included Harris hip scores (HHS) and pain scores.ResultsNineteen articles involving 4046 THAs met the inclusion criteria. Our analysis revealed that additional screws did not increase the stability of acetabular cups, and there was no statistical significance between the groups with and without screws in osteolysis and clinically relevant migration. Revision rates showed no significant difference between the groups with and without screws. There was no difference in wear between the two groups. Our analysis showed no difference in pain scores and HHS between groups.ConclusionPress-fit without screws could achieve sufficient acetabular cup stability. Acetabular cups without screws showed no difference from acetabular cups with screws in many outcomes. Additional screws are not required for cementless acetabular cups.Level of evidence: Level III.
Highlights
Total hip arthroplasty (THA) is an effective and commonly used treatment for various pathological hip conditions
Our analysis revealed that additional screws did not increase the stability of acetabular cups, and there was no statistical significance between the groups with and without screws in osteolysis and clinically relevant migration
Our analysis showed no difference in pain scores and Harris hip scores (HHS) between groups
Summary
Total hip arthroplasty (THA) is an effective and commonly used treatment for various pathological hip conditions. The cementless acetabular cup, which is fixed by press-fit, is widely used in THAs [1]. Their study revealed no significant differences in osteolysis, prosthesis loosening, or revision rates with or without the addition of screws. This was the first evidence-based study in this field and after being published, this matter received wide attention from peers and more relevant clinical studies were published [4, 7,8,9,10,11]. Press-fit cementless acetabular cup is widely used in total hip arthroplasty (THA). The purpose of this review is to compare the stability, revision rate, wear rate, and clinical scores of cementless acetabular cups with and without screws in THA
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