Abstract
BackgroundAseptic loosening is one of the greatest problems in hip replacement surgery. The rotation center of the hip is believed to influence the longevity of fixation. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique.MethodsWe retrospectively compared pre- and post-operative positions of the hip rotation center in 25 and 68 patients who underwent artificial hip replacements in our department in 2007 using cemented or cementless cup fixation, respectively, with digital radiographic image analysis.ResultsThe mean horizontal and vertical distances between the rotation center and the acetabular teardrop were compared in radiographic images taken pre- and post-operatively. The mean horizontal difference was −2.63 mm (range: -11.00 mm to 10.46 mm, standard deviation 4.23 mm) for patients who underwent cementless fixation, and −2.84 mm (range: -10.87 to 5.30 mm, standard deviation 4.59 mm) for patients who underwent cemented fixation. The mean vertical difference was 0.60 mm (range: -20.15 mm to 10.00 mm, standard deviation 3.93 mm) and 0.41 mm (range: -9.26 mm to 6.54 mm, standard deviation 3.58 mm) for the cementless and cemented fixation groups, respectively. The two fixation techniques had no significant difference on the position of the hip rotation center in the 93 patients in this study.ConclusionsThe hip rotation center was similarly restored using either the cemented or cementless fixation techniques in this patient cohort, indicating that the fixation technique itself does not interfere with the position of the center of rotation. To completely answer this question further studies with more patients are needed.
Highlights
Artificial hip replacement has become one of the standard procedures in orthopedic surgery, with a history of more than 100 years
In 1988, Yoder et al documented that a superior, lateral position of the rotation center of the artificial cup leads to higher loosening rates than an anatomical position
Sexton et al showed that high acetabular component inclination, high femoral offset and lateralization of the hip center resulted in increased mechanical forces across the hip joint and shortened standing time [11]
Summary
Artificial hip replacement has become one of the standard procedures in orthopedic surgery, with a history of more than 100 years. In 1988, Yoder et al documented that a superior, lateral position of the rotation center of the artificial cup leads to higher loosening rates than an anatomical position [9]. All patients included in these two studies had cemented hip prostheses. Both authors concluded that the correct position of cup and stem is of great importance for implant durability and survival. Others have reported that the position of the hip rotation center influences the range of motion, dislocation rate and loosening rate of artificial joints [12,13,14]. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique
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