Abstract
Introduction One of the most common causes of revision hip arthroplasty is aseptic instability of the primary implant. The acetabular component of the implant is less stable, even if fixed with bone cement. Two merits of cemented replacement are important for practical activity of an orthopaediс surgeon: its need for elderly patients and its low cost. In this regard, it is important to predict aseptic instability of the acetabular component and increase its survival by improving the methods of cemented fixation. Purpose To develop a method of predicting the probability of revision hip arthroplasty with replacement of the acetabular component. Materials and methods We studied 102 patients who underwent total cemented hip arthroplasty. Six clinical and radiological criteria were identified associated with revision after 10 years using a multifactorial pathometric analysis. Results A system was developed that allows integral calculation of the probability of revision hip arthroplasty with replacement of only the acetabulum component. The retrospective analysis confirmed the prognosis in 83.3 % of clinical cases. Conclusion The method proposed for prediction allows for a differentiated approach to cemented fixation of the acetabular component in primary arthroplasty, minimizing the probability of revision in 10 years.
Highlights
One of the most common causes of revision hip arthroplasty is aseptic instability of the primary implant
It was established that the higher the II value, the less was probability of revision arthroplasty, regardless of the variant of the primary cemented reinforcement of the acetabular component
The smaller was the II value, the greater was the likelihood of revision intervention. In both cases, the likelihood of revision was the least in patients of the third group, which testified to the significant clinical significance of the option to fix the acetabular component applied in them, two-stage pressurization with the preliminary formation of only two blind holes in the roof of the acetabulum
Summary
One of the most common causes of revision hip arthroplasty is aseptic instability of the primary implant. Two merits of cemented replacement are important for practical activity of an orthopaediс surgeon: its need for elderly patients and its low cost. In this regard, it is important to predict aseptic instability of the acetabular component and increase its survival by improving the methods of cemented fixation. Purpose To develop a method of predicting the probability of revision hip arthroplasty with replacement of the acetabular component. Its aseptic loosening occurs one and a half to two times more often than of the femoral one [6, 7] It refers to both cementless and cemented types of fixation, despite the continuous improvement of the technical qualities of implants and methods of their installation in both types of arthroplasty [8–11]. At the same time, cemented arthroplasty is more attractive due to its lower cost and the possibility of early mobilization, which is important for elderly patients [12].
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