Abstract
Studies over the past decade have reported that the use of highly porous sockets in total hip arthroplasty (THA) results in osseointegration and long-term implant stability. However, some reports have raised concerns regarding radiographic evidence of poor osseointegration with features of fibrous tissue ingrowth. The purpose of this study was to compare clinical and radiographic assessments of highly porous sockets with those of hydroxyapatite (HA)-coated porous sockets in THA for hip dysplasia (DDH) at least 1 year after surgery. A total of 127 patients (136 hips) were recruited for the study. Of these, 94 patients (101 hips) received highly porous sockets with clustered screws, while 33 patients (35 hips) received HA-coated porous sockets with clustered screws. There was no difference in clinical outcomes between the two types of sockets. All HA-coated porous sockets were radiographically stable, without radiolucent lines. Fifteen hips had radiolucent lines in two or three DeLee and Charnley zones, accompanied by sclerotic lines along the circumferences of the highly porous sockets. A significant difference in the height of the preoperative osteophyte of the anterior acetabular wall was observed between 86 hips with one or no radiolucent lines and 15 hips with two or three radiolucent lines. In cases of DDH with atrophic bone remodeling pattern, highly porous sockets with multiple screws may be used, while HA-coated porous sockets with clustered screws result in better sealing of the bone–component interface.
Highlights
Failed total hip arthroplasties (THAs) pose greater clinical and economic burdens than do failed total knee arthroplasties [1]
We performed a retrospective study comparing the intermediate-term with short-term clinical and radiographic outcomes of developmental dysplasia of the hip (DDH) treated with THA using either highly porous sockets or HA-coated porous sockets
No differences between the highly porous sockets and the HA-coated porous sockets were observed in terms of clinical outcomes
Summary
Failed total hip arthroplasties (THAs) pose greater clinical and economic burdens than do failed total knee arthroplasties [1]. Aseptic loosening of the acetabular component is one of the most common causes of THA failure [2]. Polyethylene wear leading to periacetabular osteolysis and failed initial stability of the acetabular component are major sources of concern in primary THA, and are caused by aseptic loosening of cementless acetabular components. It was recently shown that highly cross-linked polyethylene may be associated with reduced wear, osteolysis, and revision rates. Acetabular components using metal implants with highly porous surfaces were developed to increase surface area for tissue ingrowth and to increase the surface roughness of the component [6]. Porous metal acetabular sockets have been introduced and have reportedly led to osseointegration in primary and revision hip arthroplasty as well as immediate and long-term implant stability [7].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
