Abstract
PurposeThe cementless implantation of hip replacement cups may be performed with and without the additional use of acetabular screws. If the surgeon uses screws or not depends on variable factors. In general, the use of screws is intended to increase the primary stability of the cup. Whether screws increase the initial stability of the cup construct, or even reduce it in part, is the subject of considerable debate in the literature. It is also unclear whether the additional screws lead to increased wear or increased periacetabular osteolysis over the long-term course.MethodsTwo hundred eleven patients from a previous study with a minimum follow-up of 10.7 years were included. Of these, 68 patients with 82 total hip arthroplasties (THA) were given clinical and radiological follow-up examinations. Of these, 52 had been fitted without screws and 30 with screws. On the basis of radiographs, annual wear and osteolysis were quantified. The clinical results were recorded by means of VAS, HHS, and WOMAC scores.ResultsSignificantly more periacetabular osteolysis was found if additive acetabular screws had been used. No difference was found in relation to the volumetric wear per year. Likewise, no difference was found with regard to the clinical scores.ConclusionsThe use of additive acetabular screws leads to increased osteolysis in the periacetabular bone stock. Insofar as the primary stability of the cementless cup construct allows it, no additional acetabular screws should be used.
Highlights
Despite the continued excellent results of cemented acetabular cups, in most of the industrialised countries, cementless cups are implanted in the majority of cases
No significant difference between the two groups was found with regard to the positioning of the acetabular cup
Of utmost importance in cementless cup, implantation remains the achievement of high primary stability
Summary
Despite the continued excellent results of cemented acetabular cups, in most of the industrialised countries, cementless cups are implanted in the majority of cases. It is possible that polyethylene wear particles caused by backside wear may penetrate through the screw holes into the retroacetabular area and lead to osteolysis and, over the further course, to loosening [10]. The primary objective of the present study was to determine whether, over the long-term course, the additional use of acetabular screws leads to increased wear of the polyethylene liner, measured on the basis of decentring of the prosthetic head in the liner. The secondary objective was to examine whether the use of acetabular screws leads to increased periacetabular osteolysis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
