Risk factors for a radiolucent line around the acetabular component with an interface bioactive bone cement technique after primary cemented total hip arthroplasty: Prognostic factors for a radiolucent line and improvement of the cement-bone interface around cemented acetabular component with an interface bioactive bone cement technique
Aims: The main aims were to identify risk factors predictive of a radiolucent line (RLL) around the acetabular component with an interface bioactive bone cement (IBBC) technique in the first year after THA, and evaluate whether these risk factors influence the development of RLLs at five and ten yea...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2021-05-01
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| Series: | Bone & Joint Open |
| Subjects: | |
| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.25.BJO-2021-0010.R1 |
| _version_ | 1819295361104084992 |
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| author | Shuichi Miyamoto Satoshi Iida Chiho Suzuki Takushi Nakatani Yuya Kawarai Junichi Nakamura Sumihisa Orita Seiji Ohtori |
| author_facet | Shuichi Miyamoto Satoshi Iida Chiho Suzuki Takushi Nakatani Yuya Kawarai Junichi Nakamura Sumihisa Orita Seiji Ohtori |
| author_sort | Shuichi Miyamoto |
| collection | DOAJ |
| description | Aims: The main aims were to identify risk factors predictive of a radiolucent line (RLL) around the acetabular component with an interface bioactive bone cement (IBBC) technique in the first year after THA, and evaluate whether these risk factors influence the development of RLLs at five and ten years after THA. Methods: A retrospective review was undertaken of 980 primary cemented THAs in 876 patients using cemented acetabular components with the IBBC technique. The outcome variable was any RLLs that could be observed around the acetabular component at the first year after THA. Univariate analyses with univariate logistic regression and multivariate analyses with exact logistic regression were performed to identify risk factors for any RLLs based on radiological classification of hip osteoarthritis. Results: RLLs were detected in 27.2% of patients one year postoperatively. In multivariate regression analysis controlling for confounders, atrophic osteoarthritis (odds ratio (OR) 2.17 (95% confidence interval (CI), 1.04 to 4.49); p = 0.038) and 26 mm (OR 3.23 (95% CI 1.85 to 5.66); p < 0.001) or 28 mm head diameter (OR 3.64 (95% CI 2.07 to 6.41); p < 0.001) had a significantly greater risk for any RLLs one year after surgery. Structural bone graft (OR 0.19 (95% CI 0.13 to 0.29) p < 0.001) and location of the hip centre within the true acetabular region (OR 0.15 (95% CI 0.09 to 0.24); p < 0.001) were significantly less prognostic. Improvement of the cement-bone interface including complete disappearance and poorly defined RLLs was identified in 15.1% of patients. Kaplan-Meier survival analysis for the acetabular component at ten years with revision of the acetabular component for aseptic loosening as the end point was 100.0% with a RLL and 99.1% without a RLL (95% CI 97.9 to 100). With revision of the acetabular component for any reason as the end point, the survival rate was 99.2% with a RLL (95% CI 97.6 to 100) and 96.5% without a RLL (95% CI 93.4 to 99.7). Conclusion: This study demonstrates that acetabular bone quality, head diameter, structural bone graft, and hip centre position may influence the presence of the any RLL. |
| first_indexed | 2024-12-24T04:40:59Z |
| format | Article |
| id | doaj.art-657a6cb4c3db4fc5ae097c93ebbc099d |
| institution | Directory Open Access Journal |
| issn | 2633-1462 |
| language | English |
| last_indexed | 2024-12-24T04:40:59Z |
| publishDate | 2021-05-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj.art-657a6cb4c3db4fc5ae097c93ebbc099d2022-12-21T17:14:49ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622021-05-012527829210.1302/2633-1462.25.BJO-2021-0010.R1Risk factors for a radiolucent line around the acetabular component with an interface bioactive bone cement technique after primary cemented total hip arthroplasty: Prognostic factors for a radiolucent line and improvement of the cement-bone interface around cemented acetabular component with an interface bioactive bone cement techniqueShuichi Miyamoto0Satoshi Iida1Chiho Suzuki2Takushi Nakatani3Yuya Kawarai4Junichi Nakamura5Sumihisa Orita6Seiji Ohtori7Department of Orthopaedic Surgery, Matsudo City General Hospital, Matsudo City, JapanDepartment of Orthopaedic Surgery, Matsudo City General Hospital, Matsudo City, JapanDepartment of Orthopaedic Surgery, Matsudo City General Hospital, Matsudo City, JapanDepartment of Orthopaedic Surgery, Matsudo City General Hospital, Matsudo City, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Orthopaedic Surgery, Chiba University, Chiba, JapanDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, JapanAims: The main aims were to identify risk factors predictive of a radiolucent line (RLL) around the acetabular component with an interface bioactive bone cement (IBBC) technique in the first year after THA, and evaluate whether these risk factors influence the development of RLLs at five and ten years after THA. Methods: A retrospective review was undertaken of 980 primary cemented THAs in 876 patients using cemented acetabular components with the IBBC technique. The outcome variable was any RLLs that could be observed around the acetabular component at the first year after THA. Univariate analyses with univariate logistic regression and multivariate analyses with exact logistic regression were performed to identify risk factors for any RLLs based on radiological classification of hip osteoarthritis. Results: RLLs were detected in 27.2% of patients one year postoperatively. In multivariate regression analysis controlling for confounders, atrophic osteoarthritis (odds ratio (OR) 2.17 (95% confidence interval (CI), 1.04 to 4.49); p = 0.038) and 26 mm (OR 3.23 (95% CI 1.85 to 5.66); p < 0.001) or 28 mm head diameter (OR 3.64 (95% CI 2.07 to 6.41); p < 0.001) had a significantly greater risk for any RLLs one year after surgery. Structural bone graft (OR 0.19 (95% CI 0.13 to 0.29) p < 0.001) and location of the hip centre within the true acetabular region (OR 0.15 (95% CI 0.09 to 0.24); p < 0.001) were significantly less prognostic. Improvement of the cement-bone interface including complete disappearance and poorly defined RLLs was identified in 15.1% of patients. Kaplan-Meier survival analysis for the acetabular component at ten years with revision of the acetabular component for aseptic loosening as the end point was 100.0% with a RLL and 99.1% without a RLL (95% CI 97.9 to 100). With revision of the acetabular component for any reason as the end point, the survival rate was 99.2% with a RLL (95% CI 97.6 to 100) and 96.5% without a RLL (95% CI 93.4 to 99.7). Conclusion: This study demonstrates that acetabular bone quality, head diameter, structural bone graft, and hip centre position may influence the presence of the any RLL.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.25.BJO-2021-0010.R1total hip arthroplastycement-bone interfaceacetabular componentcementedinterface bioactive bone cement techniquehydroxyapatite |
| spellingShingle | Shuichi Miyamoto Satoshi Iida Chiho Suzuki Takushi Nakatani Yuya Kawarai Junichi Nakamura Sumihisa Orita Seiji Ohtori Risk factors for a radiolucent line around the acetabular component with an interface bioactive bone cement technique after primary cemented total hip arthroplasty: Prognostic factors for a radiolucent line and improvement of the cement-bone interface around cemented acetabular component with an interface bioactive bone cement technique Bone & Joint Open total hip arthroplasty cement-bone interface acetabular component cemented interface bioactive bone cement technique hydroxyapatite |
| title | Risk factors for a radiolucent line around the acetabular component with an interface bioactive bone cement technique after primary cemented total hip arthroplasty: Prognostic factors for a radiolucent line and improvement of the cement-bone interface around cemented acetabular component with an interface bioactive bone cement technique |
| title_full | Risk factors for a radiolucent line around the acetabular component with an interface bioactive bone cement technique after primary cemented total hip arthroplasty: Prognostic factors for a radiolucent line and improvement of the cement-bone interface around cemented acetabular component with an interface bioactive bone cement technique |
| title_fullStr | Risk factors for a radiolucent line around the acetabular component with an interface bioactive bone cement technique after primary cemented total hip arthroplasty: Prognostic factors for a radiolucent line and improvement of the cement-bone interface around cemented acetabular component with an interface bioactive bone cement technique |
| title_full_unstemmed | Risk factors for a radiolucent line around the acetabular component with an interface bioactive bone cement technique after primary cemented total hip arthroplasty: Prognostic factors for a radiolucent line and improvement of the cement-bone interface around cemented acetabular component with an interface bioactive bone cement technique |
| title_short | Risk factors for a radiolucent line around the acetabular component with an interface bioactive bone cement technique after primary cemented total hip arthroplasty: Prognostic factors for a radiolucent line and improvement of the cement-bone interface around cemented acetabular component with an interface bioactive bone cement technique |
| title_sort | risk factors for a radiolucent line around the acetabular component with an interface bioactive bone cement technique after primary cemented total hip arthroplasty prognostic factors for a radiolucent line and improvement of the cement bone interface around cemented acetabular component with an interface bioactive bone cement technique |
| topic | total hip arthroplasty cement-bone interface acetabular component cemented interface bioactive bone cement technique hydroxyapatite |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.25.BJO-2021-0010.R1 |
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