Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density: A 2-year RSA and 8-year radiographic follow-up study of 34 patients
Background and purpose — Low bone mineral density (BMD) may jeopardize the initial component stability and delay osseointegration of uncemented acetabular cups in total hip arthroplasty (THA). We measured the migration of uncemented cups in women with low or normal BMD. Patients and methods — We use...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2016-01-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.3109/17453674.2015.1115312 |
| _version_ | 1818319543787847680 |
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| author | Sami Finnilä Niko Moritz Erkki SvedströM Jessica J Alm Hannu T Aro |
| author_facet | Sami Finnilä Niko Moritz Erkki SvedströM Jessica J Alm Hannu T Aro |
| author_sort | Sami Finnilä |
| collection | DOAJ |
| description | Background and purpose — Low bone mineral density (BMD) may jeopardize the initial component stability and delay osseointegration of uncemented acetabular cups in total hip arthroplasty (THA). We measured the migration of uncemented cups in women with low or normal BMD. Patients and methods — We used radiostereometric analysis (RSA) to measure the migration of hydroxyapatite-coated titanium alloy cups with alumina-on-alumina bearings in THA of 34 female patients with a median age of 64 (41–78) years. 10 patients had normal BMD and 24 patients had low systemic BMD (T-score ≤ −1) based on dual-energy X-ray absorptiometry (DXA). Cup migration was followed with RSA for 2 years. Radiographic follow-up was done at a median of 8 (2–10) years. Results — Patients with normal BMD did not show a statistically significant cup migration after the settling period of 3 months, while patients with low BMD had a continuous proximal migration between 3 and 12 months (p = 0.03). These differences in cup migration persisted at 24 months. Based on the perceived risk of cup revision, 14 of the 24 cases were “at risk” (proximal translation of 0.2 to 1.0 mm) in the low-BMD group and 2 of the10 cases were “at risk” in the normal-BMD group (odds ratio (OR) = 8.0, 95% CI: 1.3–48). The radiographic follow-up showed no radiolucent lines or osteolysis. 2 cups have been revised for fractures of the ceramic bearings, but none for loosening. Interpretation — Low BMD contributed to cup migration beyond the settling period of 3 months, but the migrating cups appeared to osseointegrate eventually. |
| first_indexed | 2024-12-13T10:10:47Z |
| format | Article |
| id | doaj.art-8903833e6af94b6ca0bb0134aa3d59c8 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-12-13T10:10:47Z |
| publishDate | 2016-01-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-8903833e6af94b6ca0bb0134aa3d59c82022-12-21T23:51:27ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822016-01-01871485410.3109/17453674.2015.11153121115312Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density: A 2-year RSA and 8-year radiographic follow-up study of 34 patientsSami Finnilä0Niko Moritz1Erkki SvedströM2Jessica J Alm3Hannu T Aro4Turku University Hospital and University of TurkuTurku University Hospital and University of TurkuTurku University HospitalTurku University Hospital and University of TurkuTurku University Hospital and University of TurkuBackground and purpose — Low bone mineral density (BMD) may jeopardize the initial component stability and delay osseointegration of uncemented acetabular cups in total hip arthroplasty (THA). We measured the migration of uncemented cups in women with low or normal BMD. Patients and methods — We used radiostereometric analysis (RSA) to measure the migration of hydroxyapatite-coated titanium alloy cups with alumina-on-alumina bearings in THA of 34 female patients with a median age of 64 (41–78) years. 10 patients had normal BMD and 24 patients had low systemic BMD (T-score ≤ −1) based on dual-energy X-ray absorptiometry (DXA). Cup migration was followed with RSA for 2 years. Radiographic follow-up was done at a median of 8 (2–10) years. Results — Patients with normal BMD did not show a statistically significant cup migration after the settling period of 3 months, while patients with low BMD had a continuous proximal migration between 3 and 12 months (p = 0.03). These differences in cup migration persisted at 24 months. Based on the perceived risk of cup revision, 14 of the 24 cases were “at risk” (proximal translation of 0.2 to 1.0 mm) in the low-BMD group and 2 of the10 cases were “at risk” in the normal-BMD group (odds ratio (OR) = 8.0, 95% CI: 1.3–48). The radiographic follow-up showed no radiolucent lines or osteolysis. 2 cups have been revised for fractures of the ceramic bearings, but none for loosening. Interpretation — Low BMD contributed to cup migration beyond the settling period of 3 months, but the migrating cups appeared to osseointegrate eventually.http://dx.doi.org/10.3109/17453674.2015.1115312 |
| spellingShingle | Sami Finnilä Niko Moritz Erkki SvedströM Jessica J Alm Hannu T Aro Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density: A 2-year RSA and 8-year radiographic follow-up study of 34 patients Acta Orthopaedica |
| title | Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density: A 2-year RSA and 8-year radiographic follow-up study of 34 patients |
| title_full | Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density: A 2-year RSA and 8-year radiographic follow-up study of 34 patients |
| title_fullStr | Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density: A 2-year RSA and 8-year radiographic follow-up study of 34 patients |
| title_full_unstemmed | Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density: A 2-year RSA and 8-year radiographic follow-up study of 34 patients |
| title_short | Increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density: A 2-year RSA and 8-year radiographic follow-up study of 34 patients |
| title_sort | increased migration of uncemented acetabular cups in female total hip arthroplasty patients with low systemic bone mineral density a 2 year rsa and 8 year radiographic follow up study of 34 patients |
| url | http://dx.doi.org/10.3109/17453674.2015.1115312 |
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