Highly Porous Tantalum Acetabular Components Without Ancillary Screws Have Similar Migration to Porous Titanium Acetabular Components With Screws at 2 Years: A Randomized Controlled Trial
Autor: | Lucian B. Solomon, Donald W. Howie, Thomas S. Robertson, O T Holubowycz, Stuart A. Callary |
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Rok vydání: | 2020 |
Předmět: |
Adult
Reoperation Arthroplasty Replacement Hip Bone Screws Tantalum chemistry.chemical_element Dentistry Prosthesis Design law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Highly porous Humans Medicine Orthopedics and Sports Medicine Porous titanium Titanium 030222 orthopedics business.industry Acetabulum Middle Aged Prosthesis Failure chemistry Acetabular component Hip Prosthesis business Porosity Follow-Up Studies Total hip arthroplasty |
Zdroj: | The Journal of Arthroplasty. 35:2931-2937 |
ISSN: | 0883-5403 |
DOI: | 10.1016/j.arth.2020.05.049 |
Popis: | It is proposed that highly porous coatings on acetabular components, such as a porous tantalum coating, provide adequate fixation without ancillary screw fixation in primary total hip arthroplasty (THA). However, tantalum acetabular components have been associated with higher rates of revision than other uncemented components in national registries. The aim of this randomized controlled trial is to determine whether the early migration of a solid-backed tantalum acetabular component was no greater than that of a titanium acetabular component with ancillary screw fixation that has proven good clinical results.Sixty-six patients aged 40 to 64 years, with osteoarthritis and Charnley grade A or B activity grade and who underwent primary THA, were recruited into the trial. Patients were randomized intraoperatively to receive either the tantalum or titanium acetabular component. All patients received the same cemented polished tapered femoral stem, 28-mm cobalt-chromium femoral head, and highly cross-linked polyethylene liner. Acetabular component migration was measured using radiostereometric analysis at 4-6 days postoperatively and at 6 weeks, 3 months, 1 and 2 years following THA.The mean proximal migration at 2 years for the tantalum cohort was 0.17 mm (95% confidence interval, 0.09-0.24) which was no greater than that of the titanium cohort which was 0.19 mm (0.07-0.32). Harris hip scores and functional activity scores were similar between groups.These results demonstrate that early stability can be achieved without ancillary screw fixation through the use of a highly porous high friction coating on a solid-backed modular acetabular component.Level I. |
Databáze: | OpenAIRE |
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