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Cemented polyethylene cups in patients younger than 40 years.

de Kam DC, Gardeniers JW, Hendriks JC, Veth RP, Schreurs BW - Clin. Orthop. Relat. Res. (2009)

Bottom Line: The minimum followup was 2 years (average, 8.1 years; range, 2.0-18.5 years).Reasons for revision were infection (one early, seven late), recurrent dislocations (two), traumatic loosening (one), and aseptic loosening (10).Level III, therapeutic study.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery 357, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.

ABSTRACT

Unlabelled: Although uncemented cup implants frequently are used in young patients, we believe long-term survival rates of cups in these patients are somewhat disappointing, and therefore we have continued to use cemented cups in primary THA, even in young patients. However, in cases of acetabular bone stock defects, we also use bone impaction grafting. We prospectively followed 130 patients with 175 cemented cups; no patients were lost to followup. The mean age of the patients at surgery was 31 years (range, 16-39 years). An acetabular reconstruction with bone impaction grafting was performed in 84 hips (48%). The minimum followup was 2 years (average, 8.1 years; range, 2.0-18.5 years). Twenty-one of the 175 cups (12%) were revised at an average of 8.1 years (range, 2.0-18.5 years). Reasons for revision were infection (one early, seven late), recurrent dislocations (two), traumatic loosening (one), and aseptic loosening (10). The 10-year survival rate of all cemented cups with end point of revision for any cause was 85%. Survival with end point of aseptic loosening of all cups was 92%. Survival with end point of revision for aseptic loosening was 90% for the cups without impaction grafting and 95% for the cups with impaction grafting. We believe cemented acetabular cups in young patients have acceptable midterm survival; however, in the case of acetabular bone defects, we recommend reconstruction with impaction grafting.

Level of evidence: Level III, therapeutic study.

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Related in: MedlinePlus

Kaplan-Meier survival curves with 95% confidence intervals (broken lines) of all cups with end points of (A) revision for any reason and (B) revision for aseptic loosening are shown. The vertical bars indicate the censored data points.
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Fig2: Kaplan-Meier survival curves with 95% confidence intervals (broken lines) of all cups with end points of (A) revision for any reason and (B) revision for aseptic loosening are shown. The vertical bars indicate the censored data points.

Mentions: There were no differences in survival after 10 years between the groups with and without bone impaction grafting (Table 6). The midterm survival rates of all cemented polyethylene cups varied from 85% to 92% at 10 years with four end points (Table 6; Figs. 2, 3). Cup survival with an end point of radiographic loosening was 89% (95% confidence interval, 83%–95%).Table 6


Cemented polyethylene cups in patients younger than 40 years.

de Kam DC, Gardeniers JW, Hendriks JC, Veth RP, Schreurs BW - Clin. Orthop. Relat. Res. (2009)

Kaplan-Meier survival curves with 95% confidence intervals (broken lines) of all cups with end points of (A) revision for any reason and (B) revision for aseptic loosening are shown. The vertical bars indicate the censored data points.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2690764&req=5

Fig2: Kaplan-Meier survival curves with 95% confidence intervals (broken lines) of all cups with end points of (A) revision for any reason and (B) revision for aseptic loosening are shown. The vertical bars indicate the censored data points.
Mentions: There were no differences in survival after 10 years between the groups with and without bone impaction grafting (Table 6). The midterm survival rates of all cemented polyethylene cups varied from 85% to 92% at 10 years with four end points (Table 6; Figs. 2, 3). Cup survival with an end point of radiographic loosening was 89% (95% confidence interval, 83%–95%).Table 6

Bottom Line: The minimum followup was 2 years (average, 8.1 years; range, 2.0-18.5 years).Reasons for revision were infection (one early, seven late), recurrent dislocations (two), traumatic loosening (one), and aseptic loosening (10).Level III, therapeutic study.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery 357, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.

ABSTRACT

Unlabelled: Although uncemented cup implants frequently are used in young patients, we believe long-term survival rates of cups in these patients are somewhat disappointing, and therefore we have continued to use cemented cups in primary THA, even in young patients. However, in cases of acetabular bone stock defects, we also use bone impaction grafting. We prospectively followed 130 patients with 175 cemented cups; no patients were lost to followup. The mean age of the patients at surgery was 31 years (range, 16-39 years). An acetabular reconstruction with bone impaction grafting was performed in 84 hips (48%). The minimum followup was 2 years (average, 8.1 years; range, 2.0-18.5 years). Twenty-one of the 175 cups (12%) were revised at an average of 8.1 years (range, 2.0-18.5 years). Reasons for revision were infection (one early, seven late), recurrent dislocations (two), traumatic loosening (one), and aseptic loosening (10). The 10-year survival rate of all cemented cups with end point of revision for any cause was 85%. Survival with end point of aseptic loosening of all cups was 92%. Survival with end point of revision for aseptic loosening was 90% for the cups without impaction grafting and 95% for the cups with impaction grafting. We believe cemented acetabular cups in young patients have acceptable midterm survival; however, in the case of acetabular bone defects, we recommend reconstruction with impaction grafting.

Level of evidence: Level III, therapeutic study.

Show MeSH
Related in: MedlinePlus