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Published on: September 7, 2022
[Long follow-up radiological assessment of the cemented hip prosthesis]
Wiesław Kaczmarek1, Przemysław Ceglarz, Jakub Kucharski
1Klinika Ortopedii i Traumatologii, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu. wika@esculap.pl
Materials And Methods:
The postoperative and last follow-up radiograms: 7 to 25 years after surgery (mean: 10.4 +/- 3.9) were evaluated in 123 patients (167 hips). The radiological evaluation was performed according to Hip Society recommendations. The position of the cup and the stem, polyethylene wear, the migration of the cup or stem, radiolucent lines and ectopic ossification were evaluated.
Results:
At last follow-up in 17 hips a prior revision was performed and further radiological assessment revealed 16 cases of prosthesis loosening. The retrospective analysis of the postoperative radiograms of 33 hips with loosening revealed radiolucent lines around the cup in de-Lee zones I, II, III respectively in 5, 2, 5 hips where in patients without loosening radiolucent lines were found in respectively 11, 4, 17 hips. The correlation between the cup or stem positioning and the rate of loosening was not significant. Fracture of the cup cement was found in 5 hips and radiolucent line around the cup cement in I, II and III zone of deLee was found respectively in 70, 26, 52 hips at last follow-up. No polyethylene wear was found in 77 hips when mean wear of 2.9 mm was found in the rest. The radiolucent line was most often detected in Gruen zones 3, 9 and 10. The ectopic ossification was found in 67% hips at last follow-up.
Conclusions:
The radiolucent line around the cup is more often detected on postoperative radiograms in patients with early cup loosening but this correlation is not so clear in stem loosning. The increased osteolysis around the implant as well as ectopic ossifications are found in long follow-up of the cemented hip prosthesis.
