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Published on: August 4, 2022
A case control study of cemented acetabular total hip arthroplasty components in patients less than 50 with 5-year
Thomas F M Yeoman1, William Smy2, Paul Gaston1
1Department of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh - UK.
Insights
Cemented sockets in total hip replacement (THR) show excellent outcomes for both young (<50) and older (>50) patients. This study found no significant differences in survival rates or patient satisfaction, supporting the use of cemented THR in all age groups.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Investigating the efficacy of cemented sockets in total hip replacement (THR).
- Comparing outcomes in young (<50 years) versus older (>50 years) patient demographics.
Purpose of the Study:
- To evaluate prosthesis survivorship, patient outcomes, and radiological findings.
- To compare cemented THR outcomes between younger and older patient cohorts.
Main Methods:
- A consecutive series of 56 young and 56 older patients undergoing primary THR with cemented Stryker® Exeter™ Contemporary™ flanged cups.
- Minimum 5-year follow-up assessing prosthesis survival, patient-reported outcomes (Oxford Hip Score), satisfaction, and radiographic evaluation.
Main Results:
- No significant differences in Oxford Hip Scores (p=0.078) or patient satisfaction (p=0.67) between age groups.
- Worst-case scenario survival rates at 5 years were 94.6% for <50 year olds and 92.9% for >50 year olds.
- Demonstrated comparable patient outcomes, survivorship, and radiographic findings at 5 years for both age groups.
Conclusions:
- Cemented sockets yield excellent outcomes for total hip replacement patients across all age groups.
- The preference for uncemented cups may be influenced by marketing rather than evidence-based outcomes.
- Supports the continued use of cemented fixation in total hip replacement surgery.
Background:
This study investigates the outcomes of cemented sockets in young patients (<50 years) requiring a total hip replacement (THR) compared to older patients (>50 years) having the same procedure, under the same surgeon between June 2005 and May 2009.
Methods:
Prosthesis survivorship rates, patient outcomes and radiological findings were compared between a consecutive series of 56 young patients (mean 42, range 25-49) and 56 older patients (mean 69, range 53-81) that underwent a primary THR using a cemented Stryker® Exeter™ Contemporary™ flanged cup. The minimum follow-up was 5 years.
Results:
No significant difference was observed between the groups' Oxford Hip Scores (p = 0.078) or satisfaction scores (p = 0.67). Worst case scenario analysis for revision, failure or lost to follow-up showed 94.6% survival in the <50 year olds and 92.9% survival in the >50 year olds at 5 years. This study demonstrates no significant difference in patient outcomes, survivorship or radiographic findings at a minimum of 5 years between patients <50 years old and those >50 years old undergoing THR with a cemented socket.
Conclusions:
We believe the current trend towards uncemented cups may be driven by marketing rather than by evidence of improved outcomes. Cemented sockets provide very good outcomes for patients of all ages.
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