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Acetabular components with or without screws in total hip arthroplasty
Murad Pepe1, Onur Kocadal2, Tamer Erener2
1Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, 06340 Ankara, Turkey. dr_muradpepe@hotmail.com.
World Journal of Orthopedics
|October 6, 2017
Summary
Using screws with acetabular components in total hip arthroplasty did not change blood loss or early outcomes. However, screw use significantly increased operation time compared to non-screw methods.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
- Medical Device Design
Background:
- Cementless acetabular components are widely used in total hip arthroplasty (THA).
- The necessity and impact of supplemental screw fixation for these components remain a subject of investigation.
- Optimizing surgical efficiency and patient outcomes in THA is a continuous goal.
Purpose of the Study:
- To compare the operative time, blood loss, and early clinical outcomes of cementless acetabular components with versus without screw fixation.
- To evaluate the influence of screw use on component migration and osteolysis in THA.
- To determine if screw fixation offers significant advantages in early functional recovery or implant stability.
Main Methods:
- A retrospective analysis of 30 patients undergoing cementless THA with posterior approach was conducted.
- Patients were divided into two groups: those receiving acetabular components with screw fixation and those without.
- Data collected included operation time, intraoperative and postoperative blood loss, Harris hip score, cup migration, and osteolysis at one-year follow-up.
Main Results:
- No significant difference in blood loss or Harris hip scores was observed between the screw and no-screw groups.
- One patient in the screw group developed a 3 mm osteolytic lesion; no cup migration occurred in either group.
- The mean operation time was significantly longer in the screw group (121.8 min) compared to the no-screw group (102.7 min) (P=0.002).
Conclusions:
- Cementless acetabular components with or without screw fixation demonstrate comparable early clinical outcomes and implant stability.
- The use of screws in cementless acetabular component fixation significantly increases operative time without a corresponding reduction in blood loss.
- Surgical decision-making regarding screw use should consider the trade-off between potential (though not demonstrated here) benefits and increased operative time.
