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Total hip arthroplasty using hydroxyapatite-coated cementless cup for rapidly destructive coxarthrosis: Minimum
Motoki Sonohata1, Takema Nakashima1, Masaru Kitajima1
1Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
Insights
Total hip arthroplasty (THA) using conventional cementless cups is effective for rapidly destructive coxarthrosis (RDC). This study shows acceptable clinical outcomes and a high survival rate, minimizing surgical stress in RDC patients.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Bone Defect Management
Background:
- Rapidly destructive coxarthrosis (RDC) necessitates early total hip arthroplasty (THA) due to progressive pain.
- Acetabular bone loss is a significant challenge in THA for RDC.
- Minimally invasive options are preferred, especially for elderly patients, but conventional methods are being evaluated.
Purpose of the Study:
- To evaluate the clinical and radiographic outcomes of THA using conventional hydroxyapatite-coated cementless cups in patients with RDC.
- To assess the long-term efficacy and safety of this implant in managing acetabular bone defects.
Main Methods:
- Retrospective analysis of 32 patients (35 hips) with RDC undergoing THA.
- Minimum 10-year follow-up with clinical evaluation using Harris hip score (HHS).
- Acetabular bone deficiency classified using the American Academy of Orthopaedic Surgeons (AAOS) criteria.
Main Results:
- Eleven hips (31%) presented with AAOS type III acetabular bone deficiency.
- Significant improvement in HHS from 36.5 to 79.4 (p < 0.01).
- Overall implant-associated survival rate was 91.4% at 10 years, with two cases of cup loosening.
Conclusions:
- THA with conventional cementless implants yields acceptable clinical results for RDC.
- This surgical approach is effective and safe, offering a way to minimize surgical stress in RDC patients.
- Conventional cementless cups demonstrate reliable performance in managing RDC with acetabular bone defects.
Background:
Performing total hip arthroplasty (THA) as early as possible is recommended for rapidly destructive coxarthrosis (RDC) as it causes pain that becomes progressively more severe. However, acetabular bone loss remains an issue in THA. Special devices, such as a Kerboull-type plate, may be used for acetabular bone defects, but the procedure is highly invasive and often the patients are elderly, further complicating matters. We retrospectively investigated the clinical and radiographic results of THA using conventional hydroxyapatite-coated cementless cup in RDC.
Methods:
A total of 32 patients (35 hips) with RDC were enrolled in the study with a minimum 10-year follow-up. All THAs were performed using conventional hydroxyapatite-coated cementless cup. All patients were evaluated clinically according to the Harris hip score (HHS). Acetabular bone deficiency was classified according to the American Academy of Orthopaedic Surgeons (AAOS) classification.
Results:
Eleven hips (31%) were AAOS type III, and none were type IV. Total HHS significantly improved from 36.5 to 79.4 (p < 0.01). Two cups exhibited loosening. The overall implant-associated survival rate after 10 years was 91.4%.
Conclusions:
Clinical results of THA using conventional cementless implants for patients with RDC were acceptable. Thus, THA using conventional cementless implant is an effective and safe surgery for patients with RDC, minimizing surgical stress.
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