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Component Asymmetry in Bilateral Cementless Total Hip Arthroplasty

Seung Hun Woo1, Won Chul Shin1, Jung Bum Han1

  • 1Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Clinics in Orthopedic Surgery
|February 13, 2023
PubMed

Insights

Component asymmetry (CA) occurred in 25.7% of patients undergoing bilateral cementless total hip arthroplasty (THA). Despite asymmetry, stable component fixation led to satisfactory outcomes, especially when the time interval between surgeries was shorter.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Radiology

Background:

  • Component asymmetry (CA) is a potential concern in bilateral cementless total hip arthroplasty (THA).
  • Understanding the incidence and impact of CA is crucial for optimizing patient outcomes.
  • Previous research has not extensively detailed the radiologic and clinical implications of CA in THA.

Purpose of the Study:

  • To investigate the incidence and outcomes of component asymmetry (CA) in patients who underwent bilateral cementless total hip arthroplasty (THA).
  • To compare radiologic and clinical results between patients with component symmetry (CS) and component asymmetry (CA).
  • To identify factors associated with CA, such as the time interval between operations.

Main Methods:

  • A cohort of 300 patients undergoing bilateral cementless THA between 2000 and 2017 was retrospectively analyzed.
  • Patients were categorized into component symmetry (CS) and component asymmetry (CA) groups.
  • The CA group was further sub-classified into acetabular component asymmetry (ACA) and femoral component asymmetry (FCA); radiologic and clinical outcomes were compared.

Main Results:

  • The incidence of CA was 25.7%, with ACA being more common than FCA.
  • A significantly longer time interval between operations was observed in the CA group compared to the CS group.
  • Despite CA, mean Harris Hip Scores were similar between the CA and CS groups, indicating comparable functional outcomes.

Conclusions:

  • Component asymmetry is not uncommon in bilateral cementless THA, particularly with longer intervals between surgeries.
  • Achieving stable component fixation is paramount for obtaining satisfactory radiologic and clinical outcomes, irrespective of component alignment.
  • Further research may explore strategies to minimize CA and its potential long-term effects.
Abstract

Keywords:
Bilateral total hip arthroplastyCementless total hip arthroplastyComponent asymmetry

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