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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Press-fit vs threaded acetabulum components for total hip arthroplasty - A systematic review with metanalysis
Christos Koutserimpas1, Dimitrios Kotzias2, Alexandra Argyrou3
1Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece.
Journal of Clinical Orthopaedics and Trauma
|July 29, 2024
Summary
Threaded acetabular components (TACs) show comparable outcomes to press-fit acetabular components (PFACs) in total hip arthroplasty (THA). While PFACs are common, TACs offer a viable alternative, particularly for patients with osteoporosis, suggesting potential benefits in specific patient groups.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Clinical Outcomes Research
Background:
- Threaded acetabular components (TACs) offer superior initial stability over press-fit acetabular components (PFACs) in total hip arthroplasty (THA).
- Despite biomechanical advantages, the clinical use and comparative outcomes of TACs versus PFACs require further evidence-based evaluation.
- This study addresses the need for data on failure rates and radiological outcomes comparing TACs and PFACs in THA.
Purpose of the Study:
- To compare the failure rates and radiological outcomes of threaded acetabular components (TACs) versus press-fit acetabular components (PFACs) in total hip arthroplasty (THA).
- To provide evidence-based data to inform clinical decision-making regarding the selection of acetabular components in THA.
- To analyze revision rates due to aseptic loosening and radiolucency findings between TACs and PFACs.
Main Methods:
- A systematic literature search was conducted using PubMed and MEDLINE databases, adhering to PRISMA guidelines.
- A meta-analysis was performed on seven studies, encompassing 7878 PFAC cases and 6684 TAC cases in THA.
- Statistical analyses focused on revision rates for aseptic loosening and radiological evaluations, including sensitivity analysis and adjustments for age and gender.
Main Results:
- The overall odds ratio for revision due to aseptic loosening with PFACs compared to TACs was 3.10 (95% CI 0.37-25.72).
- Pooled odds ratio for radiolucency findings was 0.53 (95% CI 0.26-1.08), indicating a potential benefit for TACs.
- Gender adjustment revealed females using PFACs had a higher risk of revision (OR=5.26), though not statistically significant; females also showed a trend towards increased revision risk and radiolucency with PFACs compared to males.
Conclusions:
- Press-fit acetabular components (PFACs) remain the predominant choice for total hip reconstruction.
- Threaded acetabular components (TACs) represent a viable alternative, particularly beneficial for patients with osteoporosis.
- Further research may clarify the long-term efficacy and specific indications for TACs in total hip arthroplasty.
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