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Cementless acetabular replacement using a pegged polyethylene prosthesis.

K C Bertin, M A Freeman, E Morscher

    Archives of Orthopaedic and Traumatic Surgery. Archiv Fur Orthopadische Und Unfall-Chirurgie
    |January 1, 1985
    PubMed
    Summary
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    This study on cementless acetabular replacement using pegged polyethylene prostheses in 1878 hips showed a 97% success rate for pain relief and walking. Preliminary results are comparable to cemented techniques, with low complication rates.

    Area of Science:

    • Orthopedic surgery
    • Biomaterials science
    • Medical device technology

    Background:

    • Cemented acetabular replacement has been the standard for hip arthroplasty.
    • Concerns exist regarding long-term loosening and complications associated with cement fixation.

    Purpose of the Study:

    • To evaluate the efficacy and safety of cementless acetabular replacement using pegged polyethylene prostheses.
    • To assess clinical outcomes, radiographic findings, and complication rates in a large prospective series.

    Main Methods:

    • Prospective trial involving 1878 hip replacements using three types of pegged polyethylene prostheses (Morscher, Ring, Freeman).
    • Follow-up averaged 2 years (range: 6 months-6 years).
    • Clinical assessment of pain relief, walking ability, and flexion; radiographic review for component stability; and analysis of revision rates and infection incidence.

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    Main Results:

    • 97% of patients achieved successful pain relief and satisfactory walking ability.
    • 90% demonstrated adequate hip flexion.
    • Radiographic analysis revealed a stable sclerotic line without component migration; 10 hips required revision for femoral loosening.
    • Deep infection rate was 0.37%, occurring only in patients without perioperative antibiotics or specialized air-flow enclosures.

    Conclusions:

    • Cementless acetabular replacement with pegged polyethylene prostheses demonstrates promising preliminary results.
    • The technique offers reproducible outcomes, a low complication rate, minimal skeletal invasion, and facilitates revision if necessary.
    • Outcomes appear comparable to cemented acetabular components in large series with similar follow-up durations.