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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
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Is There Still a Place for Threaded Spherical Acetabular Components in Modern Arthroplasty? Observations Based on an
Marek Drobniewski1, Bartosz Gonera2, Łukasz Olewnik2
1Clinic of Orthopaedic and Paediatric Orthopaedics, Medical University of Lodz, 90-419 Łódź, Poland.
Journal of Clinical Medicine
|June 13, 2025
Summary
This study shows that spherical screw-in acetabular cups offer durable fixation and good long-term results for total hip arthroplasty (THA), especially in complex cases like hip dysplasia. These implants demonstrate high survival rates, supporting their use in modern hip replacement surgery.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
Background:
- Total hip arthroplasty (THA) is a primary treatment for advanced osteoarthritis and complex hip deformities.
- Innovations in acetabular components, such as spherical screw-in designs, aim to improve implant fixation and patient outcomes.
- Evaluating the long-term efficacy of cementless THA with these advanced components is crucial for surgical practice.
Purpose of the Study:
- To assess the long-term clinical and radiographic outcomes of cementless total hip arthroplasty utilizing spherical screw-in acetabular components.
- To evaluate implant survival rates and identify factors influencing revision surgery.
- To determine the effectiveness of this implant system in a large patient cohort over an extended follow-up period.
Main Methods:
- Retrospective analysis of 277 patients (293 hips) undergoing cementless THA with spherical screw-in acetabular cups and Antega femoral stems (2005-2024).
- Clinical outcomes assessed using the modified Merle d'Aubigné and Postel (MAP) score and Visual Analog Scale (VAS) for pain.
- Radiographic evaluation included implant positioning (Lewinnek safe zone) and survival analysis via Kaplan-Meier method.
Main Results:
- Mean follow-up of 13.8 years.
- Excellent MAP scores achieved in 58.7% of hips; significant VAS pain score reduction (7.1 to 1.8, p < 0.05).
- 77.1% of implants positioned within the Lewinnek safe zone; 6.1% required revision (primarily aseptic loosening). Five- and ten-year survival rates were 98.3% and 94.0%, respectively.
Conclusions:
- Spherical screw-in acetabular cups demonstrate durable fixation and satisfactory long-term outcomes in total hip arthroplasty.
- These components are particularly effective for treating hip dysplasia, offering a reliable solution.
- Continued use of these implants is supported, emphasizing the importance of meticulous surgical technique for optimal results.
