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Outcomes of dual mobility cemented versus cementless cups in primary total hip arthroplasty: a systematic review and
Michael Silveira Santiago1, Fatemeh Akbarpoor2, Felipe J Aidar3,4
1Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil.
Purpose:
With the increased use of dual mobility primary hip arthroplasty with cementless and cemented cups, we found different clinical and radiographic responses. The goal of this systematic review is to compare the types of acetabular fixation according to clinical and radiographic changes.
Methods:
We conducted a pairwise analysis comparing cementless versus cemented cups in a dual mobility hip arthroplasty. The outcomes of interest were pain at rest, pain during activity, functional score, wear rate, and cup migration up to 7 years of follow-up. Of the 596 studies identified, only 3 were eligible for inclusion in the study. Our search strategy was broad and carefully designed to capture all relevant studies.
Results:
We included two randomized controlled trials and one cohort study, amounting to 233 patients, of which 108 used cemented cups and 125 received cementless cups. There was no statistical significance (P > 0.05) in all outcomes analyzed between both types of acetabular fixation: pain at rest (SMD: 0.17; 95% CI: - 0.21 to 0.56), pain during activity (SMD: 0.36; 95% CI: - 0.03 to 0.74), functional score (MD: 1.72; 95% CI: - 0.51 to 3.95), cup migration (SMD: - 0.45; 95% CI:-0.96 to 0.05), and wear rate (MD: -0.13; 95% CI: -0.40 to 0.13).
Conclusion:
Dual mobility primary total hip arthroplasty, whether using a cemented or uncemented cup, represents an effective treatment option, yielding similar clinical and radiographic outcomes.
