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Hip replacement with a threaded acetabular cup. A follow-up study

G M Fox1, A A McBeath, J P Heiner

  • 1University of Wisconsin Hospital and Clinics, Madison.

The Journal of Bone and Joint Surgery. American Volume
|February 1, 1994
PubMed
Summary
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This study found that threaded titanium acetabular cups have a high failure rate. At six years, 38% of these hip implants required revision surgery or were pending revision.

Area of Science:

  • Orthopedic surgery
  • Biomaterials engineering
  • Medical device evaluation

Background:

  • Acetabular cups are crucial components in total hip arthroplasty.
  • Threaded acetabular cup designs were introduced to improve fixation.
  • Long-term efficacy data for early threaded cup designs are essential.

Purpose of the Study:

  • To evaluate the clinical and radiographic efficacy of a specific threaded titanium acetabular cup.
  • To determine the failure rate and identify predictors of failure for this implant.

Main Methods:

  • Prospective study initiated in 1983.
  • Inclusion of 68 threaded titanium acetabular cups in 55 patients (52 primary, 16 revision arthroplasties).
  • Annual clinical and radiographic evaluations over an average of 6 years (range 5-9 years).

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Main Results:

  • A 38% failure rate (26 of 68 cups) was observed, defined as revision or pending revision.
  • 16 primary arthroplasties (31%) and 10 revision arthroplasties failed.
  • Radiographic signs of failure included superomedial migration and osteolysis (Zone 3), often preceding symptoms.

Conclusions:

  • The high failure rate of this threaded acetabular component at six years suggests it is not warranted for use.
  • Early radiographic changes may indicate impending failure before clinical symptoms manifest.
  • Further research into acetabular component design and fixation is necessary.