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Revision of cemented hip arthroplasties. 101 hips followed for 5 (4-9) years
Insights
Revision hip arthroplasty using cemented Lubinus prostheses shows high rates of loosening, particularly in younger patients. Varus stem insertion and acetabular malposition significantly increase revision failure risk.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Medical device engineering
Background:
- Failed primary cemented hip arthroplasty necessitates revision surgery.
- Cemented Lubinus prostheses are utilized for hip revision procedures.
- Long-term outcomes of cemented revision hip arthroplasty require further investigation.
Purpose of the Study:
- To evaluate the radiographic outcomes and loosening rates of cemented Lubinus prostheses in revision hip arthroplasty.
- To identify factors associated with prosthesis loosening after revision surgery.
Main Methods:
- A retrospective review of 101 hip revision surgeries using cemented Lubinus prostheses.
- Radiographic assessment for prosthesis loosening and sinking over a 5-year follow-up period.
- Analysis of surgical technique variables including intramedullary plug use, cementation technique, stem alignment, and acetabular component position.
Main Results:
- 41 hips (40.6%) exhibited radiographic loosening (36 femoral stems, 13 acetabular components).
- Intramedullary plug use did not prevent prosthesis sinking.
- No significant difference in loosening was observed between conventional and pressure-injection cementation.
- Varus stem insertion and acetabular component malposition were associated with increased loosening.
- Patients under 50 years old experienced more stem sinking and prosthesis loosening.
Conclusions:
- Cemented Lubinus prostheses in revision hip arthroplasty demonstrate a substantial risk of radiographic loosening.
- Younger patient age, varus stem alignment, and acetabular malposition are critical risk factors for revision failure.
- Further research into optimizing fixation strategies for younger, high-demand patients undergoing hip revision is warranted.
Abstract:
101 hips were revised with cemented Lubinus prostheses after failed primary cemented arthroplasty, and followed for 5 (4-9) years. Radiographically, 41 hips (36 femoral stems and 13 acetabular components) had become loose. The use of an intramedullary plug at the revision did not prevent sinking of the prosthesis. No difference was found between conventional or pressure-injection cementation techniques. In cases where the stem was inserted in varus or the acetabular component was in malposition there was increased loosening. Patients below 50 years of age had oftener more than 5 mm sinking of the stem and more prosthesis loosenings.