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Comparison of early migration patterns between a ceramic and polyethylene liner in uncemented Trabecular Titanium cups: a 2-year randomized controlled trial of 52 hips using radiostereometric analysis.
Acta Orthopaedica ( IF 3.7 ) Pub Date : 2022-04-28 , DOI: 10.2340/17453674.2022.2267
Amanda D Klaassen 1 , Elisabeth A Schäffer 1 , Nienke W Willigenburg 1 , Loes W A H Van Beers 1 , Vanessa A B Scholtes 1 , Victor P M Van der Hulst 2 , Lennard A Koster 3 , Bart L Kaptein 3 , Dirk Jan F Moojen 1 , Rudolf W Poolman 4
Affiliation  

BACKGROUND AND PURPOSE Ceramic liners may reduce early stability of uncemented acetabular components due to higher stiffness. However, the bone ingrowth capacities of porous trabecular titanium might compensate for this effect. This prospective randomized trial quantifies migration patterns of the Delta-TT cup, and compares polyethylene and ceramic liners. PATIENTS AND METHODS Patients undergoing primary uncemented total hip arthroplasty with the Delta-TT cup and femoral stem with ceramic head were randomized to a polyethylene (n = 25) or ceramic (n = 28) liner. Radiostereometric analysis (RSA) radiographs, patient-reported hip function (HOOS-PS, OHS), and quality of life (EQ5D) were collected at baseline and 1.5, 3, 6, 12, and 24 months postoperatively. Model-based RSA was used to calculate 3D cup translation and rotation, and mixed models were used to compare effects over time between groups. RESULTS At 2 years follow-up, Delta-TT cups showed similar mean proximal translation of 0.56 mm (95% CI 0.38-0.75) in the ceramic (CE) group and 0.54 mm (0.30-0.77) in the polyethylene (PE) group, with a between group effect of 0.02 mm (-0.20-0.23). Most cup migration occurred in the first 1.5 to 3 months, stabilizing within 6 months. Any between-group effects were ≤ 0.30 mm for translation and ≤ 0.45° for rotation. Improvements in patient-reported hip function and quality of life were similar in both groups. INTERPRETATION Regardless of liner type, Delta-TT cups showed some initial migration and stabilized within 6 months, which seems promising for long-term fixation in both cup-liner constructs.

中文翻译:

未骨水泥小梁钛杯中陶瓷和聚乙烯衬垫早期迁移模式的比较:使用放射立体分析对 52 个髋关节进行为期 2 年的随机对照试验。

背景和目的陶瓷衬垫可能会降低未骨水泥固定的髋臼假体的早期稳定性,因为它的刚度较高。然而,多孔骨小梁钛的骨向内生长能力可能会弥补这种影响。这项前瞻性随机试验量化了 Delta-TT 杯的迁移模式,并比较了聚乙烯和陶瓷内衬。患者和方法 使用 Delta-TT 杯和带陶瓷头的股骨柄进行初次非骨水泥全髋关节置换术的患者被随机分配到聚乙烯 (n = 25) 或陶瓷 (n = 28) 衬垫组。在基线和术后 1.5、3、6、12 和 24 个月收集放射立体分析 (RSA) 射线照片、患者报告的髋关节功能 (HOOS-PS、OHS) 和生活质量 (EQ5D)。基于模型的 RSA 用于计算 3D 杯子平移和旋转,和混合模型用于比较各组之间随时间的影响。结果 在 2 年的随访中,Delta-TT 杯在陶瓷 (CE) 组和聚乙烯 (PE) 组中显示出相似的平均近端平移 0.56 mm (95% CI 0.38-0.75) 和 0.54 mm (0.30-0.77) , 组间效应为 0.02 mm (-0.20-0.23)。大多数杯迁移发生在前 1.5 至 3 个月,在 6 个月内稳定。对于平移,任何组间效应均≤ 0.30 mm,对于旋转,≤ 0.45°。两组患者报告的髋关节功能和生活质量的改善相似。解释 无论衬垫类型如何,Delta-TT 杯都显示出一些初始迁移并在 6 个月内稳定下来,这似乎有望在两种杯衬结构中长期固定。Delta-TT 杯在陶瓷 (CE) 组和聚乙烯 (PE) 组中显示相似的平均近端平移 0.56 mm (95% CI 0.38-0.75) 和 0.54 mm (0.30-0.77),组间效应为 0.02毫米 (-0.20-0.23)。大多数杯迁移发生在前 1.5 至 3 个月,在 6 个月内稳定。对于平移,任何组间效应均≤ 0.30 mm,对于旋转,≤ 0.45°。两组患者报告的髋关节功能和生活质量的改善相似。解释 无论衬垫类型如何,Delta-TT 杯都显示出一些初始迁移并在 6 个月内稳定下来,这似乎有望在两种杯衬结构中长期固定。Delta-TT 杯在陶瓷 (CE) 组和聚乙烯 (PE) 组中显示相似的平均近端平移 0.56 mm (95% CI 0.38-0.75) 和 0.54 mm (0.30-0.77),组间效应为 0.02毫米 (-0.20-0.23)。大多数杯迁移发生在前 1.5 至 3 个月,在 6 个月内稳定。对于平移,任何组间效应均≤ 0.30 mm,对于旋转,≤ 0.45°。两组患者报告的髋关节功能和生活质量的改善相似。解释 无论衬垫类型如何,Delta-TT 杯在 6 个月内都显示出一些初始迁移并稳定下来,这似乎有望在两种杯衬结构中长期固定。组间效应为 0.02 mm (-0.20-0.23)。大多数杯迁移发生在前 1.5 至 3 个月,在 6 个月内稳定。对于平移,任何组间效应均≤ 0.30 mm,对于旋转,≤ 0.45°。两组患者报告的髋关节功能和生活质量的改善相似。解释 无论衬垫类型如何,Delta-TT 杯在 6 个月内都显示出一些初始迁移并稳定下来,这似乎有望在两种杯衬结构中长期固定。组间效应为 0.02 mm (-0.20-0.23)。大多数杯迁移发生在前 1.5 至 3 个月,在 6 个月内稳定。对于平移,任何组间效应均≤ 0.30 mm,对于旋转,≤ 0.45°。两组患者报告的髋关节功能和生活质量的改善相似。解释 无论衬垫类型如何,Delta-TT 杯在 6 个月内都显示出一些初始迁移并稳定下来,这似乎有望在两种杯衬结构中长期固定。
更新日期:2022-04-28
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