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Acetabular cup migration after primary cementless total hip arthroplasty in rheumatoid arthritis and its influencing factors: a comparative study with osteoarthritic hip

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Abstract

Purpose

To compare the radiographic migration profiles of primary cementless total hip arthroplasty (THA) between patients with rheumatoid arthritis (RA) and those with osteoarthritis (OA).

Methods

A total of 197 patients (215 hips) who underwent cementless THA for RA or OA between January 2001 and January 2013 and followed up for a minimum of 5.5 years were included. Ninety-four RA patients (109 hips) were compared with 103 OA patients (106 hips). Radiological evaluation was performed for acetabular cup loosening, and cup migration was measured using Einzel-Bild-Röntgen-Analyse (EBRA) software. Multiple variables were assessed to identify influencing factors for cup migration.

Results

Early cup migration was observed in 13 hips (11.9%) in the RA group and four hips (3.8%) in the OA group, showing a significant difference (p = 0.041). Acetabular cup loosening occurred in three cups (2.8%) in the RA group and in one cup (0.9%) in the OA group, showing no significant difference (p = 0.321). Total cup migration was higher in the RA group (2.62 mm) than in the OA group (1.44 mm, p = 0.005). Total cup migration was significantly higher in patients aged < 50 years than in those aged > 50 years (p = 0.005). Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibody influenced total cup migration. Patients with seropositive RA showed significantly higher total cup migration and early cup migration incidence than those with seronegative RA (p = 0.005, p = 0.038, respectively).

Conclusions

Acetabular cups in primary cementless THAs of RA patients were less stable in terms of cup migration compared with that of OA patients.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Hanyang University Guri Hospital, Gyomoon-dong 249-1, Guri, Gyunggi-do, 471-701, South Korea

    Jun-Ki Moon, Jae-Hyuk Yang, Ye-Soo Park & Young-Ho Kim

  2. Department of Orthopedic Surgery, Hanyang University Hospital, Seoul, South Korea

    Ji-Won Jung & Yeesuk Kim

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  1. Jun-Ki Moon
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  2. Ji-Won Jung
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  3. Yeesuk Kim
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  4. Jae-Hyuk Yang
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  5. Ye-Soo Park
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Correspondence to Young-Ho Kim.

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The authors declare that they have no conflict of interest.

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Ethical approval was obtained from Institutional Review Board of the university hospital prior to conducting this study.

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Informed consent was obtained from all patients included in the study.

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Moon, JK., Jung, JW., Kim, Y. et al. Acetabular cup migration after primary cementless total hip arthroplasty in rheumatoid arthritis and its influencing factors: a comparative study with osteoarthritic hip. International Orthopaedics (SICOT) 44, 1047–1053 (2020). https://doi.org/10.1007/s00264-020-04502-3

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  • DOI: https://doi.org/10.1007/s00264-020-04502-3

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