Abstract
Monoblock acetabular cups represent a subtype of uncemented cups with the polyethylene liner molded into a metal shell, thus eliminating or at least minimizing potential backside wear. We hypothesized that the use of monoblock cups could reduce the incidence of osteolysis and aseptic loosening, and thus improve survival compared with modular designs.
All 210 primary total hip arthroplasty (THA) procedures in the Swedish Hip Arthroplasty Register using uncemented monoblock cups during 1999-2010 were identified. Kaplan-Meier and Cox-regression analysis with adjustment for age, sex, and other variables were used to calculate survival rates and adjusted hazard ratios (HR) of the revision risk for any reason. 1,130 modular cups, inserted during the same time period were used as a control group.
There was a nearly equal sex distribution in both groups. The median age at index operation was 47 years in the monoblock group and 56 years in the control group (p<0.001). The cumulative 5-year survival with any revision as the endpoint was 95% (95% CI 91-98) for monoblock cups and 97% (CI 96-98) for modular cups (p=0.6). The adjusted HR of monoblock cups for revision compared with modular cups was 2 (CI 0.8-6; p=0.1). The use of 28 mm prosthesis heads compared with 22 mm heads decreased the risk of cup revision (HR 0.2, CI 0.1-0.5; p=0.001).
Both cups showed good mid-term survival rates. There was no statistically significant difference in revision risk between the cup designs. Further review of the current patient population is warranted to determine the long-term durability and risk of revision of monoblock cup designs.
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Weiss, R.J., Kärrholm, J., Stark, A., Hailer, N.P. (2013). Survival of Monoblock Acetabular Cups Versus an Uncemented Modular Cup Design: A Population-Based Study from the Swedish Hip Arthroplasty Register. In: Knahr, K. (eds) Total Hip Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35653-7_20
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