Advertisement

International Orthopaedics

, Volume 35, Issue 8, pp 1109–1118 | Cite as

Is there evidence for a superior method of socket fixation in hip arthroplasty? A systematic review

  • Dean PakvisEmail author
  • Gijs van Hellemondt
  • Enrico de Visser
  • Wilco Jacobs
  • Maarten Spruit
Review Article

Abstract

Purpose

Total hip arthroplasty has been a very succesful orthopaedic procedure. The optimal fixation method of the acetabular component however, has not yet been defined.

Methods

We performed a systematic review using the Medline and Embase databases to find evidence for the superiority of cemented or cementless acetabular components on short- and long-term clinical and radiological parameters. Methodological quality for randomised trials was assessed using the van Tulder checklist, and for the non randomised studies we used the Newcastle-Ottawa quality assessment scale.

Results

Our search strategy revealed 16 randomised controlled trials (RCT) and 19 non RCT studies in which cemented and cementless acetabular components are compared. A best evidence analysis for complications, wear, osteolysis, migration and clinical scores showed no superiority for either cemented or cementless socket in the RCTs. A best evidence analysis for non RCT studies revealed better osteolysis, migration properties and aseptic loosening survival for cementless sockets; however, wear and overall survival favoured the cemented sockets.

Conclusions

We recommend that an orthopaedic surgeon should choose an established cemented or cementless socket for hip replacement based on patient characteristics, knowledge, experience and preference.

Keywords

Aseptic Loosening Acetabular Component Randomise Control Trial Study Cementless Fixation Cementless Acetabular Component 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest statement

The authors declare that they have no conflict of interest.

References

  1. 1.
    Learmonth ID, Young C, Rorabeck C (2007) The operation of the century: total hip replacement. Lancet 370:1508–1519PubMedCrossRefGoogle Scholar
  2. 2.
    Eskelinen A, Remes V, Helenius I, Pulikkinen P, Nevalainen J, Paavolainen P (2005) Total hip arthroplasty for primary osteoarthrosis in younger patients in the Finnish arthroplasty register. 4,661 primary replacements followed 0–22 years. Acta Orthop Scand 76:28–41CrossRefGoogle Scholar
  3. 3.
    Caton J, Prudhon JL (2011) Over 25 years survival after Charnley’s total hip arthroplasty. Int Orthop 35:185–8PubMedCrossRefGoogle Scholar
  4. 4.
    Callaghan JJ, Templeton JE, Liu SS, Pedersen DR, Goetz DD, Sullivan PM, Johnston RC (2004) Results of Charnley total hip arthroplasty at a minimum of thirty years. A concise follow-up of a previous report. J Bone Joint Surg Am 86:690–695PubMedGoogle Scholar
  5. 5.
    Franklin J, Robertsson O, Gestsson J, Lohmander LS, Ingvarsson T (2003) Revision and complication rates in 654 Exeter total hip replacements, with a maximum follow-up of 20 years. BMC Musculoskelet Disord 25:4–6Google Scholar
  6. 6.
    Wroblewski BM, Siney PD, Fleming PA (2009) Charnley low-frictional torque arthroplasty: follow-up for 30 to 40 years. J Bone Joint Surg Br 91:447–50PubMedGoogle Scholar
  7. 7.
    Callaghan JJ, Liu SS, Firestone DE, Yehyawi TM, Goetz DD, Sullivan J, Vittetoe DA, O’Rourke MR, Johnston RC (2008) Total hip arthroplasty with cement and use of a collard matte-finish femoral component. Nineteen to twenty-year follow up. J Bone Joint Surg Am 90:299–306PubMedCrossRefGoogle Scholar
  8. 8.
    Madey SM, Callaghan JJ, Olejniczak JP, Goetz DD, Johnston RC (1997) Charnley total hip arthroplasty with use of improved techniques of cementing. The results after a minimum of fifteen years of follow up. J Bone Joint Surg Am 79:53–64PubMedCrossRefGoogle Scholar
  9. 9.
    Buckwalter AE, Callaghan JJ, Liu SS, Pedersen DR, Goetz DD, Sullivan PM, Leinen JA, Johnston RC (2006) Results of Charnley total hip arthroplasty with use of improved femoral cementing techniques. A concise follow-up, at a minimum of twenty-five years, of a previous report. J Bone Joint Surg Am 88:1481–5PubMedCrossRefGoogle Scholar
  10. 10.
    Ries MD (2008) Review of the evolution of the cementless acetabular cup. Orthopedics 31(12 suppl 2)Google Scholar
  11. 11.
    Powers CC, Ho H, Beykirch SE, Huynh C, Hopper RH Jr, Engh CA Jr, Engh CA (2010) A comparison of a second- and a third- generation modular cup design. Is new improved? J Arthroplasty 25:514–521PubMedCrossRefGoogle Scholar
  12. 12.
    Ihle M, Mai S, Pfluger D, Siebert W (2008) The results of the titanium-coated RM acetabular component at 20 years: a long-term follow-up of an uncemented primary total hip replacement. J Bone Joint Surg Br 90:1284–1290PubMedCrossRefGoogle Scholar
  13. 13.
    Della Valle CJ, Mesko NW, Quigley L, Rosenberg AG, Jacobs JJ, Galante JO (2009) Primary total hip arthroplasty with a porous-coated acetabular component. A concise follow-up, at a minimum of twenty years, of previous reports. J Bone Joint Surg Am 91:1130–1135PubMedCrossRefGoogle Scholar
  14. 14.
    Moher D, Cook DJ, Easwood S, Olkin I, Rennie D, Stroup D (1999) Improving the quality of reports of meta-analyses of randomized controlled trials: the QOUROM statement Quality of reporting of meta-analyses. Lancet 354:1896–1900PubMedCrossRefGoogle Scholar
  15. 15.
    Van Tulder M, Furlan A, Bombardier C, Bouter L (2003) Updated method guidelines for systematic reviews in the Cochrane collaboration back review group. Spine 28:1290–1299PubMedGoogle Scholar
  16. 16.
    Wells G, Shea B, O’Connell D, Peterson J, Welch V, Tugwell P. (2000) The Newcastle-Ottewa Scale (NOS) for assessing the quality of non-randomised studies in meta-analyses. Proceedings of the 3rd symposium on systematic reviews: beyond the basics. Oxford Centre for Statistics in Medicine, Oxford, EnglandGoogle Scholar
  17. 17.
    Olsson E, Goldie I, Wykman A (1986) Total hip replacement. A comparison between cemented (Charnley) and non-cemented (HP Garches) fixation by clinical assessment and objective gait analysis. Scand J Rehabil Med 18:107–116PubMedGoogle Scholar
  18. 18.
    Wykman A, Olsson E, Axdorph G, Goldie I (1991) Total hip arthroplasty. A comparison between cemented and press-fit non-cemented fixation. J Arthroplasty 6:19–29PubMedCrossRefGoogle Scholar
  19. 19.
    Nayak KN, Mulliken B, Rorabeck CH, Bourne RB, Woolfrey MR (1997) Prevalence of heterotopic ossification in cemented versus non-cemented total hip joint replacement in patients with osteoarthrosis: a randomized clinical trial. Can J Surg 40:368–374PubMedGoogle Scholar
  20. 20.
    Devane PA, Robinson EJ, Bourne RB, Rorabeck CH, Nayak NN, Horne JG (1997) Measurement of polyethylene wear in acetabular components inserted with and without cement. A randomized trial. J Bone Joint Surg Am 79:682–689PubMedGoogle Scholar
  21. 21.
    Nayak NK, Mulliken B, Rorabeck CH, Bourne RB, Robinson EJ (1996) Osteolysis in cemented versus cementless acetabular components. J Arthroplasty 11:135–140PubMedCrossRefGoogle Scholar
  22. 22.
    Rorabeck CH, Bourne RB, Mulliken BD, Nayak N, Laupacis A, Tugwell P, Feeney D (1996) The Nicolas Andry award: comparative results of cemented and cementless total hip arthroplasty. Clin Orthop Relat Res 325:330–344PubMedCrossRefGoogle Scholar
  23. 23.
    Mulliken BD, Nayak N, Bourne RB, Rorabeck CH, Bullas R (1996) Early radiographic results comparing cemented and cementless total hip arthroplasty. J Arthroplasty 11:24–33PubMedCrossRefGoogle Scholar
  24. 24.
    Rorabeck CH, Bourne RB, Laupacis A, Feeny D, Wong C, Tugwell P, Leslie K, Bullas R (1994) A double-blind study of 250 cases comparing cemented with cementless total hip arthroplasty. Cost-effectiveness and its impact on health-related quality of life. Clin Orthop Relat Res 298:156–164PubMedGoogle Scholar
  25. 25.
    Bourne RB, Rorabeck CH, Laupacis A, Feeny D, Wong C, Tugwell P, Leslie K, Bullas R (1994) A randomized clinical trial comparing cemented to cementless total hip replacement in 250 osteoarthritic patients: the impact on health related quality of life and cost effectiveness. Iowa Orthop J 14:108–114PubMedGoogle Scholar
  26. 26.
    Laupacis A, Bourne R, Rorabeck C, Feeny D, Tugwell P, Wong C (2002) Comparison of total hip arthroplasty performed with and without cement: a randomized trial. J Bone Joint Surg Am 84:1823–1828PubMedGoogle Scholar
  27. 27.
    Onsten I, Carlsson AS, Besjakov J (1998) Wear in uncemented porous and cemented polyethylene sockets: a randomised, radiostereometric study. J Bone Joint Surg Br 80:345–350PubMedCrossRefGoogle Scholar
  28. 28.
    Onsten I, Carlsson AS (1994) Cemented versus uncemented socket in hip arthroplasty. A radiostereometric study of 60 randomized hips followed for 2 years. Acta Orthop Scand 65:517–521PubMedCrossRefGoogle Scholar
  29. 29.
    Onsten I, Carlsson AS, Ohlin A, Nilsson JA (1994) Migration of acetabular components, inserted with and without cement, in one-stage bilateral hip arthroplasty. A controlled, randomized study using roentgenstereophotogrammetric analysis. J Bone Joint Surg Am 76:185–194PubMedGoogle Scholar
  30. 30.
    Digas G, Thanner J, Anderberg C, Kärrholm J (2004) Bioactive cement or ceramic/porous coating vs conventional cement to obtain early stability of the acetabular cup. Randomized study of 96 hips followed with radiostereometry. J Orthop Res 22:1035–1043PubMedCrossRefGoogle Scholar
  31. 31.
    Digas G, Kärrholm J, Thanner J (2006) Different loss of BMD using uncemented press-fit and whole polyethylene cups fixed with cement. Repeated DXA studies in 96 hips randomized to 3 types of fixation. Acta Orthop Scand 77:218–226CrossRefGoogle Scholar
  32. 32.
    McCombe P, Williams SA (2004) A comparison of polyethylene wear rates between cemented and cementless cups. A prospective, randomised trial. J Bone Joint Surg Br 86:344–349PubMedCrossRefGoogle Scholar
  33. 33.
    Gaffey JL, Callaghan JJ, Pedersen DR, Goetz DD, Sullivan PM, Johnston RC (2004) Cementless acetabular fixation at fifteen years. A comparison with the same surgeon's results following acetabular fixation with cement. J Bone Joint Surg Am 86:257–261PubMedGoogle Scholar
  34. 34.
    Clohisy JC, Harris WH (2001) Matched pair analysis of cemented and cementless acetabular reconstruction in primary total hip arthroplasty. J Arthroplasty 16:697–705PubMedCrossRefGoogle Scholar
  35. 35.
    Hearn SL, Bicalho PS, Eng K, Booth RE Jr, Hozack WJ, Rothman RH (1995) Comparison of cemented and cementless total hip arthroplasty in patients with bilateral hip arthroplasties. J Arthroplasty 10:603–608PubMedCrossRefGoogle Scholar
  36. 36.
    Hartofilakidis G, Georgiades G, Babis GC (2009) A comparison of the outcome of cemented all-polyethylene and cementless metal-backed acetabular sockets in primary total hip arthroplasty. J Arthroplasty 24:217–225PubMedCrossRefGoogle Scholar
  37. 37.
    Zicat B, Engh CA, Gokcen E (1995) Patterns of osteolysis around total hip components inserted with and without cement. J Bone Joint Surg Am 77:432–439PubMedGoogle Scholar
  38. 38.
    Callaghan J, Pedersen D, Olejniczak J, Goetz D, Johnston R (1995) Radiographic measurement of wear in 5 cohorts of patients observed for 5 to 22 years. Clin Orthop Relat Res 317:14–18PubMedGoogle Scholar
  39. 39.
    Kim Y, Oh S, Kim J, Lee S (2003) Total hip arthroplasty for the treatment of osseous ankylosed hips. Clin Orthop Relat Res 414:136–148PubMedCrossRefGoogle Scholar
  40. 40.
    Kirk P, Rorabeck C, Bourne R, Burkart B (1993) Total hip arthroplasty in rheumatoid arthritis: comparison of cemented uncemented implants. Can J Surg 36:229–232PubMedGoogle Scholar
  41. 41.
    Knessl J, Gschwend N, Scheier H, Munzinger U (1989) Comparative study of cemented and cementless hip prostheses in the same patient. Arch Orthop Trauma Surg 108:276–278PubMedCrossRefGoogle Scholar
  42. 42.
    Kordelle J, Starker M (2000) Migration analysis of cemented muller polyethylene acetabular cups versus cement-free zweymuller screw-attached acetabular cups. Z Orthop Ihre Grenzgeb 138:46–51PubMedCrossRefGoogle Scholar
  43. 43.
    Krismer M, Fischer M, Klestil T, Frischhut B (1991) Uncoated polyethelene RM acetabular component versus muller cemented acetabular component. A 4- to 8-year follow-up study. Arch Orthop Trauma Surg 110:195–199PubMedCrossRefGoogle Scholar
  44. 44.
    Kruckhans A, Dustmann H (2004) Indications, methods, and results of cemented, hybrid, and cement-free implantations of THR. Surg Technol Int 12:253–257PubMedGoogle Scholar
  45. 45.
    Pospula W, Abu Noor T, Roshdy T, Al MA (2008) Cemented and cementless total hip replacement. Critical analysis and comparison of clinical and radiological results of 182 cases in Al Razi Hospital, Kuwait. Med Princ Pract 17:239–243PubMedCrossRefGoogle Scholar
  46. 46.
    Ring P (1983) Uncemented acetabular replacement. Arch Orthop Trauma Surg 101:225–229PubMedCrossRefGoogle Scholar
  47. 47.
    Riska E (1993) Ceramic endoprosthesis in total hip arthroplasty. Clin Orthop Relat Res 297:87–94PubMedGoogle Scholar
  48. 48.
    Runkel M, Wenda K, Jaeger U, Rudig L, Roder W (1994) 2- to 7-year results of cement-free and cemented joint replacement in femoral neck fractures and coxarthrosis. Aktuelle Traumatol 24:173–179PubMedGoogle Scholar
  49. 49.
    Volkmann R, Schneider M, Bretschneider C, Weise K (1999) More failures of uncemented acetabular screw-rings than of cemented polyethylene cups in total hip arthroplasties. Int Orthop 23:138–139PubMedCrossRefGoogle Scholar
  50. 50.
    Weber M, Berry D, Harmsen W (1998) Total hip arthroplasty after operative treatment of an acetabular fracture. J Bone Joint Surg Am 80:1295–1305PubMedGoogle Scholar
  51. 51.
    Wixson R, Stulberg S, Mehlhoff M (1991) Total hip replacement with cemented, uncemented, and hybrid prostheses. A comparison of clinical and radiographic results at two to four years. J Bone Joint Surg 73:257–270PubMedGoogle Scholar
  52. 52.
    Vandenbroucke JP (2009) The HRT controversy: observational studies and RCTs fall in line. Lancet 11:373(9671):1233–1235Google Scholar
  53. 53.
    Rawlins MD (2008) De Testimonio: on the evidence for decisions about the use of therapeutic interventions. The Harveian Oration 2008. The royal college of physicians. Clin Med 8(6):579–588Google Scholar
  54. 54.
    Santavirta S, Bohler M, Harris WH, Konttinen YT, Muratogulu O, Rieker C, Salzer M (2003) Alternative materials to improve total hip replacement tribology. Acta Orthop Scand 74:380–388PubMedCrossRefGoogle Scholar
  55. 55.
    Oral E, Muratoglu OK (2011) Vitamin E diffused, highly crosslinked UHMWPE: a review. Int Orthop 35:215–223PubMedCrossRefGoogle Scholar
  56. 56.
    Mazoochian F, Pietschmann M, Hocke S, Fottner A, van Schulze-Pellengahr C, Jansson V (2007) Hip dislocation following THA. Orthopade 36:935–943PubMedCrossRefGoogle Scholar
  57. 57.
    Hailer P, Garelilick G, Karrholm J (2010) Uncemented and cemented primary total hip arthroplasty in the Swedish hip arthroplasty register. Acta Orthop Scand 81:34–41CrossRefGoogle Scholar
  58. 58.
    Havelin LI, Fenstad AM, Salomonsson R, Mehnert F, Furnes O, Overgaard O, Pedersen AB, Herberts P, Karrholm J, Garellick G (2009) The Nordic arthroplasty register association. A unique collaboration between 3 national hip arthroplasty registries with 280,201 THRS. Acta Orthop Scand 80:394–401Google Scholar
  59. 59.
    Yahiro MA, Gantenberg JB, Nelson R, Lu HT, Mishra NK (1995) Comparison of the results of cemented, porous-in growth, and threaded acetabular cup fixation. A meta-analysis of the orthopaedic literature. J Arthroplasty 10:339–350PubMedCrossRefGoogle Scholar
  60. 60.
    Morshed S, Bozic KJ, Ries MD, Malchau H, Colford JM Jr (2007) Comparison of cemented and uncemented fixation in total hip replacement. Acta Orthop Scand 78:315–326CrossRefGoogle Scholar
  61. 61.
    Huo MH, Osier CJ (2008) Is cement still a fixation option for total hip arthroplasty? J Arthroplasty 23:51–54PubMedCrossRefGoogle Scholar
  62. 62.
    Makela K, Eskellinen A, Pulkinnen P, Paavolainen P, Remes V (2008) Total hip arthroplasty for primary osteoarthritis in patients fifty-five years of age or older. An analysis of the Finnish arthroplasty registry. J Bone Joint Surg 90:2160–2170PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Dean Pakvis
    • 1
    Email author
  • Gijs van Hellemondt
    • 2
  • Enrico de Visser
    • 3
  • Wilco Jacobs
    • 4
  • Maarten Spruit
    • 2
  1. 1.Department of Orthopaedic SurgeryMedisch Spectrum TwenteKA EnschedeThe Netherlands
  2. 2.Department of Orthopaedic SurgeryNijmegenThe Netherlands
  3. 3.Department of Orthopaedic SurgeryAlysis ZorggroepArnhemThe Netherlands
  4. 4.OrthoResearch UnitSt. Maartens Kliniek Research, Development and EducationNijmegenThe Netherlands

Personalised recommendations