Abstract
Introduction
Survivorship analysis was performed on 479 Link V-type threaded cups and on 110 modified V-type Bad Bramstedt cups (a modification of the Link V-type cup since 1993 with a smaller primary coil) to evaluate the effect of the modifications.
Materials and methods
Indication for hip arthroplasty with a Link V-type cup was an inflammatory arthritis in 310 patients, osteoarthritis in 138 patients and dysplastic hip joints in 31 patients. The average follow-up was 8.6±3.2 (range 3.0–15.2) years. The 110 modified V-type Bad Bramstedt cups had a mean follow-up period of 4.5±0.7 (range 3.0–5.9) years, including 49 with inflammatory arthritis, 49 with osteoarthritis and 12 with dysplastic hip joints. To evaluate the migration rate and radiolucent lines, radiographical examination according to the method of Nunn et al. and Delee and Charnley was performed on 264 Link V-type cups with a mean follow-up period of 8.2±2.7 years and 59 modified V-type Bad Bramstedt cups with a mean follow-up period of 4.6±0.7 years. Relevant parameters influencing cup migration were analysed.
Results
The cumulative survival rate of the former Link V-type acetabular cup was 94.5% after 5 years, 88.1% after 10 years and 70.2% after 15 years. The Bad Bramstedt cup showed a 5-year survivorship rate of 97.9%. Migration of more than 3 mm or tilting of the cup greater than 5 degrees was found in 73% of the former type and in 39% of the modified cup. Radiolucent lines greater than 2 mm and detectable in two zones appeared in 6.4% of the former Link V-type and in 1.7% of the Bad Bramstedt cup design. Among the influencing factors analysed, length of follow-up and primary cup positioning showed a significant correlation to cup migration.
Conclusion
The modification of the Link V-type cup showed no satisfactory improvement in cup migration. Therefore, both threaded cups were abandoned in favour of cementless press-fit cups.
Similar content being viewed by others
References
Aigner C (1998) 10-year results of the corund-blasted Zweymüller threaded acetabular ring. Z Orthop 136:110–114
Antolic V, Iglisc A, Herman S, Srakar F, Macek Leber A, Krajl Iglic V, Brajnik D, Stanic U (1994) Resultant hip joint force after total hip replacement. Acta Chir Orthop Traumatol Cech 61:42–44
Baldursson H, Hansson LI, Olsson TH, Selvik G (1980) Migration of the acetabular socket after total hip replacement determined by roentgen stereophotogrammetry. Acta Orthop Scand 51:535–540
Beckenbaugh RD, Ilstrup DM (1978) Total hip arthroplasty. A review of three hundred and thirty-three cases with long-term follow-up. J Bone Joint Surg Am 60:306–313
Blum HJ, Noble PC, Tullos HS (1990) Migration and rotation of cementless acetabular cups: incidence, etiology and clinical significance. 57th Annual AAOS Meeting, New Orleans, Louisiana, February 8–13
Brujin JD, Seelen JL, Feenstra RM, Hansen BE, Bernoski FP (1995) Failure of the Mecring screw-ring acetabular component in total hip arthroplasty. A three to seven-year follow-up study. J Bone Joint Surg Am 77:760–766
Capello WN, Colyer RA, Kernek CB, Carnahan JV, Hess JJ (1993) Failure of the Mecron screw-in ring. J Bone Joint Surg Br 75:835–836
Carlsson AS, Gentz C-F, Sanzén L (1986) Socket loosening after hip arthroplasty. Radiographic observations in 241 cases up to 15 years. Acta Orthop Scand 57:97–100
Cordero-Ampuero J, Garcia-Cimbrelo E, Munuera L (1994) Fixation of cementless acetabular cups. A radiographic 4–8-year study of 102 porous-coated components. Acta Orthop Scand 65:263–266
Cotterill P, Hunter GA, Tile M (1982) A radiographic analysis of 166 Charnley-Müller total hip arthroplasties. Clin Orthop 163:120–126
Coudane H, Fery A, Sommelet J, Lacoste J, Leduc P, Gaucher A (1981) Aseptic loosening of cemented total arthroplasties of the hip in relation to positioning of the prosthesis: new utilization of the Tschuprow-Cramer statistical test. Acta Orthop Scand 52:201–205
Delaunay CP, Kapandji AI (1998) Survivorship of rough-surfaced threaded acetabular cups. 382 consecutive primary Zweymüller cups followed for 0.2–12 years. Acta Orthop Scand 69:379–383
DeLee JG, Charnley J (1976) Radiological demarcation of cementless sockets in total hip replacement. Clin Orthop 121:20–32
Dickob M, Bleher J, Puhl W (1994) Standardisierte Pfannenwanderungsanalyse in der Hüftendoprothetik mittels digitaler Bildverarbeitung. Unfallchirurg 97:92–97
Dominikus M, Wanivenhaus AH, Morscher M, Powell G, Krismer M, Wölfl G (1998) Different cup migration in rheumatoid arthritis and arthrosis. A radiographic analysis of 127 uncemented acetabular cups. Acta Orthop Scand 69:455–462
Hamilton HW (1986) Prosthetic position in total hip replacement. Orthop Rev 15:294–300
Havelin LI, Vollset SE, Engesaeter LB (1995) Revision for aseptic loosening of uncemented cups in 4352 primary total hip prostheses. A report form the Norwegian Arthorplasty Register. Acta Orthop Scand 66:494–500
Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481
Karachalios T, Hartofilakidis G, Zacharakis N, Tsekoura M (1993) A 12- to 18-year radiographic follow-up study of Charnley low-friction arthroplasty. The role of the centre of rotation. Clin Orthop 296:140–147
Krismer M, Stoeckl B, Fischer M, Bauer R, Mayrhofer P, Ogan M (1996) Early migration predicts late aseptic failure of hip sockets. J Bone Joint Surg Br 78:422–426
Krismer M, Tschupik JP, Bauer R, Mayrhofer P, Stöckl B, Fischer M, Biedermann R (1997) Einzel-Bild-Röntgen-Analyse (EBRA) zur Messung der Migration von Hüftendoprothesen. Orthopäde 26:229–236
Kutschera HP, Eyb R, Schartelmüller T, Toma C, Zweymüller K (1993) Das zementfreie Zweymüller Hüft-System. Ergebnisse einer 5-Jahres-Nachuntersuchung. Z Orthop 131:513–517
Malchau H, Herberts P, Wang YX, Kärrholm J, Romanus B (1986) Long-term clinical and radiological results of the Lord total hip prosthesis. A prospective study. J Bone Joint Surg Br 78:884–891
Manley MT, Capello WN, D’Antonio JA, Edidin AA, Geesink RGT (1998) Fixation of acetabular cups without cement in total hip arthroplasty. J Bone Joint Surg Am 80:1175–1185
McBroom R, Müller M (1984) Aseptic loosening: fifteen years’ experience with the Müller total hip arthroplasty. J Bone Joint Surg Br 66:300–301
Mjöberg B (1991) Fixation and lossening of hip prostheses. A review. Acta Orthop Scand 62:500–508
Mjöberg B, Selvik G, Hansson LI, Rosenqvist R, Önnerfält R (1986) Mechanical loosening of total hip prostheses. A radiographic and roentgen stereogrammatic study. J Bone Joint Surg Br 68:770–774
Morscher E, Schmassmann A (1983) Failures of total hip arthroplasty and probable incidence of revision surgery in the future. Arch Orthop Trauma Surg 101:137–142
Morscher EW (1992) Current status of acetabular fixation in primary total hip arthroplasty. Clin Orthop 274:172–193
Nunn D, Freeman MAR, Hil PF, Evans SJW (1989) The measurement of migration of the acetabular component of hip prostheses. J Bone Joint Surg Br 71:629–631
Önsten I, Bengner U, Besjakov J (1993) Socket migration after Charnley arthroplasty in rheumatoid arthritis and osteoarthritis. A roentgen stereophotogrammetric study. J Bone Joint Surg Br 75:677–680
Önsten I, Akesson K, Obrant KJ (1995) Micromotion of the acetabular component and periactabular bone morphology. Clin Orthop 310:103–110
Pagnano MW, Hanssen AD, Lewallen DG, Shaughnessy WJ (1996) The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg Am 78:1004–1012
Pellici PM, Wilson PD Jr, Sledge CB, Salvati EA, Ranawat CS, Poss R (1982) Revision total hip arthroplasty. Clin Orthop 170:34–41
Rapperport DJ, Carter DR, Schurman DJ (1987) Contact finite element stress analysis of porous ingrowth acetabular cup implantation, ingrowth, and loosening. J Orthop Res 5:548–561
Rosler J, Perka C (2000) The effect of anatomical positional relationships on kinetic parameters after total hip replacement. Int Orthop 24:23–27
Simank H-G, Brocal DRC, Reiser D, Thomsen M, Sabo D, Lukoschek M (1997) Middle-term results of threaded acetabular cups. High failure rates five years after surgery. J Bone Joint Surg Br 79:366–370
Snorrason F, Kärrholm J (1990) Primary migration of fully-threaded acetabular prostheses. A roentgen stereophotogrammetric analysis. J Bone Joint Surg Br 72:647–652
Stauffer RN (1982) Ten-year follow-up study of total hip replacements. With particular reference to roentgenographic loosening of the components. J Bone Joint Surg Am 64:983–990
Wilson-MacDonald J, Morscher E, Masar Z (1990) Cementless uncoated polyethylene acetabular components in total hip replacement. Review of five- to 10-year results. J Bone Joint Surg Br 72:423–430
Wroblewski BM (1979) Wear of high-density polyethylene on bone and cartilage. J Bone Joint Surg Br 61:498–500
Wroblewski BM, Lynch M, Atkinson JR, Dowson D, Isaac GH (1987) External wear of the polyethylene socket in cemented total hip arthroplasty. J Bone Joint Surg Br 69:61–63
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fink, B., Protzen, M., Hansen-Algenstaedt, N. et al. High migration rate of two types of threaded acetabular cups. Arch Orthop Trauma Surg 124, 17–25 (2004). https://doi.org/10.1007/s00402-003-0592-y
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-003-0592-y