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No difference in clinical outcome, bone density and polyethylene wear 5–7 years after standard navigated vs. conventional cementfree total hip arthroplasty

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this investigation was to compare clinical outcome, component loosening, polyethylene cup wear and periprosthetic bone mineral density between “cup first” navigated and conventional cementless total hip arthroplasty (THA) 5–7 years after surgery.

Materials and methods

Fifty patients who received THA with (n = 25) or without (n = 25) the use of an image-free navigation system by a single surgeon were investigated after a mean follow-up of 6.4 (4.8–7.4) years. The Hip Osteoarthritis Outcome Score (HOOS) and the Harris Hip Score (HHS) were obtained; range-of-motion (ROM) was evaluated by a blinded examiner. Radiographic cup inclination, signs of radiographic loosening and polyethylene wear were analysed with the help of digital analysis software on anterio-posterior radiographs by a blinded examiner. Acetabular and femoral periprosthetic bone density was evaluated with the help of dual-energy X-ray absorptiometry.

Results

We were unable to find any statistical significant or clinically relevant difference for the HOOS, HHS, ROM and polyethylene wear between the navigated and the conventional THA group 5–7 years after surgery. Cup inclination was more precise in the navigated THA group in relation to the target value of 45°.

Conclusions

Standard “cup first” THA navigation does not improve mid-term functional outcome, bony ingrowth and/or polyethylene wear. New concepts in computer-assisted THA, considering cup and stem as coupled biomechanical partners are needed to justify the effort of navigation in routine operations.

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Conflict of interest

Each author certifies that he has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. The work was performed at the Department of Orthopaedic Surgery at the Medical University of Regensburg/Germany.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Regensburg, Kaiser-Karl-V Allee 3, 93077, Bad Abbach, Germany

    Armin Keshmiri, Christoph Schröter, Markus Weber, Benjamin Craiovan, Joachim Grifka & Tobias Renkawitz

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  1. Armin Keshmiri
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  2. Christoph Schröter
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  3. Markus Weber
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Correspondence to Armin Keshmiri.

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Keshmiri, A., Schröter, C., Weber, M. et al. No difference in clinical outcome, bone density and polyethylene wear 5–7 years after standard navigated vs. conventional cementfree total hip arthroplasty. Arch Orthop Trauma Surg 135, 723–730 (2015). https://doi.org/10.1007/s00402-015-2201-2

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  • DOI: https://doi.org/10.1007/s00402-015-2201-2

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