Advertisement

Are cementless acetabular components contra-indicated in the elderly?

  • A. Wahab
  • J. F. QuinlanEmail author
  • S. Sherif
  • I. P. Kelly
Original Article
  • 72 Downloads

Abstract

The long-term success of primary total hip arthroplasty in elderly patients has been well documented. In addition, the use of uncemented acetabular components in younger patients has been well established. However, as yet, there has not been widespread use of uncemented acetabular components in older patients. This study reviews a single surgeon series of 179 consecutive primary total hip replacements using an uncemented acetabular component. Patients were followed up clinically, radiologically and by means of a postal questionnaire. Patients were divided into under-70 years (n = 80) and 70 years and older (n = 99). There were 88 males and 91 females who were followed up to a mean of 24.1 months. There were no significant differences between the groups with respect to the need for additional screw fixation, post-operative complications or implant loosening. Functionally, no differences were recorded in terms of pain, limp, mobility or ability to put on shoes and socks post-operatively. There was no significant difference between the two groups in the levels of satisfaction reported. These results justify the use of uncemented acetabular components in older patients.

Keywords

Total hip arthroplasty Cementless components Functional outcomes 

Les cupules acétabulaires non cimentées sont-elles contre-indiquées chez les patients âgés?

Résumé

Les succès à long terme de l’arthroplastie totale de hanche de première intention chez les personnes âgées a été bien analysée et documentée. De plus l’utilisation de cupules acétabulaires non cimentées chez des sujets plus jeunes est bien établie. Cependant à ce jour l’utilisation large de cupules non cimentées chez les patients âgés n’a pas été prônée. Cette étude porte sur 179 poses consécutives de prothèses de hanche par le même chirurgien avec utilisation d’une cupule acétabulaire non cimentée. Les patients ont été suivis cliniquement, radiologiquement et grâce à un questionnaire envoyé par la poste. Les patients ont été regroupés en deux groupes, âge inférieur à 70 ans (n = 80) et âge de 70 ans et au-delà (n = 99). Il y avait 88 hommes et 91 femmes qui ont été suivis en moyenne 24.1 mois. Il n’ a pas été noté de différence significative entre les deux groupes concernant la nécessité de vis additionnelles, les complications post-opératoires ou le descellement des implants. Au point de vue fonctionnel aucune différence n’a pas non plus été notée concernant les douleurs, la boiterie, la mobilité, la possibilité de se chausser et de mettre ses bas ou chaussettes. Enfin aucune différence n’est apparue entre les deux groupes quant au degré de satisfaction. Ces résultats justifient l’utilisation de cupules acétabulaires non cimentées chez les personnes âgées.

Mots clés

Arthroplastie totale de hanche Composants non cimentés Résultats fonctionnels 

References

  1. 1.
    Adler E, Stuchin SA, Kummer FJ (1992) Stability of press-fit acetabular cups. J Arthroplasty 7(3):295–301PubMedCrossRefGoogle Scholar
  2. 2.
    Berry DJ, Harmsen WS, Cabanela ME, Morrey BF (2002) Twenty-five year survivorship of two thousand consecutive primary Charnley total hip replacements: factors affecting survivorship of acetabular and femoral components. J Bone Joint Surg 84A:171–177Google Scholar
  3. 3.
    Boettcher WG (1992) Total hip arthroplasties in the elderly. Morbidity, mortality, and cost effectiveness. Clin Orthop 274:30–34PubMedGoogle Scholar
  4. 4.
    Brander VA, Malhotra S, Jet J, Heinemann AW, Stulberg SD (1997) Outcome of hip and knee arthroplasty in persons aged 80 years and older. Clin Orthop 345:67–78PubMedGoogle Scholar
  5. 5.
    Christie J, Burnett R, Potts HR, Pell AC (1994) Echocardiography of transatrial embolism during cemented and uncemented hemiarthroplasty of the hip. J Bone Joint Surg 76B:409–412Google Scholar
  6. 6.
    Curtis MJ, Jinnah RH, Wilson VD, Hungerford DS (1992) The initial stability of uncemented acetabular components. J Bone Joint Surg 74B:372–376Google Scholar
  7. 7.
    Della Valle AG, Zoppi A, Peterson MG, Salvati EA (2004) Clinical and radiographic results associated with a modern, cementless modular cup design in total hip arthroplasty. J Bone Joint Surg 86A:1998–2003Google Scholar
  8. 8.
    Dorr LD, Wan Z, Gruen T (1997) Functional results in total hip replacement in patients 65 years and older. Clin Orthop 336:143–151PubMedCrossRefGoogle Scholar
  9. 9.
    Dunkley AB, Eldridge JD, Lee MB, Smith EJ, Learmonth ID (2000) Cementless acetabular replacement in the young. A 5- to 10-year prospective study. Clin Orthop 376:149–155PubMedCrossRefGoogle Scholar
  10. 10.
    Ekelund A, Rydell N, Nilsson OS (1992) Total hip arthroplasty in patients 80 years of age and older. Clin Orthop 281:101–106PubMedGoogle Scholar
  11. 11.
    Hagio K, Sugano N, Takashina M, Nishii T, Yoshikawa H, Ochi T (2003) Embolic events during total hip arthroplasty: an echocardiographic study. J Arthroplasty 18(2):186–192PubMedCrossRefGoogle Scholar
  12. 12.
    Healy WL (1995) Economic considerations in total hip arthroplasty and implant standardization. Clin Orthop 311:102–108PubMedGoogle Scholar
  13. 13.
    Healy WL (2002) Hip implant selection for total hip arthroplasty in elderly patients. Clin Orthop 405:54–64PubMedCrossRefGoogle Scholar
  14. 14.
    Keisu KS, Orozco F, Sharkey PF, Hozack WJ, Rothman RH (2001) Primary cementless total hip arthroplasty in octogenarians: two to eleven-year follow up. J Bone Joint Surg 83A:359–363Google Scholar
  15. 15.
    Levy RN, Levy CM, Snyder J, Digiovanni J (1995) Outcome and long-term results following total hip replacement in elderly patients. Clin Orthop 316:25–30PubMedGoogle Scholar
  16. 16.
    Massin P, Schmidt L, Engh CA (1989) Evaluation of cementless acetabular component migration. An experimental study. J Arthroplasty 4(3):245–251PubMedCrossRefGoogle Scholar
  17. 17.
    Orsini EC, Byrick RJ, Mullen JB, Kay JC, Waddell JP (1987) Cardiopulmonary function and pulmonary microemboli during arthroplasty using cemented or non-cemented components. The role of intramedullary pressure. J Bone Joint Surg 69A:822–832Google Scholar
  18. 18.
    Pettine KA, Aamild BC, Cabanela ME (1991) Elective total hip arthroplasty in patients older than 80 years of age. Clin Orthop 266:127–132PubMedGoogle Scholar
  19. 19.
    Rorabeck CH, Bourne RB, Mulliken BD, Nayak N (1997) Acetabular osteolysis with cementless cups: a 5 to 7 year follow-up. Acta Orthop Belg 63(Suppl 1):83–92PubMedGoogle Scholar
  20. 20.
    Sharkey PF, Hozack WJ, Callaghan JJ et al (1999) Acetabular fracture associated with cementless acetabular component insertion: a report of 13 cases. J Arthroplasty 18(2):186–192Google Scholar
  21. 21.
    Spicer DD, Schaper LA, Pomeroy DL, et al (2001) Cementless cup fixation in total hip arthroplasty after 5–8 years. Int Orthop 25(5):286–289PubMedCrossRefGoogle Scholar
  22. 22.
    Torga Spak R, Stuchin SA (2005) Cementless porous-coated sockets without holes implanted with pure press-fit technique. J Arthroplasty 20(1):4–10PubMedCrossRefGoogle Scholar
  23. 23.
    Wixson RL, Stulberg SD, 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 73A:257–270Google Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • A. Wahab
    • 1
  • J. F. Quinlan
    • 1
    • 2
    Email author
  • S. Sherif
    • 1
  • I. P. Kelly
    • 1
  1. 1.Department of Orthopaedic SurgeryLourdes Regional Orthopaedic Hospital, KilcreeneCo. KilkennyRepublic of Ireland
  2. 2.Co. DublinRepublic of Ireland

Personalised recommendations