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.
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.
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Wahab, A., Quinlan, J.F., Sherif, S. et al. Are cementless acetabular components contra-indicated in the elderly?. Eur J Orthop Surg Traumatol 17, 263–266 (2007). https://doi.org/10.1007/s00590-006-0170-4
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DOI: https://doi.org/10.1007/s00590-006-0170-4