Title: Assessment of Orientation and Fixation of Acetabular Component in Uncemented total Hip Arthroplasty and its Outcome: A Case Series Study

Authors: A.Sudharsan, G.A.Rajmohan

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i6.18

Abstract

Introduction: Fixation of porous im plant depends on bone in growth and bone on growth in hydroxyapatite coated acetabular implant, CT scans were played an important role in evaluating acetabular cup position precisely.  Formation of new bone in prosthetic bone interface (osteointegration) is a good sign of stability in uncemented total hip replacement.

Aim: A study to analyse the importance of acetabular component orientation and fixation for the outcome of uncemented total hip arthroplasty.

Meterial & Methods: 18 to 60 years of aged fifteen patients underwent uncemented total hip arthroplasty through posterior approach during June2013 to March2015.Periodic evaluation of osteointegration and orientation of acetabular component was done clinically and radiologically using CT scan.

Results: Harris Hip Score improved from 29.9 preoperative to 91.4 postoperatively in our study with one case of deterioration but gave fair result. Mean acetabularante version and inclination was 21 degree and 41 degree respectively.

Conclusion: In this short term study clinical outcome correlated well with radiological appearance and had comparable results with previous studies.

Keywords: osteointegration, acetabular component, anteversion, inclination, arthroplasty.

References

  1. BN Weissman, Imaging of total hip replacement, Radiology 1997;202:611
  2. Paul RT Kuzyk and Emil H Schemitsch The basic science of periimplant bone healing Indian J Orthop. 2011 Mar-Apr; 45(2): 108–115.
  3. Anna nilsdotter and Ann bremander, Measures of Hip function and symptoms, Arthritis care & Research vol63,no.S11, nov201,ppS200-207
  4. DeLee J.G, and Charnley, John, Radiolical demarcation of cemented sockets in total hip replacement Clin Orthop.,121;20-32,1976.
  5. Pidhorz LE, UrbanRM, JacobsJJ, Sumner DR, Galante JO. Aquantitative study of bone and soft tissues in cementless porous-coatedacetabular components retrieved at autopsy. J. Arthroplasty, 8(2):213-225, 1993
  6. Engh CA, Bobyn JD, Glassman AH. Porous coated hip replacement. The factors governing bone ingrowth, stress shielding, andclinical results. J Bone Joint Surg Br.1987;69:45-55.
  7. Wines AP, McNicol D. Computed tomography measurement of the accuracy of component version in total hip arthroplasty. J Arthroplasty. 2006;21(5) :696–701. doi: 10.1016/j.arth.2005.11.008.
  8. Charnley J. Total hip replacement by low friction arthroplasty. Clin Orthop Relat Res.1970;(72):7-21.
  9. Coventry MB. Late dislocations in patients with Charnley total hip arthroplasty. J Bone Joint Surg Am.1985;67(6):832-841.
  10. Harris WH. Advances in surgical technique for total hip replacement without and with osteotomy of the greater trochanter. Clin Orthop Relat Res. 1980;146(2):188-204.
  11. Ranawat CS, Dorr LD, Inglis AE. Total hip arthroplasty in protrusion acetabula of rheumatoid arthritis. J Bone Joint Surg Am.1980,62(7):   1059-1065.

Corresponding Author

A.Sudharsan

Department of Orthopaedics, Sivagangai Medical College Hospital,

Sivagangai, Tamilnadu, India