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Proximal translation of > 1 mm within the first two years of revision total hip arthroplasty correctly predicts whether or not an acetabular component is loose in 80% of cases: a case-control study with confirmed intra-operative outcomes.
- Source :
-
The bone & joint journal [Bone Joint J] 2017 Apr; Vol. 99-B (4), pp. 465-474. - Publication Year :
- 2017
-
Abstract
- Aims: The purpose of this study was to determine the sensitivity, specificity and predictive values of previously reported thresholds of proximal translation and sagittal rotation of cementless acetabular components used for revision total hip arthroplasty (THA) at various times during early follow-up.<br />Patients and Methods: Migration of cementless acetabular components was measured retrospectively in 84 patients (94 components) using Ein-Bild-Rontgen-Analyse (EBRA-Cup) in two groups of patients. In Group A, components were recorded as not being loose intra-operatively at re-revision THA (52 components/48 patients) and Group B components were recorded to be loose at re-revision (42 components/36 patients).<br />Results: The mean proximal translation and sagittal rotation were significantly higher in Group B than in Group A from three months onwards (p < 0.02). Proximal translation > 1.0 mm within 24 months had a positive predictive value (PPV) of 90% and a specificity of 94%, but a sensitivity of 64%. Proximal translation > 1.0 mm within the first 24 months correctly identified 76 of 94 (81%) of components to be either loose or not loose. However, ten components in Group B (24%) did not migrate proximally above 1.0 mm within the first 60 months.<br />Conclusion: The high PPV of EBRA-Cup measurements of proximal translation (90%) shows that this can be used in early follow-up to identify patients at risk of aseptic loosening. The absence of proximal translation within the first 60 months indicates a component is not likely to be loose at re-revision THA although it does not exclude late aseptic loosening as a cause of failure. Cite this article: Bone Joint J 2017;99-B:465-74.<br /> (©2017 The British Editorial Society of Bone & Joint Surgery.)
- Subjects :
- Acetabulum pathology
Acetabulum surgery
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip instrumentation
Case-Control Studies
Female
Follow-Up Studies
Foreign-Body Migration pathology
Hip Prosthesis
Humans
Male
Middle Aged
Observer Variation
Postoperative Period
Predictive Value of Tests
Prosthesis Design
Reoperation adverse effects
Acetabulum diagnostic imaging
Arthroplasty, Replacement, Hip adverse effects
Foreign-Body Migration diagnostic imaging
Prosthesis Failure etiology
Subjects
Details
- Language :
- English
- ISSN :
- 2049-4408
- Volume :
- 99-B
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The bone & joint journal
- Publication Type :
- Academic Journal
- Accession number :
- 28385935
- Full Text :
- https://doi.org/10.1302/0301-620X.99B4.BJJ-2016-0805.R1