Survie de l’arthroplastie totale de hanche sans ciment metal-polyéthylène hautement réticulé versus céramique céramique : une étude cas-contrôle à 5–9 ans de recul - 23/08/18
Comparison of cementless total hip arthroplasty survivorship between metal-on-highly cross-linked polyethylene and ceramic-on-ceramic bearings: A case control study with a 5–9-year follow-up
, Taisuke Seki, Yukiharu Hasegawa, Daigo Morita, Daigo Komatsu, Yasuhiko Takegami, Naoki IshiguroAbstract |
Background |
Currently, there is a lack of evidence on the medium-term follow-up of cementless total hip arthroplasty (THA) using metal-on highly cross-linked polyethylene bearing (MoXPE), ceramic on ceramic bearing (CoC) at more than 5 years follow-up. Therefore, we performed a case control study to: 1) compare the incidence rate of osteolysis, 2) compare the longevity for both types of THAs, and 3) to evaluate the wear rate of MoXPE THAs.
Hypothesis |
CoC THAs will have a lower rate of osteolysis and better longevity than MoXPE THAs.
Patients and methods |
We performed a retrospective analysis of 77 MoXPE (68 women, 9 men) and 105 CoC (85 women, 20 men) THAs, with an average patient age at the time of surgery of 64.7 years (range, 27 to 76 years). The cohorts were matched according to sex, body mass index, or diagnosis of hip joint disease. Clinical and radiologic measurements were analyzed at a mean follow-up of 6.7 years (range, 5–9 years).
Results |
There were no between-group differences with regard to the Harris hip score (87.0 (64.0–98.0) and 89.9 (70.0–100.0) for the MoXPE and CoC group, respectively) and the incidence rate of osteolysis (2.6% and 1.9%, respectively). Revision was required for 1 case for each THA type. The Kaplan–Meier survival at 8 years, using implant loosening or revision as the end-point of analysis, was 96.1% (95% confidence interval (CI), 90.0–99.3) for the MoXPE group and 98.9% (95% CI, 92.2–99.8) for the CoC group (p=0.189). The mean annual liner wear rate was 0.0160mm/year (range, 0.0050 to 0.0390mm/year) for the MoXPE THAs.
Discussion |
There was no difference between CoC and MoXPE THAs in the incidence of osteolysis or in survival rate at 8 years post-surgery. Excellent clinical and radiological outcomes were obtained for both types of bearings.
Level of evidence |
III, Case control study, case control retrospective design.
Le texte complet de cet article est disponible en PDF.Keywords : Ceramic on ceramic bearing, Metal on highly cross-linked polyethylene bearing, Total hip arthroplasty, Wear
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 104 - N° 5
P. 471 - septembre 2018 Retour au numéro
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