1
|
Comment to "Ceramic-on-ceramic articulation in press-fit total hip arthroplasty as a potential reason for early failure, what about the survivors: a ten year follow-up". INTERNATIONAL ORTHOPAEDICS 2021; 45:1379-1380. [PMID: 33725129 DOI: 10.1007/s00264-021-05001-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
|
2
|
van Loon J, Vervest AMJS, van der Vis HM, Sierevelt IN, Baas DC, Opdam KTM, Kerkhoffs GMMJ, Haverkamp D. Ceramic-on-ceramic articulation in press-fit total hip arthroplasty as a potential reason for early failure, what about the survivors: a ten year follow-up. INTERNATIONAL ORTHOPAEDICS 2021; 45:1447-1454. [PMID: 33459828 PMCID: PMC8178149 DOI: 10.1007/s00264-020-04895-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/03/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE In press-fit total hip arthroplasty (THA), primary stability is needed to avoid micromotion and hereby aseptic loosening, the main reason for early revision. High aseptic loosening revision rates of the seleXys TH+ cup (Mathys Medical) with Ceramys ceramic-on-ceramic (CoC) bearing are seen in literature. Since CoC is presumed to overcome long-term wear-related revisions, the reason for early failure of this cup is important to clarify. The aim is to investigate its ten year outcomes and differentiate between potential causes and identify risk factors for aseptic loosening. METHODS Retrospective screening of a prospectively documented series of 315 THAs was performed. Primary outcome was cumulative incidence of cup revision due to aseptic loosening. Secondary outcomes were component revision and reoperation. Additionally, potential predictive factors for aseptic loosening were evaluated. RESULTS At the median follow-up of 9.7 years [IQR 4.4; 10.3], 48 TH+ (15.2%) were revised due to aseptic loosening. Competing risk analysis showed a ten year cumulative incidence of cup revision due to aseptic loosening of 15.6% (95% CI 12.0-20.2). Stabilization of early revision rates was observed, following a high rate of respectively 81.3% (n = 39) and 95.8% (n = 46) within the first two and three years. No significant predictive factors for aseptic loosening were found. CONCLUSION The ten year results of seleXys TH+ cup with Ceramys CoC bearing showed an unacceptable high aseptic loosening rate, which stabilized over time after a high early failure incidence. This could be attributed to a problem with osseointegration during the transition of primary to definitive stability.
Collapse
Affiliation(s)
- J van Loon
- Department of Orthopedic Surgery, Xpert Clinics/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA, Amsterdam, The Netherlands.,Department of Orthopaedic Surgery, Amsterdam University Medical Centers, location Academic Medical Center, Meibergdreef 15, 1105, AZ, Amsterdam, The Netherlands.,Department of Orthopaedic Surgery, Tergooi, Van Riebeeckweg 212, 1213, XZ, Hilversum, The Netherlands
| | - A M J S Vervest
- Department of Orthopaedic Surgery, Tergooi, Van Riebeeckweg 212, 1213, XZ, Hilversum, The Netherlands
| | - H M van der Vis
- Department of Orthopedic Surgery, Xpert Clinics/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA, Amsterdam, The Netherlands
| | - I N Sierevelt
- Department of Orthopedic Surgery, Xpert Clinics/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA, Amsterdam, The Netherlands.,Department of Orthopaedic Surgery, Spaarne Gasthuis, Spaarnepoort 1, 2134, TM, Hoofddorp, The Netherlands
| | - D C Baas
- Department of Orthopaedic Surgery, Tergooi, Van Riebeeckweg 212, 1213, XZ, Hilversum, The Netherlands
| | - K T M Opdam
- Department of Orthopaedic Surgery, Amsterdam University Medical Centers, location Academic Medical Center, Meibergdreef 15, 1105, AZ, Amsterdam, The Netherlands
| | - G M M J Kerkhoffs
- Department of Orthopaedic Surgery, Amsterdam University Medical Centers, location Academic Medical Center, Meibergdreef 15, 1105, AZ, Amsterdam, The Netherlands
| | - D Haverkamp
- Department of Orthopedic Surgery, Xpert Clinics/SCORE (Specialized Center of Orthopedic Research and Education), Laarderhoogtweg 12, 1101EA, Amsterdam, The Netherlands.
| |
Collapse
|
3
|
Halasi T, Kieser D, Frampton CM, Hooper GJ. Midterm analysis of the seleXys cup with ceramic inlay. Arthroplast Today 2016; 3:171-175. [PMID: 28913402 PMCID: PMC5585767 DOI: 10.1016/j.artd.2016.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 09/21/2016] [Accepted: 10/01/2016] [Indexed: 11/29/2022] Open
Abstract
Background Ceramic-on-ceramic (CoC) articulations in total hip replacement (THR) has been accepted as giving reliable mid-term results; however recent studies have reported higher revision rates of some implants. This study analyses the nationwide results of the seleXys TPS cup and the Bionit2 liner (Mathys, Bettlach, Switzerland) with respect to implant survival, cause for revision and mortality rates compared to other CoC articulations using the same stem. Methods Utilising the New Zealand Joint Registry, we compared the seleXys TPS cup with Bionit2 liner used with an uncemented Twinsys femoral stem to every other uncemented CoC THR using the same stem. Multivariate analysis was used to determine the effects of patient age, gender, ASA score and implant head size on these rates. Results Between 2006 and 2013 a total of 1035 seleXys THRs were performed on 862 patients. The comparison group had 375 THRs on 280 patients. There were 77 revisions (1.4/100 component years) in the study group and two in the comparison group (0.12/100 component years). Overall hazards ratio for revision was 12.22 times higher and female gender was associated with an increased risk (hazards ratio 1.77). Causes for revision were disturbing noises (23.4%), acetabular loosening (20.8%), and fracture of the liner (18.2%). Mortality rates were not significantly different (P = .567). Conclusions The seleXys TPS cup with the Bionit2 ceramic inlay coupling has an unacceptably high failure rate. We recommend avoiding this implant coupling and would advise that patients treated with this implant need close clinical and radiological follow-up.
Collapse
Affiliation(s)
| | - David Kieser
- Corresponding author. Department of Orthopaedic Surgery and MSM, University of Otago, Riccarton Avenue, Christchurch, New Zealand. Tel.: +64 3 364 0640.Department of Orthopaedic Surgery and MSMUniversity of OtagoRiccarton AvenueChristchurchNew Zealand
| | | | | |
Collapse
|