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Radiographic signs and hip pain 5 years after THA with a cemented stem predict future revision for aseptic loosening: a prospective cohort study.
Lübbeke, Anne; Barea, Christophe; Zingg, Matthieu; Lauper, Nicolas; Hannouche, Didier; Garavaglia, Guido.
Afiliación
  • Lübbeke A; Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. anne.lubbekewolff@hcuge.ch.
  • Barea C; Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland.
  • Zingg M; Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland.
  • Lauper N; Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland.
  • Hannouche D; Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland.
  • Garavaglia G; Ars Medica Centro Medico, Bellinzona, Switzerland.
Acta Orthop ; 95: 32-38, 2024 01 29.
Article en En | MEDLINE | ID: mdl-38284749
ABSTRACT
BACKGROUND AND

PURPOSE:

We aimed to evaluate the long-term predictive value of radiographic abnormality and/or hip pain assessed 5 years following primary total hip arthroplasty (THA) and the occurrence of revision for aseptic loosening between 5 and 25 years postoperatively. PATIENTS AND

METHODS:

We included all primary THAs performed between 1996 and 2011 (same uncemented cup, polyethylene-ceramic bearing, 28 mm head, cemented stem) and prospectively enrolled in the institutional registry, for whom baseline and follow-up radiographs were available. At 5 years radiographically we assessed femoral osteolysis and/or stem migration. Pain was evaluated with the Harris Hip pain subscore. Kaplan-Meier survival and Cox regression analyses were performed.

RESULTS:

1,317 primary THAs were included. 25 THAs (2%) were revised for aseptic stem loosening. Any abnormal radiographic sign at 5 years was present in 191 THAs (14%). Occasional hip pain was reported by 20% and slight to severe pain by 12% of patients at 5 years. In patients < 60 years, 10 of the 12 later revised for aseptic stem loosening had abnormal radiographs at 5 years vs. 5 of the 13 later revised in those ≥ 60 years. Hazard ratios (HR) were 34 (95% confidence interval [CI] 7-155) in younger vs. 4 (CI 1-11) in the older group. HR for association of hip pain at 5 years with future revision was 3 (CI 1-5).

CONCLUSION:

The presence of abnormal radiographic signs 5 years after THA was strongly associated with later revision for aseptic stem loosening, especially in patients < 60 years. The association between pain at 5 years and future revision was much weaker.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Cadera / Prótesis de Cadera Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Acta Orthop Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Suecia
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Cadera / Prótesis de Cadera Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Acta Orthop Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Suecia