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1.
Bone Joint J ; 106-B(5): 435-441, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38688480

RESUMEN

Aims: Refobacin Bone Cement R and Palacos R + G bone cement were introduced to replace the original cement Refobacin Palacos R in 2005. Both cements were assumed to behave in a biomechanically similar fashion to the original cement. The primary aim of this study was to compare the migration of a polished triple-tapered femoral stem fixed with either Refobacin Bone Cement R or Palacos R + G bone cement. Repeated radiostereometric analysis was used to measure migration of the femoral head centre. The secondary aims were evaluation of cement mantle, stem positioning, and patient-reported outcome measures. Methods: Overall, 75 patients were included in the study and 71 were available at two years postoperatively. Prior to surgery, they were randomized to one of the three combinations studied: Palacos cement with use of the Optivac mixing system, Refobacin with use of the Optivac system, and Refobacin with use of the Optipac system. Cemented MS30 stems and cemented Exceed acetabular components were used in all hips. Postoperative radiographs were used to assess the quality of the cement mantle according to Barrack et al, and the position and migration of the femoral stem. Harris Hip Score, Oxford Hip Score, Forgotten Joint Score, and University of California, Los Angeles Activity Scale were collected. Results: Median distal migration (y-axis) at two years for the Refobacin-Optivac system was -0.79 mm (-2.01 to -0.09), for the Refobacin-Optipac system was -0.75 mm (-2.16 to 0.20), and for the Palacos-Optivac system was -1.01 mm (-4.31 to -0.29). No statistically significant differences were found between the groups. Secondary outcomes did not differ statistically between the groups at the two-year follow-up. Conclusion: At two years, we found no significant differences in distal migration or clinical outcomes between the three groups. Our data indicate that Refobacin Bone Cement R and Palacos R + G are comparable in terms of stable fixation and early clinical outcomes.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Cementos para Huesos , Prótesis de Cadera , Humanos , Masculino , Femenino , Estudios Prospectivos , Artroplastia de Reemplazo de Cadera/métodos , Artroplastia de Reemplazo de Cadera/instrumentación , Anciano , Persona de Mediana Edad , Análisis Radioestereométrico , Falla de Prótesis , Diseño de Prótesis , Medición de Resultados Informados por el Paciente , Anciano de 80 o más Años , Polimetil Metacrilato
2.
Acta Orthop ; 93: 459-465, 2022 04 22.
Artículo en Inglés | MEDLINE | ID: mdl-35478261

RESUMEN

BACKGROUND AND PURPOSE: Computed tomography micromotion analysis (CTMA) can be used to determine implant micro-movements using low-dose CT scans. By using CTMA, a non-invasive measurement of joint implant movement is enabled. We evaluated the precision of CTMA in measuring early cup migration. Standard marker-based radiostereometric analysis (RSA) was used as reference. We hypothesised that CTMA can be used as an alternative to RSA in assessing implant micromotions. PATIENTS AND METHODS: We included 30 patients undergoing total hip arthroplasty (THA). Acetabular cup migration at 1 year was measured with RSA and CTMA. To determine the precision of both methods, 20 double examinations (postoperatively) with repositioning of the patients were performed. The precision was calculated from zero by assuming that there was no motion of the prosthesis between the 2 examinations. RESULTS: The precision of RSA ranged from 0.06 to 0.15 mm for translations and 0.21° to 0.63° for rotations. Corresponding values for CTMA were 0.06 to 0.13 mm and 0.23° to 0.35°. A good level of agreement was found between the methods regarding cup migration and rotation at 1 year. INTERPRETATION: The precision of CTMA in measuring acetabular cup migration and rotation is comparable to marker-based RSA. CTMA could possibly thus be used as an alternative method to detect early implant migration.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Análisis Radioestereométrico , Acetábulo/diagnóstico por imagen , Acetábulo/cirugía , Artroplastia de Reemplazo de Cadera/efectos adversos , Humanos , Estudios Prospectivos , Análisis Radioestereométrico/métodos , Tomografía Computarizada por Rayos X
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