Highly-porous metal option for primary cementless acetabular fixation. What is the evidence?

Samik Banerjee, Kimona Issa, Bhaveen H. Kapadia, Robert Pivec, Harpal S. Khanuja, Michael A. Mont

Research output: Contribution to journalReview articlepeer-review

Abstract

The purported improvement in the initial stability and enhanced osseointegration has stimulated a recent increase in the use of highly-porous interfaces for acetabular fixation in cementless hip arthroplasty. The aim of this study was to comprehensively review the literature and report the clinical outcomes of highly-porous metals in primary cementless acetabular fixation. Aseptic survivorship, osteolysis, Harris hip scores, cup migration and the incidence of peri-acetabular gaps, and periprosthetic fractures were assessed. A search of four electronic databases yielded 16 level IV studies that reported on the use of these newer highly-porous metals in primary cementless acetabular fixation. The mean cup-survivorship for aseptic loosening with the use of these modern interfaces was 100% and the mean acetabular component revision rate for any reason at 100-component years was 0.14 (range 0 to 0.55) at a mean follow-up of five years. The functional outcomes were also noted to be excellent with significant improvement in Harris Hip scores from a mean of 46 points pre-operatively (15 to 85 points) to 91 points (range, 80 to 97 points) post-operatively. Cup-stability was found to be excellent with a mean incidence of migration of less than 2% at mean follow-up of five years (range, 0.6 to 12 years). None of the studies on primary arthroplasty had any evidence of progressive periacetabular osteolysis in their study population at final follow-up. In summary, randomised controlled trials and long-term evaluation of these highly-porous implants will be needed in future to determine their potential superiority and to justify the increased cost.

Original languageEnglish (US)
Pages (from-to)509-521
Number of pages13
JournalHIP International
Volume23
Issue number6
DOIs
StatePublished - Jan 1 2013

Keywords

  • Acetabular
  • Fixation
  • Highly-porous
  • Metal
  • Primary
  • Review

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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