Comparison of early migration patterns between a ceramic and polyethylene liner in uncemented Trabecular Titanium cups: a 2-year randomized controlled trial of 52 hips using radiostereometric analysis

Authors

  • Amanda D Klaassen Department of Orthopedic Surgery, OLVG, Amsterdam https://orcid.org/0000-0002-8499-2814
  • Elisabeth A Schäffer Department of Orthopedic Surgery, OLVG, Amsterdam
  • Nienke W Willigenburg Department of Orthopedic Surgery, OLVG, Amsterdam
  • Loes W A H van Beers Department of Orthopedic Surgery, OLVG, Amsterdam
  • Vanessa A B Scholtes Department of Orthopedic Surgery, OLVG, Amsterdam
  • Victor P M van der Hulst Department of Radiology, OLVG, Amsterdam
  • Lennard A Koster Department of Orthopedic Surgery, RSAcore, LUMC, Leiden https://orcid.org/0000-0002-5874-389X
  • Bart L Kaptein Department of Orthopedic Surgery, RSAcore, LUMC, Leiden https://orcid.org/0000-0001-8772-9985
  • Dirk Jan F Moojen Department of Orthopedic Surgery, OLVG, Amsterdam
  • Rudolf W Poolman Department of Orthopedic Surgery, OLVG, Amsterdam; Department of Orthopedic Surgery, LUMC, Leiden, The Netherlands https://orcid.org/0000-0003-3178-2247

DOI:

https://doi.org/10.2340/17453674.2022.2267

Keywords:

Cup, Implants, Osteoarthrosis, Radiostereometric analysis, RCT, RSA, Total hip arthroplasty

Abstract

Background and purpose: Ceramic liners may reduce early stability of uncemented acetabular components due to higher stiffness. However, the bone ingrowth capacities of porous trabecular titanium might compensate for this effect. This prospective randomized trial quantifies migration patterns of the Delta-TT cup, and compares polyethylene and ceramic liners.
Patients and methods: Patients undergoing primary uncemented total hip arthroplasty with the Delta-TT cup and femoral stem with ceramic head were randomized to a polyethylene (n = 25) or ceramic (n = 28) liner. Radiostereometric analysis (RSA) radiographs, patient-reported hip function (HOOS-PS, OHS), and quality of life (EQ5D) were collected at baseline and 1.5, 3, 6, 12, and 24 months postoperatively. Model-based RSA was used to calculate 3D cup translation and rotation, and mixed models were used to compare effects over time between groups.
Results: At 2 years follow-up, Delta-TT cups showed similar mean proximal translation of 0.56 mm (95% CI 0.38–0.75) in the ceramic (CE) group and 0.54 mm (0.30–0.77) in the polyethylene (PE) group, with a between group effect of 0.02 mm (–0.20–0.23). Most cup migration occurred in the first 1.5 to 3 months, stabilizing within 6 months. Any between-group effects were ≤ 0.30 mm for translation and ≤ 0.45° for rotation. Improvements in patient-reported hip function and quality of life were similar in both groups.
Interpretation: Regardless of liner type, Delta-TT cups showed some initial migration and stabilized within 6 months, which seems promising for long-term fixation in both cup-liner constructs.

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Published

2022-04-28

How to Cite

Klaassen, A. D., Schäffer, E. A., Willigenburg, N. W., van Beers, L. W. A. H., Scholtes, V. A. B., van der Hulst, V. P. M., Koster, L. A., Kaptein, B. L., Moojen, D. J. F., & Poolman, R. W. (2022). Comparison of early migration patterns between a ceramic and polyethylene liner in uncemented Trabecular Titanium cups: a 2-year randomized controlled trial of 52 hips using radiostereometric analysis. Acta Orthopaedica, 93, 451–458. https://doi.org/10.2340/17453674.2022.2267

Issue

Section

Randomized clinical trial

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