Migration patterns of acetabular cups: a systematic review and meta-analysis of RSA studies

Authors

  • Chan Hee Cho Centre for Orthopaedic and Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia https://orcid.org/0000-0003-4598-451X
  • Bart G Pijls Department of Orthopaedics, Leiden University Medical Centre, Leiden, Netherlands https://orcid.org/0000-0001-5351-5057
  • John M Abrahams Centre for Orthopaedic and Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia; Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA, Australia
  • Anne Roerink Department of Orthopaedics, Leiden University Medical Centre, Leiden, Netherlands https://orcid.org/0000-0001-8384-4935
  • Raissa Katembwe Centre for Orthopaedic and Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
  • Andrew Baker Centre for Orthopaedic and Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
  • Lucian B Solomon Centre for Orthopaedic and Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia; Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA, Australia
  • Stuart A Callary Centre for Orthopaedic and Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia; Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SA, Australia https://orcid.org/0000-0002-2892-5238

DOI:

https://doi.org/10.2340/17453674.2023.24580

Abstract

Background and purpose: We conducted a systematic review and meta-analysis of RSA studies to investigate the early and long-term migration patterns of acetabular cups and the influence of implant factors on cup migration over time.
Methods: We performed a systematic search of PubMed, Embase, and Scopus databases to identify all RSA studies of cup migration following primary total hip replacement (THR). Proximal migration at 3 and 6 months, 1, 2, 5, and 10 years were considered for analysis. Implant factors investigated included fixation type, head size, bearing surface, uncemented coating design, and the decade of RSA introduction.
Results: 47 studies reported the proximal migration of 83 cohorts (2,328 cups). Besides 1 threaded cup design, no implant factor investigated was found to significantly influence proximal migration. The mean pooled 2-year proximal migration of cemented cups (0.14 mm, 95% confidence interval [CI] 0.08–0.20) was not significantly different from uncemented cups (0.12 mm, CI 0.04–0.19). The mean pooled proximal migration at 6 months was 0.11 mm (CI 0.06–0.16) and there was no significant increase between 6 months and 2 years (0.015 mm, CI 0.000–0.030). 27 of 75 cohorts (36%) reported mean proximal migration greater than 0.2 mm at 2 years, which has previously been identified as a predictor of implants at risk of long-term loosening.
Conclusion: Our meta-analysis demonstrated that the majority of cup migration occurs within the first 6 months. With one exception, no implant factors influenced the 2-year proximal migration of acetabular cups. 36% of studies with 2-year migration were considered at risk of long-term loosening. Further investigation and comparison against long-term survivorship data would validate 6-month and/or 1-year proximal migration measurements as an earlier predictor of long-term loosening than the current 2-year threshold.

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2023-12-29

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Cho, C. H., Pijls, B. G., Abrahams, J. M., Roerink, A., Katembwe, R., Baker, A., … Callary, S. A. (2023). Migration patterns of acetabular cups: a systematic review and meta-analysis of RSA studies. Acta Orthopaedica, 94, 626–634. https://doi.org/10.2340/17453674.2023.24580

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Vol. 94 (2023): Acta Orthopaedica

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Copyright (c) 2023 Chan Hee Cho, Bart G Pijls, John M Abrahams, Anne Roerink, Raissa Katembwe, Andrew Baker, Lucian B Solomon, Stuart A Callery

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Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.
 
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