title: Risk factors for periacetabular osteolysis and wear in asymptomatic patients with uncemented total hip arthroplasties.
abstract: Osteolysis is a silent disease leading to aseptic loosening. This has not been studied in a cohort of asymptomatic patients. The aim of this study was to detect factors that might be associated with the development of periacetabular osteolysis and wear around an uncemented cup. We assessed 206 patients with an uncemented cup, measuring wear and periacetabular osteolysis using computed tomography with a median follow-up of 10 years after surgery (range 7-14 years). EQ5D, pain from the hip, and satisfaction were assessed. The association between periacetabular osteolysis and wear, age, gender, activity, BMI, cup type, cup age, positioning of the cup, and surface coating was investigated with a proportional odds model. Wear and male gender were associated with an increased risk for periacetabular osteolysis. There was no association with periacetabular osteolysis for time from operation, patient age, UCLA Activity Score, liner thickness at time of operation, BMI, cup positioning, and type of implant. A thin liner at time of operation is correlated to increased wear. Linear wear rate was 0.18 mm/year and 46 of 206 patients had large periacetabular osteolysis. Asymptomatic patients with these implants should be followed up on a regular basis with a sensitive method such as CT in order to detect complications early.
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, 17176 Stockholm, Sweden.
authors.forename: Buster
authors.identifier: 0000-0001-8073-9910
authors.initials: B
authors.lastname: Sandgren
authors.affiliation: Department of Radiology, Karolinska University Hospital, 17176 Stockholm, Sweden.
authors.forename: Joakim
authors.identifier: 0000-0002-4728-769X
authors.initials: J
authors.lastname: Crafoord
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, 17176 Stockholm, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Olivecrona
authors.affiliation: Swedish Hip Arthroplasty Register, Registercentrum, 41345 Gothenburg, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Garellick
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, 17176 Stockholm, Sweden.
authors.forename: Lars
authors.identifier: 0000-0002-4280-1178
authors.initials: L
authors.lastname: Weidenhielm
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology / Q000473:pathology*; D011183:Postoperative Complications / Q000473:pathology*; D012307:Risk Factors