Survival of hydroxyapatite-coated cups: acetabular screws involve a lower rate of revision surgery due to aseptic loosening.
BACKGROUND
It is believed that the path of acetabular screws may represent a shuttle between hydroxyapatite (HA) particles and the liner. The aim was to assess the relationship between acetabular screws and revision surgery for aseptic loosening in total hip arthroplasties (THAs).


METHODS
A retrospective multicentric study was performed. Patients older than 18 years and patients who underwent THA with both the stem and cup HA-coated were included. The rate of revision-surgery considering only aseptic loosening was calculated. The proportion of cases in which acetabular screws were used was registered, as well as the proportion of cups that showed osteolysis. The statistical relationship between acetabular screws and osteolysis, as well as acetabular screws and revision-surgery for aseptic loosening were assessed.


RESULTS
There were 749 cases. Mean age 62.1 (45-84) years. Mean follow-up 14.19 (8.9-16.7) years. Revision surgery was performed in 12.8% (96/749) of the cups. 73.95% (71/96) of the revised cups showed aseptic loosening. The overall 15-year survival of the cups considering only aseptic loosening was 84.4%. Acetabular screws were used in 47.5% (356/749) of the cups. Acetabular screws were used in 40.44% (55/136) of the cups that showed osteolysis. The use of acetabular screws was associated with less osteolysis (p = 0.006). Acetabular screws were used in 35.21% (25/71) of the cups that were revised for aseptic loosening. The use of acetabular screws was associated with a lower rate of revision surgery (p = 0.020).


CONCLUSIONS
In THA with the stem and cup HA-coated, the use of acetabular screws is associated with a lower rate of revision surgery.
Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona - Spain.|Hospital General de Catalunya, Sant Cugat del Vallés - Spain.
Luis
L
Natera
Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona - Spain.
Marius
M
Valera
Hip Unit, Department of Orthopaedic Surgery, University Hospital Dexeus, Barcelona - Spain.
Esther Moya
EM
Gómez
Hospital Universitario Mútua de Terrassa, Terrassa, Barcelona - Spain.
Natalia
N
Ibañez
Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona - Spain.
Xavier
X
Crusi
Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona - Spain.
Rogelio
R
Sancho
D000077:Acetabulum / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001863:Bone Screws; D020099:Coated Materials, Biocompatible; D015331:Cohort Studies; D017886:Durapatite / Q000737:chemistry*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000639:trends*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies
D020099:Coated Materials, Biocompatible; D017886:Durapatite