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Is removal of subchondral bone plate advantageous in cemented cup fixation? A randomized RSA study.

Flivik, Gunnar LU ; Kristiansson, Ingvar ; Kesteris, Uldis LU and Ryd, Leif LU (2006) In Clinical Orthopaedics and Related Research 448. p.164-172
Abstract
There is uncertainty regarding whether and how the subchondral bone plate should be treated during acetabular preparation for cemented cup fixation in a total hip arthroplasty. We hypothesized that removing the bone plate would improve the cement-bone interface without jeopardizing the initial cup stability, and therefore, be advantageous to long-term cup survival. We randomized 50 patients with primary osteoarthritis into two groups, one for removal and one for retention of the subchondral bone plate. The patients were evaluated during 2 years followup using repeated radiostereometric examinations, analyses of radiolucent lines, and clinical followups. Patient scoring was done using the Western Ontario and McMaster Universities... (More)
There is uncertainty regarding whether and how the subchondral bone plate should be treated during acetabular preparation for cemented cup fixation in a total hip arthroplasty. We hypothesized that removing the bone plate would improve the cement-bone interface without jeopardizing the initial cup stability, and therefore, be advantageous to long-term cup survival. We randomized 50 patients with primary osteoarthritis into two groups, one for removal and one for retention of the subchondral bone plate. The patients were evaluated during 2 years followup using repeated radiostereometric examinations, analyses of radiolucent lines, and clinical followups. Patient scoring was done using the Western Ontario and McMaster Universities Osteoarthritis Index, the Short Form-12, and the Harris hip score. Removal of the subchondral bone plate resulted in a superior cement-bone interface with less development of radiolucent lines. The radiostereometry results showed small migrations in both groups. We found no differences in cup stability between groups, although a difference was observed in rotational behavior with the removal group stabilizing in a slightly vertical position whereas the retention group showed slight but progressive rotation into a more horizontal position. No differences were found during clinical followups. Removing the subchondral bone plate, where possible, improves the cement-bone interface without jeopardizing the stability, implying better long-term cup survival. However, it is a more demanding surgical technique. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Orthopaedics and Related Research
volume
448
pages
164 - 172
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000243020700025
  • scopus:33746929124
ISSN
0009-921X
DOI
10.1097/01.blo.0000203479.27044.d3
language
English
LU publication?
yes
id
dd8ebde9-7a0b-4b69-a5e1-210ac8f56dfb (old id 159117)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16826112&dopt=Abstract
date added to LUP
2016-04-01 11:49:34
date last changed
2021-02-17 03:54:42
@article{dd8ebde9-7a0b-4b69-a5e1-210ac8f56dfb,
  abstract     = {There is uncertainty regarding whether and how the subchondral bone plate should be treated during acetabular preparation for cemented cup fixation in a total hip arthroplasty. We hypothesized that removing the bone plate would improve the cement-bone interface without jeopardizing the initial cup stability, and therefore, be advantageous to long-term cup survival. We randomized 50 patients with primary osteoarthritis into two groups, one for removal and one for retention of the subchondral bone plate. The patients were evaluated during 2 years followup using repeated radiostereometric examinations, analyses of radiolucent lines, and clinical followups. Patient scoring was done using the Western Ontario and McMaster Universities Osteoarthritis Index, the Short Form-12, and the Harris hip score. Removal of the subchondral bone plate resulted in a superior cement-bone interface with less development of radiolucent lines. The radiostereometry results showed small migrations in both groups. We found no differences in cup stability between groups, although a difference was observed in rotational behavior with the removal group stabilizing in a slightly vertical position whereas the retention group showed slight but progressive rotation into a more horizontal position. No differences were found during clinical followups. Removing the subchondral bone plate, where possible, improves the cement-bone interface without jeopardizing the stability, implying better long-term cup survival. However, it is a more demanding surgical technique.},
  author       = {Flivik, Gunnar and Kristiansson, Ingvar and Kesteris, Uldis and Ryd, Leif},
  issn         = {0009-921X},
  language     = {eng},
  pages        = {164--172},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Clinical Orthopaedics and Related Research},
  title        = {Is removal of subchondral bone plate advantageous in cemented cup fixation? A randomized RSA study.},
  url          = {http://dx.doi.org/10.1097/01.blo.0000203479.27044.d3},
  doi          = {10.1097/01.blo.0000203479.27044.d3},
  volume       = {448},
  year         = {2006},
}