Relationship between use of screws and acetabular cup stability in total hip arthroplasty: a meta-analysis

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Abstract

Objective

The relationship between the use of screws and acetabular cup stability in total hip arthroplasty (THA) remains controversial. We evaluated cup stability in THA with and without the use of screws.

Methods

We performed a systematic literature search to identify studies on cup stability relative to the use of screws in patients undergoing THA before October 2018. Methodological quality assessment and data collection were performed by two individual reviewers. Meta-analysis was performed using Review Manager version 5.3.5.

Results

We included seven trials involving 1402 patients (1469 THAs): 767 patients (809 THAs) with screws and 635 patients (660 THAs) without screws. The findings of meta-analysis indicated that uncemented acetabular component fixation with the use of additional screws was not correlated with migration of the cup, migration on roentgen stereophotogrammetry, or reoperation after THA. Moreover, operation time was not significantly different according to whether screws were used. There was no relationship between use of additional screws and osteoporosis or Harris Hip Score; however, THA with or without the use of screws might be related to bone sclerosis in the C1 region.

Conclusion

Currently, limited evidence shows that the use of screws during THA may not improve cup stability.

Related collections

Most cited references 22

Record: found
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Radiological Demarcation of Cemented Sockets in Total Hip Replacement

JOHN CHARNLEY, JESSE DELEE (1976)

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Complications After Revision Total Hip Arthroplasty in the Medicare Population.

Sameer Badarudeen, Albert C Shu, Kevin Ong … (2017)

The purpose of this study was to identify the incidence and types of complications after revision total hip arthroplasty (THA) within the first year, and determine the relative risk factors for these complications and of re-revision.

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Effect of augmented cup fixation on stability, wear, and osteolysis: a 5-year follow-up of total hip arthroplasty with RSA.

S Röhrl, B Nivbrant, H. Strom … (2004)

To evaluate different modes of cementless fixation of hemispherical cups, we operated on 87 hips in 81 patients using 4 different means of cup fixation. The hips were randomly assigned to fixation with press-fit technique only (PF), or with augmentation with screws (S), pegs (P), or hydroxyapatite (HA) coating. The patients were evaluated with radiostereometric analysis (RSA) for cup migration and wear, conventional radiography for osteolysis, and Harris Hip Score for clinical outcome over 5 years. The fixation of the cups did not differ between the groups, but HA showed a tendency to decrease proximal migration. HA-coated cups displayed the best interface with hardly any signs of radiolucent lines, indicating a superior sealing effect of the HA coating. Cups with screws or pegs had more radiolucent lines and osteolytic lesions than the other groups. Radiolucent lines were correlated to higher proximal migration, young age, and female gender (r2=.2). The wear rate of the ethylene oxide-sterilized polyethylene liner was high (0.2 mm/y) but did not differ between the groups. Two cups with a perioperative fracture of the acetabular rim showed large initial migration but stabilized thereafter.

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Author and article information

Journal

Journal ID (nlm-ta): J Int Med Res

Journal ID (iso-abbrev): J. Int. Med. Res

Journal ID (publisher-id): IMR

Journal ID (hwp): spimr

Title: The Journal of International Medical Research

Publisher: SAGE Publications (Sage UK: London, England )

ISSN (Print): 0300-0605

ISSN (Electronic): 1473-2300

Publication date (Electronic): 13 February 2020

Publication date Collection: February 2020

Volume: 48

Issue: 2

Electronic Location Identifier: 0300060520903649

Affiliations

[1 ]Department of Orthopedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong University, Beilin District, Xi’an, Shaanxi Province, China

[2 ]Xi’an Medical University, Beilin District, Xi’an, Shaanxi Province, China

Author notes

[*]Bin-Fei Zhang, Department of Orthopedic Trauma, Hong-Hui Hospital, Xi’an Jiaotong University, No. 555 Youyi East Road, Beilin District, Xi’an, Shaanxi Province 710054, China. Email: zhangbf07@ 123456gmail.com

Author information

Chen Fei https://orcid.org/0000-0003-4390-1469

Yan Zhuang https://orcid.org/0000-0002-6816-3071

Article

Publisher ID: 10.1177_0300060520903649

DOI: 10.1177/0300060520903649

PMC ID: 7111112

PubMed ID: 32054354

SO-VID: cdb7578d-1f50-419f-b8de-f5f51fc29264

License:

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 30 October 2019

Date accepted : 8 January 2020

Funding

Funded by: Social Development Foundation of Shaanxi Province;

Award ID: 2014JM-8183

Award ID: 2017ZDXM-SF-009

Custom metadata

edited-state corrected-proof

typesetter ts2

Keywords: total hip arthroplasty,cup stability,screws,meta-analysis,reoperation,uncemented acetabular component fixation

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Keywords: total hip arthroplasty, cup stability, screws, meta-analysis, reoperation, uncemented acetabular component fixation

Relationship between use of screws and acetabular cup stability in total hip arthroplasty: a meta-analysis

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Abstract

Objective

Methods

Results

Conclusion

Related collections

International Journal of Medicine and Medical Research

Most cited references 22

Radiological Demarcation of Cemented Sockets in Total Hip Replacement

Complications After Revision Total Hip Arthroplasty in the Medicare Population.

Effect of augmented cup fixation on stability, wear, and osteolysis: a 5-year follow-up of total hip arthroplasty with RSA.

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