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KMID : 0386720040160030324
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Journal of the Korean Hip Society
2004 Volume.16 No. 3 p.324 ~ p.331
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Pelvic Osteolysis in Hybrid THA(5~11.5 Years Follow-up Study)
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Shon Won-Yong
Hur Chong-Yong
Moon Jun-Gyu
Hwang Jin-Ho
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Abstract
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Purpose: Pelvic osteolysis was one of the common complications after a total hip arthroplasty. In this report, we present the prevalence, type of pelvic osteolysis and contributing factors in a hybrid type total hip arthroplasty.
Materials and Methods: This study was conducted on 84 total hip arthroplasty(66 patients), which were available for the clinical and radiographic follow-up for an average of 7.2 years(range, 5 to 11.5 years) and showed stable fixation of the acetabular and femoral component. The average age of the patients at surgery was 50.3 years(range, 22~75 years). 45 patients(57 hips) were male and 21 patients(27 cups) were female. 39 hips were on the left side and 45 hips were on the right side. The average Harris hip score was 85.6(range, 51 to 98). The location and size of the pelvic osteolysis on the last follow-up antero-posterior radiograph were analyzed. Polyethylene wear was also measured using the Livermore techniques. The clinical relationship between age, gender and the primary diagnosis of patients, the position of the cups and size of the cups to the pelvic osteolysis were evaluated.
Results: Pelvic osteolysis was noted in 32 cups(38%). Osteolysis was observed in 3 zones according to DeLee and Charnley. The diffuse type osteolysis was observed in 15 hips, localized type in 14 hips and periscrew in 3 hips. The mean size of the pelvic osteolysis was 27 mm(range, 7 to 62 mm). The mean rate of linear polyethylene wear was 0.17 mm/y. Pelvic osteolysis was significantly correlated with an increased polyethylene wear rate(0.11 + 0.056 mm/y in the non-osteolysis group, 0.21+ 0.633 mm/y, p<0.05). With the number of patients available, a younger age(p=0.0216) and the duration of the implantation(p=0.0725) were also found to be associated with pelvic osteolysis.
Conclusion: These results show that pelvic osteolysis is a common complication and more severe in a hybrid THA than the other type. The wear rate of polyethylene was significantly higher in the hips with pelvic osteolysis. This
study also demonstrated that osteolysis and polyethylene wear are important prognostic factors for the mid-long term results of cementless Harris Galante acetabular cups.
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KEYWORD
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Cementless acetabular cup, Osteolysis, Hybrid total hip replacement
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