Carli Alberto V, Galmiche Romain, Dobransky Johanna, Beaulé Paul E
Adult Reconstuction and Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA.
TheDivision of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ontario, Canada.
Hip Int. 2022 Jan;32(1):80-86. doi: 10.1177/1120700020958694. Epub 2020 Sep 14.
Acetabular components utilising novel ultraporous metal matrices have been recently introduced into clinical practice with improved interference fit, decreased stress shielding, and hope for more reliable osseointegration. 1 such example is the Dynasty Biofoam cup, which has been in clinical use for over a decade but has few reports documenting its clinical and radiographic performance.
A single-centre retrospective study was performed evaluating 96 Dynasty Biofoam acetabular components implanted between March 2010 and August 2014 with minimum 2-year radiographic follow-up. Patients that received components for revision surgery or that had early complications postoperatively (femur fracture, prosthetic infection) were excluded. Biofoam patients were compared to 96 patients that received the Trident PSL acetabular component and were matched for age, gender, and BMI. Patient reported outcomes, component position and radiographic features of cup loosening, including radiolucent lines and sclerosis were compared among groups.
Patient-reported outcomes at 2 years were similar among groups. Cup anteversion was similar but inclination was significantly greater in the Biofoam group ( = 0.006). A significantly greater number of Biofoam components exhibited 2-zone (27.2%) and 3-zone (12.0%) radiolucencies compared to 0% of the Trident shells ( < 0.05). 2 Biofoam cups were revised for aseptic loosening compared to no Trident cups ( = 0.49).
Despite adequate implant survivorship, over a quarter of Biofoam cups had 2 or more radiolucent zones in early follow-up. Longer follow-up is needed to determine if the aseptic revision rate for this cup will increase.
利用新型超多孔金属基质的髋臼组件最近已引入临床实践,具有更好的压配效果、降低的应力遮挡,并有望实现更可靠的骨整合。一个这样的例子是王朝生物泡沫杯,它已在临床使用超过十年,但很少有报告记录其临床和影像学表现。
进行了一项单中心回顾性研究,评估了2010年3月至2014年8月间植入的96个王朝生物泡沫髋臼组件,影像学随访至少2年。接受翻修手术组件的患者或术后有早期并发症(股骨骨折、假体感染)的患者被排除。将生物泡沫杯组患者与96例接受Trident PSL髋臼组件且年龄、性别和BMI匹配的患者进行比较。比较了各组患者报告的结局、组件位置以及杯体松动的影像学特征,包括透亮线和硬化。
两组患者2年时报告的结局相似。杯体前倾角相似,但生物泡沫杯组的倾斜角明显更大(P = 0.006)。与Trident杯体的0%相比,生物泡沫组件出现2区(27.2%)和3区(12.0%)透亮线的数量明显更多(P < 0.05)。2个生物泡沫杯因无菌性松动进行了翻修,而Trident杯体则没有(P = 0.49)。
尽管植入物有足够的生存率,但在早期随访中,超过四分之一的生物泡沫杯有2个或更多的透亮区。需要更长时间的随访来确定该杯体的无菌翻修率是否会增加。