Université de Lille, Hauts de France, 59000 Lille, France; Hôpital Roger Salengro, service d'orthopédie 2, CHU Lille, place de Verdun, 59000 Lille, France.
Université de Lille, Hauts de France, 59000 Lille, France; Hôpital Roger Salengro, service d'orthopédie 2, CHU Lille, place de Verdun, 59000 Lille, France.
Orthop Traumatol Surg Res. 2023 Feb;109(1):103438. doi: 10.1016/j.otsr.2022.103438. Epub 2022 Oct 10.
The ceramic-on-ceramic couple in total hip arthroplasties (THA) has the advantage of excellent wear resistance and the bioinert nature of its debris. Noise occurring from this friction torque is a common complication, the contributing factors of which are debated. The noise is caused by a lack of lubrication, due in most part to the positioning of the acetabular cup. The study of metal-on-metal couples identified that the calculation of the Contact Patch to Rim (CPR) distance provides information on lubrication defects and also that it is correlated with the wear of metal-on-metal implants. This CPR distance is not recognized to be correlated with the occurrence of noise for the ceramic-on-ceramic couple at a caliber ≤ 36mm. We therefore conducted a retrospective case-control study to assess: 1) The influence of the CPR distance on noise occurrence; 2) Whether other factors associated to noise occurrence exist?
Our hypothesis was that a low CPR distance was correlated with noise occurrence.
This was a case-control study with 3 controls for each case, analyzing 21 THAs (21 patients) with noise compared to 63 THAs without noise (63 patients) matched for age, sex and body mass index. These patients were taken from a continuous retrospective series of 96 patients for 104 total hip arthroplasties (THA) with a single operator and 4 generation Biolox Delta ceramic-on-ceramic single implant, performed between 2007 and 2012. The calculation of the CPR distance was then performed for both groups using measurements of inclination angles, anteversion angles, and implant data regarding the head/insert contact angle, head/insert diameter and clearance.
At the mean follow-up of 7.1 years±1.2 [5 to 9.6], the mean CPR distance was lower in the noise group 10mm±3.3 [3.8 to 16.4] than in the control group 14.8mm±4.3 [7.3 to 24.4] (p=0.0007). The mean inclination angle was higher in the noise group 45.1°±7.8 [31 to 62] than in the control group 41.2°±7.2 [26 to 56] (p=0.04). The occurrence of noise was independent of anteversion, head caliber, cup diameter, neck length and stem size, and stem type (standard or lateralized).
A low CPR distance was correlated with the occurrence of noises, similarly a steep inclination was correlated with the occurrence of noises.
III; Retrospective case-control study.
全髋关节置换术（THA）中的陶瓷对陶瓷结合具有出色的耐磨性和其碎屑的生物惰性优势。这种摩擦扭矩产生的噪音是一种常见的并发症，其促成因素存在争议。这种噪音是由于缺乏润滑引起的，主要是由于髋臼杯的定位所致。对金属对金属结合的研究表明，计算接触斑到边缘（CPR）距离可以提供有关润滑缺陷的信息，并且与金属对金属植入物的磨损有关。对于口径≤36mm 的陶瓷对陶瓷结合，尚未发现 CP 距离与陶瓷对陶瓷结合发生噪音有关。因此，我们进行了一项回顾性病例对照研究，以评估：1）CPR 距离对噪音发生的影响；2）是否存在与噪音发生相关的其他因素？
我们的假设是低 CP 距离与噪音发生有关。
这是一项病例对照研究，每个病例有 3 个对照，分析了 21 例（21 例患者）发生噪音的 THR，与 63 例（63 例患者）无噪音的 THR 相匹配，年龄、性别和体重指数。这些患者来自一位医生连续进行的 96 例患者中的 104 例全髋关节置换术（THA）的连续回顾性系列研究，使用生物洛克斯三角洲陶瓷对陶瓷单植入物进行了 4 代治疗，植入物为单个植入物。2007 年至 2012 年间。然后使用倾斜角、前倾角以及植入物的头部/插入接触角、头部/插入直径和间隙的测量值，为两组计算 CP 距离。
在平均 7.1 年±1.2 年（5 至 9.6 年）的随访中，噪音组的平均 CP 距离为 10mm±3.3 [3.8 至 16.4]，而对照组为 14.8mm±4.3 [7.3 至 24.4]（p=0.0007）。噪音组的平均倾斜角为 45.1°±7.8 [31 至 62]，而对照组为 41.2°±7.2 [26 至 56]（p=0.04）。噪音的发生与前倾角、头口径、杯径、颈长和柄大小以及柄类型（标准或侧化）无关。
低 CP 距离与噪音的发生有关，同样陡峭的倾斜与噪音的发生有关。
III；回顾性病例对照研究。
