Department of Surgical Sciences, Section of Orthopedics, Uppsala University, Uppsala, Sweden.
BMC Musculoskelet Disord. 2024 Sep 16;25(1):741. doi: 10.1186/s12891-024-07865-5.
The trabeculae-oriented pattern (TOP) cup was designed to minimize acetabular periprosthetic bone loss. In our previous prospective study comprising 30 patients with a two-year follow-up we found a substantial decrease in periprosthetic bone mineral density (pBMD) in the proximal and medial regions of the TOP cup. The present study aims to investigate pBMD changes in the mid-term and how this affects implant survival.
We followed the previous cohort and estimated implant survival by Kaplan-Meier analysis, evaluated pBMD with dual-energy X-ray absorptiometry (DXA) and clinical outcome using the Harris Hip Score (HHS).
Mean follow-up was 8.6 (range 7.8-9.1) years. The eight-year implant survival rate for cup revision for all reasons was 83% (95% confidence interval {CI}: 70-97) and 86% (CI: 74-99) when cup revision due to aseptic loosening was the endpoint. Mean HHS at eight years was 95 (range 77-100). A further 12% (CI: 5-17) loss in pBMD was detected in the proximal Digas zone 1 and 12% (CI: 7-17) loss in Digas zone 2 also between two and eight years after surgery. pBMD continued to decrease up to 30% (CI: 24-36) in Digas zones 1, 2 and 3 compared to pBMD immediately postoperatively.
The TOP cup shows inferior mid-term survival rates compared to other uncemented cups, as well as a continuous decrease in pBMD. Periprosthetic bone loss cannot be prevented by this uncemented cup.
Not applicable.
定向小梁（TOP）杯的设计旨在最大限度地减少髋臼假体周围骨丢失。在我们之前的一项包含 30 例患者、为期两年随访的前瞻性研究中，我们发现 TOP 杯的近端和内侧区域假体周围骨矿物质密度（pBMD）显著下降。本研究旨在探讨中期 pBMD 的变化及其对植入物存活率的影响。
我们对之前的队列进行了随访，采用 Kaplan-Meier 分析评估了植入物存活率，采用双能 X 线吸收法（DXA）评估了 pBMD，并采用 Harris 髋关节评分（HHS）评估了临床结果。
平均随访时间为 8.6 年（范围为 7.8-9.1 年）。所有原因的杯翻修 8 年植入物存活率为 83%（95%置信区间{CI}：70-97），当以无菌性松动为翻修终点时，8 年的植入物存活率为 86%（CI：74-99）。8 年时的平均 HHS 为 95（范围为 77-100）。术后 2-8 年，近端 Digas 区 1 的 pBMD 进一步下降了 12%（CI：5-17），Digas 区 2 的 pBMD 也下降了 12%（CI：7-17）。与术后即刻相比，Digas 区 1、2 和 3 的 pBMD 继续下降了 30%（CI：24-36）。
与其他非骨水泥杯相比，TOP 杯的中期生存率较低，同时 pBMD 持续下降。这种非骨水泥杯不能预防假体周围骨丢失。
不适用。
