SC Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, 40136, Italy.
Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, Bologna, 40136, Italy.
Arch Orthop Trauma Surg. 2024 Nov;144(11):4865-4872. doi: 10.1007/s00402-024-05573-2. Epub 2024 Sep 23.
Comparative studies evaluating the different material and surface finishing of acetabular components in total hip arthroplasty (THA) are lacking. Using a regional arthroplasty registry, the survival rates and the hazard ratios of different cups in THA performed for primary osteoarthritis were assessed, using endpoints: (1) every cup failure, (2) cup aseptic loosening, (3) periprosthetic infection.
The inclusion criteria were: residing patients, THA for primary osteoarthritis, Delta-on-Delta bearings, head sizes 32 mm and 36 mm. Only the most implanted cementless cups were considered and were grouped according to material and surface finishing into three cohorts: 3D printed cups (I), ultraporous tantalum or titanium- coated cups (II), second-generation cups (III). 15,737 cups were included in the study: 9,862 cups (62.7%) in cohort I, 2,067 implants (13.1%) in cohort II, 3,808 implants (24.2%) in cohort III.
The three cohorts achieved comparable general 10-year survival rates (p = 0.62). In I and II cohorts, the survival rates of the cup types within cohorts were analogous (p = 0.86 and p = 0.31), but not in cohort III (p = 0.004). The hazard ratios for overall failure adjusted for age and sex were similar among the cohorts. Regarding cup aseptic loosening, the three cohorts had similar rates (p = 0.48) and similar adjusted hazard ratios. With periprosthetic hip infection as endpoint, the survival rates and the adjusted hazard ratios of the three cohorts were comparable (p = 0.68).
3D printed cups provided similar 10-year outcomes compared to ultraporous cups and second-generation cups, with no additional risks of aseptic loosening and infection.
IV (therapeutic study).
评估全髋关节置换术（THA）中髋臼部件不同材料和表面处理的比较研究尚缺乏。本研究使用区域关节置换登记处，评估了用于原发性骨关节炎的 THA 中不同髋臼杯的生存率和危险比，终点包括：（1）每个髋臼杯失败，（2）髋臼杯无菌性松动，（3）假体周围感染。
纳入标准为：居住患者，THA 用于原发性骨关节炎，Delta-on-Delta 轴承，头大小 32mm 和 36mm。仅考虑最植入的非骨水泥髋臼杯，并根据材料和表面处理分为三组：3D 打印髋臼杯（I 组）、多孔钽或钛涂层髋臼杯（II 组）、第二代髋臼杯（III 组）。本研究共纳入 15737 个髋臼杯：I 组 9862 个髋臼杯（62.7%），II 组 2067 个髋臼杯（13.1%），III 组 3808 个髋臼杯（24.2%）。
三组获得了相似的总体 10 年生存率（p=0.62）。在 I 组和 II 组中，组内髋臼杯类型的生存率相似（p=0.86 和 p=0.31），但在 III 组中则不同（p=0.004）。调整年龄和性别后，总体失败的危险比在各组之间相似。关于髋臼杯无菌性松动，三组的发生率相似（p=0.48），调整后的危险比也相似。以假体周围髋关节感染为终点，三组的生存率和调整后的危险比相当（p=0.68）。
3D 打印髋臼杯与多孔髋臼杯和第二代髋臼杯相比，具有相似的 10 年结果，不存在无菌性松动和感染的额外风险。
IV（治疗研究）
3D 打印髋臼杯与多孔髋臼杯和第二代髋臼杯相比，具有相似的 10 年结果，不存在无菌性松动和感染的额外风险。
