Pantè Salvatore, Fassino Vesconi Riccardo, Braconi Lorenzo, D'Amelio Andrea, Aprato Alessandro, Massè Alessandro
University of Turin, Turin, Italy.
Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Eur J Orthop Surg Traumatol. 2025 Jun 5;35(1):236. doi: 10.1007/s00590-025-04364-8.
Threaded cups in total hip arthroplasty (THA) have been introduced to overcome the complications associated with the cemented cups in use until then. Their structure allowed the cup to be screwed into the acetabulum after careful preparation, achieving strong primary stability. However, the materials available at the time did not provide certainties about the long-term durability of these implants. This systematic review aims to evaluate the long-term results of many threaded cups used over the years, focusing on survivorship, clinical outcomes, and complications.
A systematic review was conducted adhering to the PRISMA guidelines. Relevant studies were searched in four databases: PubMed, Scopus, Embase, and Medline. The selected articles were evaluated according to the criteria of levels of evidence. The included studies were analyzed using the MINORS criteria for quality assessment. This paper was registered in the International Prospective Registry of Systematic Reviews (PROSPERO).
The review identified 28 studies and the reported implants were developed by different manufacturers. The threaded cups had different characteristics, belonging to different generations, but all had a minimum follow-up of at least 10 years, with a wide range in cup survivorship. The most frequent long-term complications were aseptic loosening and polyethylene wear, closely related to the available materials and the design of the implant. The different survivorship among the implants was due to the multiple variables in the implant structure and the post-operative indications reported in the studies.
Threaded cups were an important milestone in the evolution of implants in hip replacement. Although they have benefited from technological improvements over the past few decades, their use is still burdened by significant complications in the long term, and their shape makes revision more difficult compared to more modern and currently widespread implants that are hemispherical and threadless. Aseptical loosening and liner wear are the two main complications in the follow-up, so it is important to keep following these implants even after a long time and no complaints by the patient.
全髋关节置换术（THA）中的螺纹髋臼杯已被引入，以克服在此之前使用的骨水泥型髋臼杯相关的并发症。其结构允许在仔细准备后将髋臼杯拧入髋臼，实现强大的初始稳定性。然而，当时可用的材料并不能确保这些植入物的长期耐用性。本系统评价旨在评估多年来使用的多种螺纹髋臼杯的长期结果，重点关注生存率、临床结局和并发症。
按照PRISMA指南进行系统评价。在四个数据库中检索相关研究：PubMed、Scopus、Embase和Medline。根据证据水平标准对所选文章进行评估。使用MINORS标准对纳入研究进行质量评估分析。本文已在国际前瞻性系统评价注册库（PROSPERO）中注册。
该评价确定了28项研究，报道的植入物由不同制造商生产。螺纹髋臼杯具有不同特征，属于不同代，但均至少有10年的最短随访期，髋臼杯生存率范围广泛。最常见的长期并发症是无菌性松动和聚乙烯磨损，与可用材料和植入物设计密切相关。植入物之间不同的生存率归因于植入物结构中的多个变量以及研究中报告的术后指征。
螺纹髋臼杯是髋关节置换植入物发展中的一个重要里程碑。尽管在过去几十年中它们受益于技术改进，但从长期来看，其使用仍受到重大并发症的困扰，并且与更现代且目前广泛使用的半球形无螺纹植入物相比，其形状使翻修更加困难。无菌性松动和内衬磨损是随访中的两个主要并发症，因此即使在很长时间且患者无不适主诉后，持续对这些植入物进行随访仍很重要。
