Comparison of postoperative curative effect and the possible survival rate of prosthesis following cemented and cementless total hip replacement

Yong ZHANG; Tongtao YANG; Yong ZHOU; Baoan MA

ABSTRACT

BACKGROUND:

Patients who suffered total hip replacement are mostconcerned about the survivorship of prosthesis.

OBJECTIVE:

To evaluate the postoperative curative effect following ce mented and cementless THR with a retrospective method, so as to provideexperience for prolonging the survivoship of prosthesis.

DESIGN:

Randomized and controlled observation.

SETTING:

General Center of Orthopaedic Department, General Instituteof Bone Oncology, Tangdu Hospital, Fourth Military Medical University ofChinese PLA.

PARTICIPANTS:

We admitted 356 patients who underwent THR fromDepartment of Orthopaedics, Tangdu Hospital, Fourth Military Medical U niversity of Chinese PLA between March 1993 and March 2004. Amongthem, 298 were contacted and 105 (108 hips) followed up. The patientsparticipated in the review voluntarily. They were of either gender and haddifferent types of prosthesis. Prosthesis made in China was adopted before2000 and prosthesis made in American STRIKER company after 2000 Prosthesis made in China was made of home-made bone cement; Prosthesisbone cement (import) was provided by American STRIKER prosthesiscompany. Home-made bone cement and import have the same components. Barium was added in both bone cement . The whole operation was con ducted by the physicians who worked in the artificial joint department afterexamination.

METHODS:

According to informal discussion summary about total hipreplacement of Chinese Journal of Surgery in 1982 and Evaluation Scale ofMayo Total Hip Replacement Curative Effect, we designed follow-up tableby ourselves. Totally 105 (108 hips) patients were followed up, amongthem, 62 (63 hips) were in the cemented group, 43 (45 hips) in the ce mentless group. Pain, function and motion range of the patients and X-raywere evaluated and analyzed respectively. MAIN OUTCOME

MEASURES:

① Postoperative pain degrees. ② Postoperative function of hips. ③ Postoperative motion range. ④ width oflight around the prothesis , distance of horizontal or vertical shift of theprosthesis. ⑤ range of ectopic ossification of the prosthesis. ⑥Osteolysisdegree of proximal femur.

RESULTS:

①There was no significant difference of lateral femoral painduring follow-up period [Cemented group 24 hips (38.5%) ,cementlessgroup 18 hips(40.0% )]. ② Limping appeared in the both two groups ③ There was no significant difference of range of motion above 160° betweentwo groups (Cemented group 62 hips; cementless group 44 hips). ④Therewas no significant difference in subsidence of femoral prosthesis and hori zontal or vertical shift of acetabular prosthesis between two groups . ⑤ There was no significant difference of re lative value of femoral proximalbone density between cemented group [57.4(9-118)] and cementless group[72.8( 14-130)]. ⑥There was no significant difference of postoperative cu rative effect, possible survival rate of prosthesis and femoral proximal ex tensive osteolysis of the patients between the two groups.

CONCLUSION:

Postoperative curative effect of the patients between ce mented group and cementless group are similar, both not obtaining an idealfixed effect. The choice of prosthesis type does not affect the survivorship of prosthesis, but it depends on the age of patients to decide whether rebuilding is necessary or not Osteolysis is not related to age, gender or prosthesis type of the patients.