J Korean Hip Soc.  2010 Jun;22(2):143-150. 10.5371/jkhs.2010.22.2.143.

Analysis of Failure Cause of Acetabular Components Among Total Hip Replacement Arthroplasties Using RB Wagner Acetabular Cup

Affiliations
  • 1Department of Orthopaedic Surgery, College of Medicine, Inje University, Haeundae Paik Hospital, Busan, Korea. neomed95@naver.com
  • 2Department of Orthopaedic Surgery, College of Medicine, Inje University, Busan Paik Hospital, Busan, Korea.

Abstract

PURPOSE
The purpose of this study was to analyze the cause of failure of acetabular component cases after metal-on-metal primary total hip arthroplasty using RB Wagner acetabular cup.
MATERIALS AND METHODS
Between January 1993 and January 2005, we retrospectively studied failure cause of 27 patients who underwent acetabular revision surgery among 468 consecutive cementless total hip arthroplasties using RB Wagner acetabular component. The duration of primary arthroplasty to revision ranged from 5.1 years to 11.5 years (mean 9.2 years). The clinical evaluation was performed using preoperative and last follow-up modified Harris hip scores. The radiological evaluation was performed in terms of the stability, such as inclination, anteversion, cup size, acetabular bone coverage, osteolysis, radiolucency and gap.
RESULTS
The average Harris hip scores was 49.6 preoperatively and 91.3 at the most recent follow-up. In revision cases, the score was 41.2 to 51.7. Among 468 cases, 27 patients underwent revision surgery (7%, 27/468) and there was no osseointegration in all cases. The radiological evaluation in revision cases revealed inclination (46.04+/-5.328, p=0.0031), anteversion (14.14+/-2.95, p=0.584), cup size (54 mm+/-2.5, p=0.042) and acetabular bone coverage (67.9%+/-4.77, p=0.003). Focusing on the relation between disease entities, there was relatively high risk in patients with hip dysplasia (Fisher's exact test, p=0.0095).
CONCLUSION
Although Wagner acetabular cup relatively showed as high survival rate as 93%, failure rate is significantly high in dysplastic hip patients.

Keyword

Dysplastic hip; Total hip arthroplasty; RB Wagner acetabular cup

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Hip
Follow-Up Studies
Hip
Humans
Osseointegration
Osteolysis
Retrospective Studies
Survival Rate
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