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The Use of Porous Titanium Coating and the Largest Possible Head Do Not Affect Early Cup Fixation: A 2-Year Report from a Randomized Controlled Trial

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DOI

  1. Patellofemoral Arthroplasty

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. External Validation of Achieving the Patient Acceptable Symptom State for the EuroQol-5 Dimension 1 Year After Total Hip Arthroplasty

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Are functional outcomes and early pain affected by discharge on the day of surgery following total hip and knee arthroplasty?

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  3. Which Oxford Knee Score level represents a satisfactory symptom state after undergoing a total knee replacement?

    Research output: Contribution to journalJournal articleResearchpeer-review

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Cups are more frequently revised than stems after uncemented total hip arthroplasty, which warrants the development of cup surfaces that provide long-lasting, stable fixation. Large heads have become popular with the aim of reducing dislocation rates, but they generate greater frictional torque that may compromise cup fixation. We aimed to investigate (1) if a novel porous titanium surface provides superior cup fixation when compared with a porous plasma spray (PPS) surface and (2) if the use of the largest possible head compromises cup fixation when compared with a 32-mm head.

Methods: Ninety-six patients were randomized to receive either a cup with a porous titanium coating (PTC) or a cup with PPS. A second randomization was performed to either the largest possible (36 to 44-mm) or a 32-mm head in metal-on-vitamin-E-infused polyethylene bearings. Roentgen stereophotogrammetric analysis (RSA) examinations were obtained postoperatively at 3, 12, and 24 months. The primary outcome was proximal cup migration when comparing the 2 cup surfaces and also when comparing the largest possible head with the 32-mm head. The patients were followed for 2 years.

Results: The median (and interquartile range) proximal cup migration was 0.15 mm (0.02 to 0.32 mm) for the PTC cup and 0.21 mm (0.11 to 0.34 mm) for the PPS cup. The largest possible head had a proximal cup migration of 0.15 mm (0.09 to 0.31 mm), and the 32-mm head had a proximal cup migration of 0.20 mm (0.04 to 0.35 mm). There were no significant differences between the cup surface (p = 0.378) or the head size (p = 0.693) groups.

Conclusions: Early cup fixation was not superior with the novel PTC cup; the use of the largest possible head (36 to 44 mm) did not compromise early cup fixation.

Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish
JournalJBJS essential surgical techniques
Volume5
Issue number4
ISSN2160-2204
DOIs
Publication statusPublished - 15 Dec 2020

ID: 61651076