Journal
INTERNATIONAL JOURNAL OF SURGERY
Volume 100, Issue -, Pages -Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1016/j.ijsu.2022.106597
Keywords
Total hip arthroplasty; Acetabular revision; Trabecular metal
Categories
Funding
- National Nature Science Foundation of Youth in China [81601907]
- China Postdoctoral Science Foundation [2020M670863]
- Natural Science Foundation of Jilin Province [20200201345JC]
- Project of Jilin Provincial Department of Finance
- [:2020SCZ63]
- [2020SCZ63]
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This study compared the cup survival and the incidence of adverse events associated with the use of trabecular metal (TM) and non-TM cups for acetabular revision surgery. The results showed no significant difference in cup survival between the two types of cups. Overall, TM cups had fewer adverse events, but the difference was not significant. The incidence of aseptic loosening and infection was significantly lower for TM cups, while the incidence of dislocation was significantly higher.
Background: The objective of this study was to compare cup survival and the incidence of adverse events associated with the use of trabecular metal (TM) and non-TM cups for acetabular revision surgery.& nbsp;Methods: The MEDLINE, EMBASE, and Cochrane Library databases were searched for comparative studies that reported cup survival and the incidence of adverse events associated with the use of TM and non-TM cups for acetabular revision surgery. Primary outcomes included cup survival, aseptic loosening, dislocation, and infection.& nbsp;Results: The meta-analysis included 6 studies that involved 13,864 total hip arthroplasty (THA) revisions who underwent acetabular revision surgery with TM (n = 5,619) or non-TM (n = 8,245) cups. The meta-analysis demonstrated no significant difference in cup survival using re-revision for any reason or aseptic loosening as the endpoint following acetabular revision surgery with TM or non-TM cups (HR = 0.96; [95% CI, 0.84-1.09]; HR = 1.29; [95% CI, 0.70-2.38]). Pooled data indicated that the overall incidence of adverse events for TM or non-TM cups was 6.8% (382/5,289) and 9.0% (725/8,083), respectively, and not significantly different (OR = 0.91; [95% CI, 0.80-1.04]). The incidence of aseptic loosening and infection were significantly lower (OR = 0.75; [95% CI, 0.58-0.96]; OR = 0.70; [95% CI, 0.54-0.90]) and the incidence of dislocation was significantly higher (OR = 1.53; [95% CI, 1.22-1.91]) for TM compared to non-TM cups.& nbsp;Conclusion: This review was the first to use reconstructed time-to-event data to find that there was no difference in survival of TM and non-TM cups in acetabular revision surgery. Overall, fewer adverse events were associated with the use of TM compared to non-TM cups, but the difference was not significant. The incidence of aseptic loosening and infection were significantly lower and the incidence of dislocation was significantly higher for TM compared to non-TM cups. This information is expected to guide orthopedic surgeons in the selection of appropriate acetabular components for THA revision.
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