PubMed · 7800600
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M A Ritter. 1994. Cemented all-poly cups.. https://doi.org/10.3928/0147-7447-19940901-14
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This study evaluated 185 cementless Mathys coated and uncoated acetabular cups inserted for total hip replacement since September 1984. All of the cups were high-density polyethylene. Sixty were uncoated (group A), 96 were coated with hydroxyapatite (group B), and 29 were coated with titanium (group C). Cup survival was assessed clinically, histologically, and radiographically, and a computer-assisted EBRA method was used to evaluate cup migration. After a mean follow-up of 8 years, five cups in group A that had previously shown migration were revised as a result of aseptic loosening, while no loosening of hip sockets occurred in groups B and C. These results suggest that Mathys cups should be used only if coated with hydroxyapatite or titanium. Furthermore, the histologic evaluation in four cups from groups B and C revealed normal bone formation without inflammation or fibrotic tissue around the cups, promising long-term survival.
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Aseptic loosening remains the leading cause of failure after total hip replacement. Extensive bone loss and acetabular bone stock deficiency are frequently encountered. Simple autografting techniques are often not possible, and copious amounts of allograft may be required to reconstruct the defect. The mechanically stable environment that is a prerequisite for successful graft incorporation cannot be achieved with routine acetabular fixation techniques alone. A reconstruction ring that is secured to the surrounding pelvis provides a more rigid construct. Several types of reconstruction rings are available for the management of acetabular bone loss during revision hip surgery. Early results suggest that these devices may prove to be a useful alternative for treatment of a difficult problem.