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Modes of failure of a threaded acetabular cup

A radiographic study with EBRA of 42 revised cups

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Abstract

A radiographic study of a singular type of threaded cup, revised due to aseptic loosening, was performed with Einzel-Bild-Roentgen-Analyse (EBRA) to detect eventual risk factors and patterns of loosening. Fifty-three cups of 50 patients were revised. Forty-two cups could be measured with EBRA. No cup had obvious osteolysis, 33 cups demonstrated early migration, and all cups had migrated at the time of revision. Twenty-eight of the cups had a change of inclination and 21 of anteversion, respectively. The mean migration was 1.9 mm in the medial and 7.9 mm in the cranial direction; the mean wear rate was 0.2 mm/year. Cups with early migration had a higher migration rate. All male patients had early migration; medially placed cups had less migration than the other cups. Wear was not significantly affected by the migration of the implant. No cup had a complete radiolucent line, and the only radiographic sign for loosening was the change of position of the cup. Medial placement showed less migration in case of loosening. Regular radiographic follow-up is recommended for the examined implant, and the cup should not be used in the future.

Résumé

Une étude radiographique d’une cupule vissée reprise pour descellement aseptique a été faite avec la méthode EBRA pour détecter les facteurs du descellement. Cinquante-trois cupules chez 50 patients étaient révisés; 42 avaient les mesures EBRA. Dans aucun cas il n’y avait d’ostéolyse évidente. Toutes les cupules avaient migré au moment de la révision et de façon précoce pour 33 d’entre elles. La migration moyenne était de 1,9 mm en dedans et de 7,9 mm vers le haut. Vingt-huit cupules avaient un changement d’inclinaison et 21 d’anteversion. L’usure moyenne était de 0,2 mm par an. La migration finale était plus importante pour les cupules ayant migré précocément. Tous les patients masculins avaient une migration précoce. L’usure n’était pas affectée par la migration. Aucune cupule n’avait de liseré complet et le seul signe de descellement était le changement de position de la cupule. La situation médiale de la cupule semble plus stable avec moins de migration en cas de descellement. Cette cupule ne doit plus être utilisée.

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Authors and Affiliations

  1. Kantonsspital Liestal, Liestal, Switzerland

    Thomas Ilchmann

  2. BG Trauma Centre University of Tübingen, Tübingen, Germany

    Severin Neher & Kuno Weise

  3. Elisabethenkrankenhaus Ravensburg, Ravensburg, Germany

    Franz Maurer

  4. Department of Orthopaedics, Kantonsspital, Rheinstr. 26, CH-4410, Liestal, Switzerland

    Thomas Ilchmann

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  1. Thomas Ilchmann
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  2. Severin Neher
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  3. Franz Maurer
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  4. Kuno Weise
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Correspondence to Thomas Ilchmann.

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Ilchmann, T., Neher, S., Maurer, F. et al. Modes of failure of a threaded acetabular cup. International Orthopaedics (SICOT) 31, 211–216 (2007). https://doi.org/10.1007/s00264-006-0155-2

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  • DOI: https://doi.org/10.1007/s00264-006-0155-2

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