A randomised study of peri-prosthetic bone density after cemented versus trabecular fixation of a polyethylene acetabular component

J Bone Joint Surg Br. 2011 Aug;93(8):1033-44. doi: 10.1302/0301-620X.93B8.26233.

Abstract

The ideal acetabular component is characterised by reliable, long-term fixation with physiological loading of bone and a low rate of wear. Trabecular metal is a porous construct of tantalum which promotes bony ingrowth, has a modulus of elasticity similar to that of cancellous bone, and should be an excellent material for fixation. Between 2004 and 2006, 55 patients were randomised to receive either a cemented polyethylene or a monobloc trabecular metal acetabular component with a polyethylene articular surface. We measured the peri-prosthetic bone density around the acetabular components for up to two years using dual-energy x-ray absorptiometry. We found evidence that the cemented acetabular component loaded the acetabular bone centromedially whereas the trabecular metal monobloc loaded the lateral rim and behaved like a hemispherical rigid metal component with regard to loading of the acetabular bone. We suspect that this was due to the peripheral titanium rim used for the mechanism of insertion.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Absorptiometry, Photon
  • Acetabulum / physiopathology
  • Acetabulum / surgery*
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / methods
  • Bone Density*
  • Cementation / methods
  • Female
  • Hip Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Polyethylene
  • Postoperative Period
  • Prosthesis Design
  • Tantalum
  • Treatment Outcome
  • Weight-Bearing

Substances

  • Tantalum
  • Polyethylene