Does load-bearing materials influence hip capsule thickness in total hip replacement? An MRI case-matched study - 30/01/21
, Julien Sanchez b, Jean-Michel Sverzut b, Jean-Denis Laredo b, Laurent Sedel a, Pascal Bizot a
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Abstract |
Background |
Ceramic-on-ceramic (COC) total hip replacements (THR) have exhibited less instability and late dislocation. Hip capsule plays an important role in hip stability. Different surrounding soft tissue reactions have been observed according to the bearing material used but no study compared these data using MRI investigation. Therefore, we performed a retrospective case control study to compare hip capsule thicknesses according to the bearing materials in THR and in native hips.
Hypothesis |
Hip capsule is thicker after COC THR compared to ceramic- or metal-on-polyethylene (PE) bearings, or native hips.
Materials and method |
Magnetic resonance imaging (MRI) images, combined with a multi acquisition variable resonance image combination (MAVRIC) sequence, was used to measure the hip capsule thickness in 16 patients (29 hips) who had either COC (13 hips, median age at surgery: 64.8 years old, median follow-up at imaging: 2482 days), PE bearings (11 hips, median age at surgery: 48.4 years old (significantly different from COC THR), median follow-up at imaging: 1860 days (NS)), or a native hip with no implant (5 hips). Two independent radiologists measured capsular thicknesses in 4 different zones and were blinded regarding the bearing components. The imaged hips were classified into three groups: native, COC and PE.
Results |
The COC THR group had the thickest capsules (median 7.0mm, range 2.9–15.5mm). This result was statistically significant (p<0.0001) when compared to PE THR (median 4.9mm, range 2.2–10.5mm), and to native hips (median 4.1mm, range 2.7–6.9mm) measurements, respectively. Furthermore, painful hips had thinner capsules (4.6mm, range 2–10.5) compared to not painful hips (6.8mm, range 2.3–15.5) (p=0.0006).
Discussion |
This is the first in-vivo study measuring capsular thickness in THR with the objective of measuring variations according to the hip implant materials used. The results revealed a significantly thicker capsule for the COC bearing compared to either PE or native hips, and a thinner capsule in painful hips.
Level of evidence |
III, retrospective non-consecutive cohort study.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Total hip replacement, Dislocation, Hip capsule, Bearings
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Vol 107 - N° 1
Articolo 102497- febbraio 2021 Ritorno al numero
Articolo precedente
- Ceramic-on-ceramic bearing: Recent progress and solved controversies
- Laurent Sedel, Daniel Chappard, Etienne L. Belzile
- Ceramic-on-ceramic total hip arthroplasty is superior to metal-on-conventional polyethylene at 20-year follow-up: A randomised clinical trial
- Pascal-André Vendittoli, Maged Shahin, Charles Rivière, Janie Barry, Pauline Lavoie, Nicolas Duval
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.