Francisco Xará-Leite1, Ana Daniela Pereira2, Renato Andrade3,4,5, André Sarmento3,6, Ricardo Sousa7, Olufemi R Ayeni8, João Espregueira-Mendes3,4,9,10, Daniel Soares7. 1. GRIP Unit, Orthopaedics Department, Centro Hospitalar e Universitário do Porto, Largo do Prof Abel Salazar, 4099-001, Porto, Portugal. franciscoxdl@gmail.com. 2. Orthopaedics Department, Centro Hospitalar de Leiria, Leiria, Portugal. 3. Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal. 4. Dom Henrique Research Centre, Porto, Portugal. 5. Faculty of Sports, University of Porto, Porto, Portugal. 6. Orthopaedics Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal. 7. GRIP Unit, Orthopaedics Department, Centro Hospitalar e Universitário do Porto, Largo do Prof Abel Salazar, 4099-001, Porto, Portugal. 8. Division of Orthopaedic Surgery, McMaster University, Hamilton, ON, Canada. 9. Orthopaedics Department, Minho University, Minho, Portugal. 10. ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal.
Abstract
INTRODUCTION: The cement-in-cement technique for revision hip arthroplasty has many potential advantages and has recently gained widespread interest but still lacks evidence to support it. Our aim was to examine the surgical and patient-reported outcomes after cement-in-cement revision hip arthroplasty. MATERIALS AND METHODS: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and EMBASE databases were searched up to February 2019 for original studies reporting the outcomes of revision hip arthroplasty surgeries using the cement-in-cement technique. The methodological quality was assessed using the methodological index for non-randomized studies scale. RESULTS: Sixteen non-comparative studies met the eligibility criteria, comprising 1899 hips in 1856 patients (72.2 mean age, 37% male), with a mean follow-up of 7.2 years. Most studies reported only primary revisions and focused on the stem component. Intraoperative complications such as femoral or acetabular fractures (5.3%) were low and easily manageable with no relevant sequelae, as were dislocation rates (2.8% of uncomplicated events and 1.6% of cases requiring re-revision). Failure (considered if there was aseptic loosening of the cement-in-cement revised component, 2%), re-revision (9.3%), implant survival and late complication rates were favourable. Functional patient-reported outcomes showed an overall improvement above the minimal clinically important difference at final follow-up. CONCLUSION: The cement-in-cement technique is a viable option for hip arthroplasty revision surgery with low intraoperative and late complication rates, dislocations and immediate post-operative morbidity, resulting in good functional patient-reported outcomes and favourable medium-term implant survival.
INTRODUCTION: The cement-in-cement technique for revision hip arthroplasty has many potential advantages and has recently gained widespread interest but still lacks evidence to support it. Our aim was to examine the surgical and patient-reported outcomes after cement-in-cement revision hip arthroplasty. MATERIALS AND METHODS: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and EMBASE databases were searched up to February 2019 for original studies reporting the outcomes of revision hip arthroplasty surgeries using the cement-in-cement technique. The methodological quality was assessed using the methodological index for non-randomized studies scale. RESULTS: Sixteen non-comparative studies met the eligibility criteria, comprising 1899 hips in 1856 patients (72.2 mean age, 37% male), with a mean follow-up of 7.2 years. Most studies reported only primary revisions and focused on the stem component. Intraoperative complications such as femoral or acetabular fractures (5.3%) were low and easily manageable with no relevant sequelae, as were dislocation rates (2.8% of uncomplicated events and 1.6% of cases requiring re-revision). Failure (considered if there was aseptic loosening of the cement-in-cement revised component, 2%), re-revision (9.3%), implant survival and late complication rates were favourable. Functional patient-reported outcomes showed an overall improvement above the minimal clinically important difference at final follow-up. CONCLUSION: The cement-in-cement technique is a viable option for hip arthroplasty revision surgery with low intraoperative and late complication rates, dislocations and immediate post-operative morbidity, resulting in good functional patient-reported outcomes and favourable medium-term implant survival.
Authors: Nana O Sarpong; Matthew J Grosso; Akshay Lakra; Michael B Held; Carl L Herndon; H John Cooper Journal: J Arthroplasty Date: 2019-02-25 Impact factor: 4.757
Authors: Derek F Amanatullah; Graham D Pallante; Lorena V Floccari; George I Vasileiadis; Robert T Trousdale Journal: Orthopedics Date: 2016-12-20 Impact factor: 1.390
Authors: Kalliopi I Lampropoulou-Adamidou; Eleftherios E Tsiridis; Eustathios I Kenanidis; George C Hartofilakidis Journal: J Arthroplasty Date: 2016-04-13 Impact factor: 4.757
Authors: Jeffrey N Katz; Charlotte B Phillips; John A Baron; Anne H Fossel; Nizar N Mahomed; Jane Barrett; Elizabeth A Lingard; William H Harris; Robert Poss; Robert A Lew; Edward Guadagnoli; Elizabeth A Wright; Elena Losina Journal: Arthritis Rheum Date: 2003-02
Authors: Brian E Schwartz; Hristo I Piponov; Cory W Helder; William F Mayers; Mark H Gonzalez Journal: Int Orthop Date: 2016-02-01 Impact factor: 3.075