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. 2008 Dec;32(6):791-4.
doi: 10.1007/s00264-007-0405-y. Epub 2007 Jul 3.

Migration of the Duraloc cup after 5 years

Christoph Stihsen  1 , Christof Pabinger, Roman Radl, Peter Rehak, Reinhard Windhager
Affiliations

Migration of the Duraloc cup after 5 years

Christoph Stihsen et al. Int Orthop. 2008 Dec.

Abstract
in English, French

The Duraloc cup is a frequently used metal-backed, porous-coated, hemispherical, press-fit acetabular component. Published data on loosening rates are contradictory. In this study we investigated migration patterns with computer-assisted Einzel-Bild-Roentgen-Analyse (EBRA) of 67 Duraloc 100 cups. Cup migration and clinical scores were analysed over a 5-year follow-up period. Median total migration of the Duraloc 100 cup was 1.21 mm at 5 years. Seventy-five percent of implants were radiologically stable at 2 years and 90% at 4 years. One cup loosened aseptically at 60 months, requiring revision. Cup diameters > or = 54 mm migrated significantly more than cups < 54 mm in diameter (p = 0.029 at 4 years). There was a significant correlation between high polyethylene wear and further migrating cups within the first post-operative year (p = 0.035 at 12 months). Our analysis revealed significantly higher wear in males (p = 0.029 at 4 years). Radiological loosening at two years could be calculated using receiver-operating characteristic curve analysis, and 1.2 mm as an adequate threshold value (sensitivity = 100%, specificity = 89%).

La cupule DURALOC est une cupule utilisée de façon fréquente avec un composant acétabulaire sans ciment, porous coated, hémisphérique. Les publications indiquant les taux de descellement de cet implant sont très contradictoires. Dans cette étude, nous avons étudié la migration de cette cupule par méthode informatique avec un logiciel de type EBRA. La migration de la cupule et les scores ont été analysés après une période de cinq ans de suivi. La migration moyenne de 100 cupules DURALOC a été de 1.21mm à 5 ans, 75% des implants étaient stables radiologiquement à 2 ans et 90% à 4 ans. Une cupule s’est descellée de façon aseptique à 60 mois, nécessitant une révision. Les cupules de diamètre ≥54mm migrant de façon plus fréquente que les cupules plus petites (p = 0.029 à 4 ans). De même, a été mis en évidence une corrélation significative entre l’usure du polyéthylène et la migration de la cupule dans les premières années (p = 0.035 à 12 mois). Notre analyse montre qu’il existe une usure significativement plus importante chez les hommes (p = 0.029 à 4 ans). La valeur seuil de l’usure à 2 ans étant de 1.2mm (sensitivité = 100% ; spécificité = 89%)

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Figures

Fig. 1
Fig. 1
ROC curve analysis (representation of the reciprocal relationship between sensitivity and specificity, calculated for all threshold values) proposes 1.2 mm as an alternative threshold value for the definition of loosening at 2 years (AUC = 0.96)
See this image and copyright information in PMC

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