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Online ISSN 1827-1707
96° CONGRESS OF THE PIEDMONTESE-LIGURIAN-LOMBARD SOCIETY OF ORTHOPEDICS AND TRAUMATOLOGY (SPLLOT) (Brescia, September 24-25, 1999)
BIOMATERIALS IN ORTOPEDICS: EXPECTATION AND CLINICAL PRACTICE
Botta M., Suligoj R., Mazze M., Zoppi P., Bottai V.
Background. In total hip replacement surgery the duration of the acetabular cup component depends on several parameters (anatomy, variation of drawings, difference in the materials) and above all on the bone-implant interaction (immune response, osteointegration, bone-remodelling). At present there is no single method of statistical analysis and in order to formulate a prognosis of the system the most accredited means is X-ray evaluation.
Methods. This study analysed 360 screwed acetabular cups implanted between 1990 and 1998; of these 181 were hemispherical and 179 biconical. Of the 181 hemispherical acetabular cups implanted from 1990 to 1995, a total of 156 patients were re-examined. The acetabular cups used were GCO (80), VP (65) and Alfa (11), with different types of associated stems.
Of the biconical cups implanted between 1995 and 1998, a total of 179 cases were re-examined and all these were Bicon Plus.
The indications, contraindications and follow-up for the two systems are described.
Results. The X-ray and above all the clinical evaluation made using the HARRIS hip-score enabled the authors to classify 94% of the hemispherical cups as excellent and good and 6% as satisfactory or poor, whereas 91% of the biconical cups were classed as excellent and good and 9% as satisfactory or poor.
Conclusions. Following an analysis of the two series and in line with the philosophy of screwed components, biconical cups are more indicated than the hemispherical models. The stability of both systems appears to be reliable, even after the crucial 5th year after implantation provided than the indications were respected and a scrupulous surgical technique was used.