Modern Surfaces of the Uncemented Cup in Total Hip Arthroplasty: A Randomized, Clinical Investigation Comparing Two Different Ultra-porous Coated Surfaces of Uncemented Cups Using CT-based Micromotion Analysis and Clinical Evaluation
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Osteoarthritis, Hip
- Sponsor
- Umeå University
- Enrollment
- 70
- Locations
- 1
- Primary Endpoint
- Early migration of the cup
- Status
- Active, not recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
A randomised controlled study comparing two types of ultra-porous coated uncemented cups in total hip arthroplasty. Primary objective is to investigate if the clinical, radiological and patient-reported outcome of the new MobileLINK TabecuLINK cup combined with an X-LINKed insert is non-inferior to the clinical and radiological outcome of the Pinnacle Gription series 100 cup combined with the Marathon liner. Patients are evaluated up to 15 years postoperatively.
Detailed Description
The purpose of this study is to evaluate the clinical outcome and long-term risk of development of osteolysis of a newly introduced cementless press-fit acetabular cup, consisting of a shell with a 3D surface structure and a highly cross-linked liner by precise measurement of early migration and wear. Migration describes the movement between the implant and the surrounding bone over time. Early migration of the implant, within 2 years after operation, has shown to be a strong predictor for increased risk for late failure. Thus, high precision migration studies can be used to evaluate the performance of new implants in small groups of patients with a relatively short observation time. Wear particles are one of the main causes of periprosthetic osteolysis. Although modern, more wear resistant materials, appears to have a greatly reduced risk of osteolysis, the desired complete elimination of osteolysis appears to be yet unachieved. It is most likely that the mechanism of periprosthetic osteolysis is multifactorial. In this study the investigators plan to include 70 patients that are planned for operation with an uncemented total hip arthroplasty. 35 patients will be randomized to receive the new implant and 35 patients will be included in the control group and receive a standard uncemented prosthesis. All patients will then be followed with CT scans and patient reported outcome measures 3-month, 1 year, 2 years, 5 years and 15 years after the operations. The CT scans will be used both for measurement of migration and wear and development of osteolysis around the implant.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients are foreseen for implantation of an uncemented acetabular press-fit cup and an uncemented stem
- •Age 30-70 years
- •Primary osteoarthritis of the hip
- •Body Mass Index between 18 and 35 kg/m2
- •Willingness and ability to follow clinical investigation protocol
Exclusion Criteria
- •Grossly abnormal hip anatomy (hip dysplasia, Crowe Grade 2 or above, Perthes or other causes)
- •Osteoporosis
- •Paget's disease
- •Inflammatory arthritis
- •Secondary osteoarthritis
- •Presence of malignancy in the area of surgery
- •Treatment with bisphosphonates, cortisol or cytostatic drugs 6 months or less prior to surgery
- •Previous surgery in the affected hip
- •Inclusion of the contralateral hip in this clinical investigation
- •Not suited for the clinical investigation for other reason (surgeon's judgment)
Outcomes
Primary Outcomes
Early migration of the cup
Time Frame: 2 years after operation
Migration of the cup between 3 month and 2 years after implantation of the cup measured with Computed Tomography scan based Micromotion Analysis (CTMA) in mm.
Secondary Outcomes
- Long term wear(15 years after operation)
- Patient reported outcome with Forgotten Joint Score(15 years after operation)
- Reoperations(15 years after operation)
- Osteolysis(15 years after operation)
- Proximal wear(5 years after operation)
- 3D wear(5 years after operation)
- Stem migration(15 years)
- Precision of migration measurements with CTMA(1 year after operation)
- Long term migratio(15 years after operation)
- Patient reported outcome with Hip dysfunction and Osteoarthritis Outcome Score(15 years after operation)
- Patient reported outcome with University of California, Los Angeles Activity Score(15 years after operation)
- Patient reported outcome with EuroQuol 5.(15 years after operation)
- Precision of wear mearurements with CTMA(1 year after operation)