โ Scribed by S. Kobayashi; K. Terayama
No coin nor oath required. For personal study only.
Two hundred and sixty-seven consecutive primary low-friction arthroplasties, followed for 5 to 18 years after surgery, were studied to assess the factors influencing survival of the socket, using the Kaplan-Meier method. The end point of survival was defined radiologically in two ways: incipient failure (migration of 3 mm or more or rotation of 4 ยฐ or more) and definite failure (progressive change of position). Twenty-four sockets (9.0%) developed incipient failure, and 14 of them progressed to definite failure. Preservation of the subchondral bone plate or eburnated bone in the acetabular roof, multiple 6-mm anchor holes, and two steps of evolution in socket design (the advent of a pressureinjection socket and than an ogee-flanged socket) benefited socket survival. Polyethylene wear was considered to be the most important factor limiting longevity of the socket.
Aseptic loosening continues to be the most common mode of failure of total hip replacement, especially on the acetabular side. Harris [7] says that no one has solved the long-term fixation problem in cementing sockets and he considers it the remaining issue. We assessed factors affecting aseptic loosening of the socket in lowfriction arthroplasty of the hip, using survival analysis to determine means of improving the durability of this procedure.
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