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Good Stability and Minimal Osteolysis with a Biconical Threaded Cup at 10 Years.

Zweymüller, Karl A MD; Steindl, Martin MD; Schwarzinger, Ulrike MD

Clinical Orthopaedics and Related Research (1976-2007): October 2007 - Volume 463 - Issue - pp 128-137
doi: 10.1097/BLO.0b013e318155978b

In the literature there is no consensus on the value of threaded cementless cups. We primarily asked whether the newly constructed threaded double-cone cup without additional screw fixation would provide high survival at intermediate followup. We retrospectively reviewed 365 patients (376 hips) who underwent primary total hip arthroplasty using this cup made of pure titanium with ceramic-on-polyethylene articulating surfaces. At a minimum followup of 10.0 years (mean, 10.3 years; range, 10.0-13.1 years), 232 cups (61.7%) were available for analysis. We performed two revisions for early infection and cup breakage. No polyethylene liner was exchanged because of wear or instability. Three of the cup shells were radiographically loose at followup; one had periacetabular osteolysis. The mean liner wear rate was 0.13 mm per year. The Kaplan-Meier 10-year survivorship with revision of the cup shell for any reason was 99.3% (95% confidence interval, 96.9-99.8%) and with revision and radiographic loosening of the cup shell 98.6% (95% confidence interval, 96.0-99.5%). These intermediate results compare favorably with survivorship and periace-tabular bone reaction data observed with the best cementless acetabular implant designs.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

From the Orthopädisches Krankenhaus Gersthof, Vienna, Austria.Received: March 13, 2006

Revised: February 28, 2007; July 5, 2007

Accepted: July 19, 2007

One or more of the authors (KAZ) have received funding from Plus Orthopedics AG (Rotkreuz, Switzerland).

Each author certifies that his or her institution either has waived or does not require approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

Correspondence to: Karl A. Zweymüller, MD, Orthopädisches Krankenhaus Gersthof, Wielemansgasse 28, A-1180 Vienna, Austria. Phone: 43-1-47611-5400; Fax: 43-1-47611-5419; E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.