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THA with cable fixation associated with increased nonunion, osteolysis rates
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BERLIN — Cable fixation of osteotomies or fractures during total hip arthroplasty yielded higher complication rates compared to wire fixation methods, according to research presented at the 13th EFORT Congress 2012, here.
“We found a higher incidence of complication and a trend toward increasing infection and foreign body reaction with the use of cable, suggesting that wiring may be the preferable surgical technique,” Charles Berton said when he presented results of the prospective cohort study that he and his colleagues recently performed.
They included in their investigation all primary and revision total hip arthroplasty (THA) procedures performed from March 1996 to December 2005.
“Cables or wires are routinely used in complex primary and revision hip arthroplasty,” Berton said, noting “there is little in the literature to support the preferential use of cable or wire.”
Berton and colleagues looked at the cohort’s 5-year clinical and radiographic outcomes, studying the complication rates of cable fixation vs. wire fixation of concurrent fractures or osteotomies.
“The choice between cable or wire was according to surgeon preference,” Berton noted.
Cable fixation was used in 51 THAs and wire fixation was used in 126 THAs. At 5-years postoperatively, 33 THAs with cable fixation and 91 THAs with wire fixation had device breakage rates on radiographs of 36% and 46%, respectively. Cable fixation was associated with a significantly higher 36% risk of nonunion vs. wire fixation, which had a 21% rate of nonunion. The rates of femoral and acetabular osteolysis adjacent to the materials were 52% for cables and 11% for wires.
Cable breakage, Berton said, raised the osteolysis risk to 86%. Clinical results did not substantially differ, however, between the cable fixation and wire fixation groups, he reported.
Three patients who received cable fixation later developed foreign-body reactions.
Reference:
Berton C, Lubbeke A, Puskas GJ, et al. Outcomes of cable vs. wire fixation five years after total hip arthroplasty. Paper #12-2811. Presented at the 13th EFORT Congress 2012. May 23-25. Berlin.
Disclosure: Berton has no relevant financial disclosures.
