Reverse THA may provide consistent, solid bony fixation of femoral, acetabular components
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Key takeaways:
- Mean migration of acetabular and femoral components differed from the published threshold.
- Most patient-reported outcome measures had significant improvements up to 24 months postoperatively.
Published results showed use of a reverse total hip arthroplasty system may provide consistent, solid bony fixation of the femoral components and acetabular components with screw augmentation in patients with end-stage osteoarthritis.
“This looks to be promising technology that has the potential to address ongoing clinical concerns with total hip arthroplasty,” Thomas R. Turgeon, MD, BSc, MPH, FRCSC, FAAOS, head of arthroplasty research at the University of Manitoba in Winnipeg, Manitoba, told Healio. “The implant was well-fixed to bone and appears to be performing well.”
Turgeon and colleagues evaluated implant fixation in 22 patients with end-stage OA who underwent reverse THA (HIT Hip Replacement System, Hip Innovation Technology) using radiostereometric analysis (RSA) and WOMAC index, Harris Hip Score, Oxford Hip Score, Hip disability and Osteoarthritis Outcome Score, SF-36 survey and EuroQol-5D health questionnaire scores at 2-year follow-up. Researchers collected RSA images at 6 weeks, used as the reference assessment, and at 6, 12 and 24 months postoperatively. Surgeons used at least one acetabular screw in all cases.
Mean migration of the acetabular component by 24 months was 0.087 mm, which researchers found differed significantly from the published threshold of 0.2 mm. Mean migration of the femoral component was –0.002 mm and significantly differed from the published reference of 0.5 mm. Except for the SF-36 mental component summary, which had a nonsignificant trend toward improvement, results showed significant improvements in all patient-reported outcome measures from preoperatively to 24 months postoperatively. Overall, 19 patients reported being “very satisfied” with the outcome of their hip surgery, one patient reported being “somewhat satisfied” and two patients reported being “somewhat dissatisfied,” according to researchers.
“This device is intended to have enhanced stability throughout the flexion arc. When you look at other designs, traditional bearings [and] dual mobility, they become more vulnerable in the extremes of motion, whereas this implant is equally stable in any position of flexion,” Turgeon said. “It does have the potential to address a number of issues but, ultimately, further study is required to formally prove that out in the scientific literature.”
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