Analysis Of Risk Factors Of Early Aseptic Loosening Of Bioartificial Acetabular Cups

Background:Total Hip Arthroplasty(THA)is one of the most successful surgeries in the 20th century.THA has resolved the pain of patients with numerous hip disorders.Bio-prosthetic hip prosthesis has been widely used in clinical practice.However,some unsatisfactory concurrences still occur after surgery,such as premature aseptic loosening of the acetabular cup after surgery.With the understanding of the aseptic loosening of the prosthesis,it has been found that aseptic loosening of the prosthesis after THA is often the result of the interaction of multiple factors.Objective:Early aseptic loosening of biotype acetabular cup is a rare complication after THA.This article reviews retrospective studies to assess risk factors for early aseptic loosening of biotype acetabular cups.Summing up the lessons learned and improving the survival rate of the acetabular cup,with a view to provide reference value for clinical work.Methods:Retrospective analysis of patients undergoing total hip arthroplasty between January 2011 and December 2017 in our hospital,who had undergone revision surgery in our institution due to early aseptic loosening of the acetabular cup after THA and met the inclusion criteria As a case group(n=20 cases,20 hips,of which 8 cases were in our hospital for the primary THA,12cases were in the external hospital for the primary THA).According to the same period of surgical treatment and the same type of prosthesis(two kinds of domestic and imported prosthesis)for 1:3 match,and no acetabular cup after aseptic loosening as a control group(n=60 cases,60 hips).A total of 14 factors were studied in the patient's own factors(such as gender,age of first surgery,BMI,postoperative activity,comorbidities,etc.)and operative factors(such as surgical approach,placement of prosthesis,etc.).Evaluation analysis may influence the risk factors for early aseptic loosening of bioartificial acetabular cups after THA.Results:Patients in the case group had aseptic loosening of the acetabular cup after surgery for 6 months to 68 months.The average life span of the acetabular cup was approximately 31 months.50%of acetabular cups had aseptic loosening within 2 years after surgery.In this study,14 factors that may affect the early postoperative aseptic loosening of the acetabular cup were statistically analyzed and showed that:BMI,acetabular cup abduction angle and HJC vertical offset distance are the risk factors affecting the occurrence of acetabular cup after THA.The risk of early aseptic loosening in the acetabular cup after surgery in patients with BMI?24 Kg/m~2 was 3.960 times higher than BMI<24 Kg/m~2;The risk of early aseptic loosening in the acetabular cup after surgery in patients with the acetabular cup abduction angle?50°was 5.011times higher than 30°~50°.However,there was no significant difference in the effect of early aseptic loosening of the acetabular cup between acetabular cups<30°and 30°~50°(P>0.05);The risk of early aseptic loosening in the acetabular cup after surgery in patients with HJC vertical offset distance?10mm was 5.473times higher than 5-10mm.However,there was no significant difference in the effect of early aseptic loosening of the acetabular cup between HJC vertical offset distance<5mm and 5mm~10mm(P>0.05).Conclusion:For patients undergoing bioartificial total hip arthroplasty,based on the results of this study:BMI,acetabular cup abduction angle and HJC vertical offset distance are independent risk factors for early aseptic loosening of the acetabular cup after THA.The poor placement of the acetabular cup may be one of the main reasons leading to early aseptic loosening of the acetabular cup.To reduce the early aseptic loosening rate of the postoperative acetabular cup,the patient's BMI should be avoided too high(?24 Kg/m~2),the acetabular cups should be kept from having an too large abduction angle(?50°)and the HJC vertical offset distance(?10 mm).