THA: Less transverse rotation of tantalum trabecular metal acetabular cup .
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(2):18 Acta Orthop. 2011 Apr;82(2):155-60. Epub 2011 Mar 2560 patients with noninflammatory hip arthritis were randomized to receive either a tantalum trabecular metal acetabular cup or titanium fiber-mesh cup, as part of the primary hip arthroplasty surgical procedure. The primary endpoint was cup migration. Bone mineral density and the Harris hip score were also evaluated. Results indicated positive early results with the tantalum trabecular metal cup on fixation outcomes, as well as comparable results on the secondary endpoint outcomes. A longer observation period is recommended to examine the effects over a longer time period.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sí = 1
Incierto = 0,5
No relevante = 0
No = 0
La evaluación de los criterios de información evalúa la transparencia con la que los autores informan de las características metodológicas y del ensayo dentro de la publicación. La evaluación se divide en cinco categorías que se presentan a continuación.
4/4
Randomization
3/4
Outcome Measurements
3/4
Inclusion / Exclusion
2/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
El Índice de Fragilidad es una herramienta que ayuda en la interpretación de hallazgos significativos, proporcionando una medida de fuerza para un resultado. El Índice de Fragilidad representa el número de eventos consecutivos que es necesario añadir a un resultado dicotómico para que el hallazgo deje de ser significativo. Un número pequeño representa un hallazgo más débil y un número grande un hallazgo más fuerte.
¿Por qué se necesitaba ahora este estudio?
Initial stability is critical for an implant to achieve bone ingrowth. A number of clinical studies have shown good outcomes in bone ingrowth with trabecular metal. However, no published studies have examined this relationship with radiostereometric analysis (RSA). This study compares tantalum trabecular metal acetabular cups and titanium fiber-mesh cups in primary hip arthroplasty.
¿Cuál era la pregunta principal de la investigación?
What are the outcomes in cup migration, bone mineral density, and Harris hip scores with tantalum trabecular metal acetabular cups compared to titanium fibermesh cups, in patients with noninflammatory hip arthritis undergoing primary hip arthroplasty at 2 years?
- Radiostereometric analysis (RSA) indicated minimal rotation and translation at the 2-year follow-up. No statistically significant difference was seen between the two groups on translation. The trabecular tantalum surface cups (Monoblock) had less rotation on the transverse axis compared to the titanium fiber-mesh cup (Trilogy) (Monoblock: Mean -0.01 degrees [95%CI: -0.11 to 0.12]; Trilogy: Mean -0.60 degrees [95%CI: -0.72 to -0.48]) (p=0.04)
- Both groups reported a similar increase in Harris hip score at 3 months postoperatively from a score of 50 (28-70) to 92 (76-100) in the tantalum group and from 48 (34-64) to 95 (77-100) in the Trilogy group
- Both groups had similar degrees of reduction in bone mineral density
¿Qué es lo que más debo recordar?
Positive early results were seen for both implant cups in terms of fixation onto the acetabular host bone. RSA revealed both groups had minimal rotation and translation (with less rotation on the transverse axis for the tantalum group). Results also indicated similar reduction in bone mineral density and similar increase in Harris hip score.
¿Cómo afectará esto al cuidado de mis pacientes?
A study with a longer observation period is recommended to determine the long-term outcomes of the tantalum trabecular metal acetabular cups.
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