Published online Sep 18, 2017. doi: 10.5312/wjo.v8.i9.705
Peer-review started: February 15, 2017
First decision: March 27, 2017
Revised: April 10, 2017
Accepted: June 6, 2017
Article in press: June 7, 2017
Published online: September 18, 2017
Processing time: 215 Days and 23.8 Hours
To compare the operation time, blood loss, and early outcomes of acetabular components with and without the screw.
Thirty patients who underwent cementless acetabular component with or without screw and whose follow-up exceeded one year period in total hip arthroplasty were evaluated. A posterior approach was used in all surgical procedures by one experienced surgeon. Demographic data, operation time, intra- and postoperative blood loss volume, follow-up clinical score, cup migration, and osteolysis were recorded. The Kolmogorov-Smirnov test was performed for testing the normality of study data. Mann-Whitney U test was used to analyze the inter-group differences. A P-value of ≤ 0.05 was considered statistically significant.
Acetabular components were used in 16 (53.3%) patients with screw and 14 (46.7%) without screw. After one year of follow-up, an osteolytic lesion of 3 mm was found in only one patient in the screw group. No cup migration was encountered. Intra-group mean Harris hip score significantly increased, but there was no significant inter-group difference. While the mean operation time of the screw group was 121.8 min (range; 95-140), it was 102.7 min (range; 80-120) in the no-screw group, and this difference was statistically significant (P = 0.002). The mean intraoperative/postoperative, and total blood loss were 556.6 mL (range: 350-800)/423.3 mL (range: 250-600), and 983.3 mL (range: 600-1350), respectively in the screw group; and 527 mL (range: 400-700)/456 mL (range: 230-600), and 983 mL (range: 630-1250), respectively in the no-screw group. The blood loss difference between the two groups was not significant. In the screw group, the operation time was 19.1 min longer than the no-screw group, and this difference was statistically significant.
Acetabular components with or without screw have similar results, but the use of screw increases the operation time significantly, while not changing the blood loss volume.
Core tip: This is a retrospective study comparing the perioperative data and early outcomes of the screw and no-screw acetabular components in total hip arthroplasty. There is no study comparing the screw and no-screw components for perioperative data in the literature. Both components were characterized with similar clinical outcomes in the early term. But additional screws significantly increase the mean operative time.