Long-Term Survival of Total Hip Arthroplasty Using Implants From Different Manufacturers

Purpose: The aim of the study was to systematically evaluate clinical outcomes of tapered fluted stems, either monoblock or modular, in revision total hip arthroplasty. Methods: PubMed, EMBASE and Web of Science and Cochrane databases were systematically searched by 2 researchers. Clinical studies reporting primarily on survival and re-revision rates, and secondarily on subsidence, dislocation, intraoperative fractures, periprosthetic fractures and infection were included. 2 investigators assessed the quality of the studies. Results: 46 studies were included in this review, reporting on 4601 stem revisions. The pooled re-revision rate was 5.1% and long-term survival ranged from 75% to 98.5%. No differences were observed between monoblock and modular stems regarding re-revision rate, dislocation rate, periprosthetic fracture rate or infection rates. Monoblock stems exhibited more subsidence and modular stems displayed more intraoperative fractures. Conclusions: Satisfactory results can be obtained with the use of tapered fluted end-bearing stems. Monoblock stems offer the same clinical results as modular stems.

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Total hip arthroplasty in patients with osteoporosis

Hip International ◽

10.1177/1120700019883244 ◽

2019 ◽

Vol 30 (4) ◽

pp. 370-379

Author(s):

Theofilos S Karachalios ◽

Antonios A Koutalos ◽

George A Komnos

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Femoral Fractures ◽

Hip Osteoarthritis ◽

Osteoporosis Treatment ◽

Term Survival ◽

Bone Implant ◽

Total Hip ◽

High Prevalence

There is a high prevalence of osteoporosis in patients undergoing total hip arthroplasty. There are several clinically relevant questions related to the management of such cases: the effect of ageing; the initial osseointegration of implants, especially when cementless THA is used; the effect of medical osteoporosis treatment on bone-implant interface; the incidence of intraoperative and late periprosthetic fractures, and the long-term survival of both cemented and cementless total hip arthroplasty performed for proximal femoral fractures and hip osteoarthritis. A critical review of the literature is presented in an attempt to draw practical conclusions.

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Patient Weight more than Body Mass Index Influences Total Hip Arthroplasty Long Term Survival

Hip International ◽

10.5301/hip.2011.8879 ◽

2011 ◽

Vol 21 (6) ◽

pp. 694-699 ◽

Cited By ~ 11

Author(s):

Francesco Traina ◽

Barbara Bordini ◽

Marcello De Fine ◽

Aldo Toni

Keyword(s):

Body Mass Index ◽

Body Weight ◽

Total Hip Arthroplasty ◽

Body Mass ◽

Hip Arthroplasty ◽

Implant Survival ◽

Term Survival ◽

Long Term Survival ◽

Implant Survivorship

The effect of obesity on the long-term survival of total hip arthroplasty remains under discussion. Reviewing meta-analyses of large cohort studies a high body mass index has been correlated with a higher incidence of complications but not univocally with a lower implant survival rate. It has been suggested that body weight rather than body mass index might be a better parameter to evaluate prosthesis outcome. We reviewed 27,571 patients retrospectively with primary arthritis as a preoperative diagnosis. Patients were divided into 4 categories based on their body mass index, or into two groups based on the body weight (<80 kg and 80 kg). Implant survivorship was estimated with use of the Cox proportional hazards model with revision for aseptic loosening as the end point. Results were stratified for sex and implant tribology. When body mass index was used the 10 years implant survival in obese versus non-obese patients was not statistically different (p=0.058), but when body weight was used a statistically different implant survivorship was found for men (p=0.009). Therefore, weight rather than than body mass index influences survival of hip prostheses, and should be used as the discriminant parameter for further studies.

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Long-term clinical and radiological outcome in patients with severe Legg-Calvé-Perthes disease after Chiari pelvic osteotomy: a mean of 14 years follow-up

Hip International ◽

10.1177/1120700020988150 ◽

2021 ◽

pp. 112070002098815

Author(s):

Dammerer Dietmar ◽

Braito Matthias ◽

Peter Ferlic ◽

Kaufmann Gerhard ◽

Juana Kosiol ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Joint ◽

Hip Arthroplasty ◽

Pelvic Osteotomy ◽

Perthes Disease ◽

Total Hip ◽

Joint Incongruence ◽

Chiari Pelvic Osteotomy

Introduction: The Chiari pelvic osteotomy (CPO) has been recommended as a salvage procedure to improve head coverage in case of hip joint incongruence in paediatric hip disease. In this study, we aimed to assess the long-term results of CPO for severe Legg-Calvé-Perthes disease (LCPD). Methods: A total of 39 patients who underwent a CPO at our department between 1995 and 2010 were prospectively followed both radiologically (Stulberg classification) and clinically (Harris Hip Score [HHS], conversion into total hip arthroplasty). In this study, we retrospectively reviewed the cases of 12 hips (12 patients, 3 girls, 8 left hips) treated by CPO for severe LCPD (Catterall grade 3 or 4) with hip joint incongruence. Mean follow-up was 14.0 (range 7.6–21.3) years. Results: Mean age at surgery was 10.2 (range 8.2–17.8) years. Additional femoral osteotomy was performed in 8 patients. A good radiological result (Stulberg I or II) was achieved in 2 patients, a fair result (Stulberg III) in 4 patients, and a poor outcome (Stulberg IV or V) in 6 patients. Mean postoperative HHS averaged 93 (range 65–100) points. An excellent functional outcome (HHS 90–100 points) was achieved in 9 patients. No patient underwent total hip arthroplasty during follow-up. Postoperative limb-length discrepancy was found in 3 patients. Conclusions: CPO for severe LCPD with hip joint incongruence resulted in good long-term clinical outcome in about ⅔ of our patients after a mean of 14 years. Our results suggest that CPO can still be considered as a salvage joint-conserving procedure in this selected group of younger patients.

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