Mid- to long-term outcomes of cementless modular, fluted, tapered stem for massive femoral bone loss in revision total hip arthroplasty

2020 ◽  
Author(s):  
Kai Zheng ◽  
Ning Li ◽  
Weicheng Zhang ◽  
Jun Zhou ◽  
Yaozeng Xu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Long Term Results ◽  
Revision Total Hip Arthroplasty ◽  
Femoral Bone ◽  
Total Hip ◽  
Tapered Stem

Abstract Background: Revision total hip arthroplasty is frequently accompanied by bone loss. The purpose of this study is to evaluate mid- to long-term results of revision total hip arthroplasty for massive femoral bone loss using cementless modular, fluted, tapered stems.Methods: During the period of 2007 to 2015 at a single hospital, 34 hips (33 patients) underwent primary revision surgery with cementless modular, fluted, tapered stems due to massive bone loss, and patients with prosthetic joint infection (PJI) or tumours were excluded. The hips were revised with the LINK MP (Waldemar Link, Hamburg, Germany) prosthesis. Bone loss was categorized by the Paprosky classification for prosthesis loosening and Vancouver classification for peri-prosthetic fracture. All revision bearing surfaces were ceramic-on-ceramic (CoC). Clinical outcomes, radiographic outcomes and survivorship were evaluated.Results: The mean follow-up was 9.1±2.5 years (range, 5-13 years). The Harris hip score was 43.6±11.5 preoperatively and maintained at 86.5±6.6 at the time of latest follow-up (p<0. 05). The X-ray showed bone ingrowth fixation in 30 hips (88%), fibrous stable fixation in 3 hips (9%) and instability in 1 hip (3%). The average stem subsidence was 3.9±2.2 mm (range, 1 to 10 mm). The survivorship of prostheses with re-revision for any reason was 95% (95% CI, 12.0 to 13.0) at the 10-year follow-up. Three (9%) re-revisions were needed, including 1 for aseptic loosening, 1 for dislocation and 1 for infection.Conclusions: The mid- to long-term results of revision total hip arthroplasty with the cementless modular, fluted, tapered stem (LINK MP stem) are encouraging for massive femoral bone loss.

scholarly journals A Contemporary Classification System of Femoral Bone Loss in Revision Total Hip Arthroplasty

2021 ◽  
Vol 9 ◽  
pp. 134-140
Author(s):  
Bryeson Rodgers ◽  
Gabrielle Wernick ◽  
Gabrielle Roman ◽  
Christopher P. Beauchamp ◽  
Mark J. Spangehl ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Loss ◽  
Hip Arthroplasty ◽  
Classification System ◽  
Revision Total Hip Arthroplasty ◽  
Femoral Bone ◽  
Total Hip

scholarly journals Ten-year comparison of two different techniques for femoral bone cavity preparation—broaching versus compaction in patients with cementless total hip arthroplasty

2021 ◽  
Vol 2 (12) ◽  
pp. 1035-1042
Author(s):  
Maciej Okowinski ◽  
Mette Holm Hjorth ◽  
Sebastian Breddam Mosegaard ◽  
Jonathan Hugo Jürgens-Lahnstein ◽  
Stig Storgaard Jakobsen ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Femoral Bone ◽  
Total Hip ◽  
Stem Subsidence ◽  
Femur Fractures

Aims Femoral bone preparation using compaction technique has been shown to preserve bone and improve implant fixation in animal models. No long-term clinical outcomes are available. There are no significant long-term differences between compaction and broaching techniques for primary total hip arthroplasty (THA) in terms of migration, clinical, and radiological outcomes. Methods A total of 28 patients received one-stage bilateral primary THA with cementless femoral stems (56 hips). They were randomized to compaction on one femur and broaching on the contralateral femur. Overall, 13 patients were lost to the ten-year follow-up leaving 30 hips to be evaluated in terms of stem migration (using radiostereometry), radiological changes, Harris Hip Score, Oxford Hip Score, and complications. Results Over a mean follow-up period of 10.6 years, the mean stem subsidence was similar between groups, with a mean of -1.20 mm (95% confidence interval (CI) -2.28 to -0.12) in the broaching group and a mean of -0.73 mm (95% CI -1.65 to 0.20) in the compaction group (p = 0.07). The long-term migration patterns of all stems were similar. The clinical and radiological outcomes were similar between groups. There were two intraoperative fractures in the compaction group that were fixed with cable wire and healed without complications. No stems were revised. Conclusion Similar stem subsidence and radiological and clinical outcomes were identified after the use of compaction and broaching techniques of the femur at long-term follow-up. Only the compaction group had intraoperative periprosthetic femur fractures, but there were no long-term consequences of these. Cite this article: Bone Jt Open 2021;2(12):1035–1042.

3rd generation ceramic-on-ceramic cementless total hip arthroplasty: a minimum 10-year follow-up study

2018 ◽  
Vol 28 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Yeong J. Lau ◽  
Shashank Sarmah ◽  
Johan D. Witt
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Senior Author ◽  
Long Term Results ◽  
Abduction Angle ◽  
Wear Properties ◽  
Total Hip ◽  
Ceramic On Ceramic

Introduction: 3rd generation ceramic bearings were introduced in total hip arthroplasty (THA) with the potential to have better mechanical strength and wear properties than their predecessors. At present, there are few studies looking at the long-term results of this latest generation of ceramic bearings. The purpose of our study was to investigate the long-term clinical and radiographic results of 3rd generation ceramic-on-ceramic THA and the incidence of ceramic specific complications such as squeaking and bearing surface fracture. Methods: The database of the senior author (J.D.W.) was reviewed. A total of 126 hip replacements performed in 108 patients (average age 39.6 years) with an average follow-up of 12.1 years (10-16 years) was identified. Clinical notes and plain radiographs were reviewed. To measure function, patients were contacted and an Oxford Hip Questionnaire was completed. Patients were also directly questioned about the presence of squeaking or any other sounds from the hip. Radiographs were evaluated for signs of wear, osteolysis, loosening and heterotopic ossification. The abduction angle of the acetabular component was measured. Results: The average Oxford Hip Score was 39.8 out of 48. Survivorship at 10 years was 94.6% (95% CI) with revision for any cause as the endpoint. There was 1 femoral head fracture, no osteolysis, no squeaking and no detectable wear. Conclusions: The good clinical and radiographic results for this series of patients are similar to other recent long-term studies looking at 3rd generation ceramic-on-ceramic THA. The results compare favourably with other bearing surfaces. The lack of osteolysis associated with this articulation is encouraging and may also make it a good choice for younger patients requiring total hip replacement.

Long-Term Results of Revision Total Hip Arthroplasty Using a Modern Extensively Porous-Coated Femoral Stem

2020 ◽  
Vol 35 (12) ◽  
pp. 3697-3702
Author(s):  
Charles N. Wallace ◽  
Justin S. Chang ◽  
Babar Kayani ◽  
Peter D. Moriarty ◽  
Jenni E. Tahmassebi ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Long Term Results ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip

Long-Term Results Using the Straight Tapered Femoral Cementless Hip Stem in Total Hip Arthroplasty: A Minimum of Twenty-Year Follow-Up

2014 ◽  
Vol 29 (8) ◽  
pp. 1559-1565 ◽  
Author(s):  
Atesch Ateschrang ◽  
Kuno Weise ◽  
Siegfried Weller ◽  
Ulrich Stöckle ◽  
Peter de Zwart ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Long Term Results ◽  
Total Hip

Long-Term Results of Total Hip Arthroplasty with the Cementless Spotorno (CLS) System

2017 ◽  
Vol 27 (5) ◽  
pp. 465-471 ◽  
Author(s):  
Christiaan Smeekes ◽  
Pieter B. de Witte ◽  
Bas F. Ongkiehong ◽  
Bart C.H. van der Wal ◽  
Alexander F.W. Barnaart
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Repeated Measures ◽  
Long Term Results ◽  
Factors Associated ◽  
Total Hip ◽  
Kaplan Meier ◽  
Age At Surgery

Background This study presents the long-term results of the Cementless Spotorno (CLS) total hip arthroplasty system and an analysis of factors associated with clinical and radiographic outcome. Methods We studied a series of 120 consecutive CLS arthroplasties in a young patient group (mean age at surgery: 55.9 ± 5.9 years). The Merle d'Aubigné-Postel score, polyethylene (PE) wear, and radiographic status were recorded during follow-up. Survival analyses, repeated-measures analysis of variance, and a nested case-control study were used for statistical evaluation. Results After a mean follow-up of 14.6 years (range 0.1-24.2 years, including revisions and lost to follow-up), 24 revisions had been performed, 16 of which for aseptic cup loosening. Kaplan-Meier survival analysis showed a 24-year survival of 72.8% (95% CI, 63.0%-82.6%) with revision for any reason as endpoint, and 80.1% (95% CI, 70.9%-89.3%) for revision for aseptic cup loosening. Mean final Merle d'Aubigné-Postel score was 16.1 points (range 7-18). Mean PE wear at final follow-up was 2.3 mm (range 0.6-6.8 mm). A higher rate of PE wear was associated with better clinical scores but also with revision for cup loosening. Factors associated with more PE wear were: younger age at surgery; 32 - mm head; longer follow-up; and steeper inclination angle. Conclusions Beyond 10 years, the CLS stem is reliable, but the high revision rate for aseptic cup loosening is concerning, specifically with better performing (cementless) alternatives available.

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