5-year clinical and radiostereometric analysis (RSA) follow-up of 39 CUT femoral neck total hip prostheses in young osteoarthritis patients

Abstract

Background As the number of young patients receiving total hip arthroplasty increases, bone-saving implantations facilitating possible future revision, such as the CUT femoral neck prosthesis, are gaining importance. There have been few medium-term results reported for this prosthesis, however, and its migration pattern has not been analyzed.Patients and methods 39 consecutive CUT femoral neck prostheses were implanted in 32 patients, mean age 37 (17–58) years, with symptomatic osteoarthritis and either less than 55 years of age or with an anatomic anomaly preventing implantation of a diaphyseal stem (n = 1). Patients were followed prospectively using routine clinical examination and radiostereometric analysis (RSA) at 6, 12, 26, and 52 weeks postoperatively and annually thereafter. This study evaluated the 5-year follow-up results.Results The mean Harris hip score increased from 26 (3–51) points preoperatively to 84 (66–98), 86 (55–98), and 87 (47–98) points at 3, 12, and 60 months. 3 stems were revised: 1 after luxation following excessive subsidence due to an undersized component and 2 due to persistent strong thigh pain. 5-year survival was 95% (95% CI: 87–100). Initial migration varied widely in magnitude; median total tip migration was 0.42 mm (0.09–9.4) at 6 weeks, 0.92 mm (0.18–5.9) at 1 year, and 1.10 mm (0.13–6.4) at 5 years. Even after high initial migration, stabilization was achieved in 31 of the 35 RSA-evaluable implants. 3 prostheses showed progressive continuous migration throughout the entire follow-up period, and were considered to be loose, suggesting reduced long-term survival.Interpretation Currently, we cannot recommend the CUT femoral neck prosthesis as a routine treatment option in (young) patients requiring THA. The CUT prosthesis may not reach the 90% survival benchmark at 10 years, and the prosthesis is difficult to implant. If initial stabilization is achieved, however, aseptic loosening is unlikely. A good clinical outcome was seen in the surviving prostheses. We will continue to follow this patient group.

The Effect of Weekly Risedronate on Periprosthetic Bone Resorption Following Total Hip Arthroplasty

“…Bone quality is a key parameter to achieve rigid press fit fixation with a metaphyseal stem (99,221,222). We found that the short stem used in study IV was not as forgiving as a conventional stem regarding surgical technique and that correct implant sizing is mandatory to achieve good fixation.…”

Analysis of Factors Influencing Return to Work after Total Hip Arthroplasty

“…Sta łe do sko na le nie pro tez sto so wa nych w cał kowi tej alo pla sty ce sta wu bio dro we go po wo du je, że wy ko ny wa nie tych ope ra cji mo żli we jest u co raz młod szych i bar dziej ak tyw nych pa cjen tów, bę dą cych w wie ku pro duk cyj nym [1][2][3]. Mi mo że do pro te zo plasty ki sta wu bio dro we go kwa li fi ko wa ne są głów nie oso by star sze, to np.…”

Reemplazo total de cadera con un tallo corto no cementado tipo 2B: resultados a los 2-5 años de seguimiento. [Total hip replacement with a short cementless stem type 2B: Results of 2 to 5 years of follow-up]

“…El índice de masa corporal promedio del grupo fue 27 (rango [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. El diagnóstico primario fue artrosis primaria (82 casos), displasia del desarrollo (6 casos), osteonecrosis (8 casos), condrólisis idiopática (2 casos), secuela de enfermedad de Perthes (1 caso) y sinovitis vellonodular pigmentada (1 caso).…”

“…[4][5][6][7][8][9][10] Kendoff y cols. 11 y otros autores [12][13][14][15][16][17][18][19][20][21][22][23][24] han publicado un 99% de supervivencia de la prótesis en 1394 casos con un seguimiento promedio de seis años usando el diseño CFP (Waldemar Link GmbH, Hamburgo, Alemania). Hay escasos informes publicados sobre los resultados con el tallo MiniHip TM (Corin, Cirencester, Reino Unido): 3,25 una sola serie de pacientes operados por un equipo quirúrgico independiente de los diseñadores.…”