Cementless Vektor-Titan stem in total hip arthroplasty / Der zementfreie Vektor-Titanschaft in der Hüftendoprothetik des Hüftgelenkes

Schuh, Alexander; Ebert, Alexander; Holzwarth, U.; Zeiler, Günther

doi:10.1515/bmt.2005.006

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…In straight stems, CH has been found to occur in 2–10% [3, 27–30], which is much lower than in this study with the Fitmore hip stem. One reason may be that conventional straight stems better follow the bending of the bone whereas the shorter Fitmore stem acts more rigidly [15].…”

Section: Discussioncontrasting

confidence: 66%

“…After settling down with some subsidence, it has a 2-point bone contact distally with increased load transfer, whereas straight stems have a larger total bone contact surface. Therefore, the Fitmore stems have a different distribution of CH than straight stems which also show CH in Gruen Zone 6 in addition to 2, 3 and 5 [3, 29, 30].…”

Section: Discussionmentioning

confidence: 99%

“…Initially, CH was observed around cemented stems [2]. The intensified appearance around uncemented stems is explained by stress-shielding, a reactive proximal bone atrophy combined with distal bone hypertrophy caused by aberrant loading through distal site [3, 4]. The increased remodeling appears to be due to greater bending stiffness, which depends on stem material and cross-sectional size and shape [5, 6].…”

Section: Introductionmentioning

confidence: 99%

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Prospective 5-year study with 96 short curved Fitmore™ hip stems shows a high incidence of cortical hypertrophy with no clinical relevance

et al. 2019

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Background An increased occurrence of cortical hypertrophy (CH) was observed 1–2 years after implanting short curved Fitmore hip stems. There are no published data about either the clinical relevance or the progression of CH over the long term. Methods Ninety-six primary total hip arthroplasties were performed between 2008 and 2010 using the Fitmore hip stem. Clinical and radiological parameters were recorded preoperatively and at 1, 2, 3, and 5 year follow-up. Results CH appeared mainly on antero-posterior radiographs in Gruen Zones 2, 3, 5, and 6. After 1 year, the diameter was 10 ± 2 mm and remained constant thereafter. The CH rate after 1 year was 69% and after 5 years 71%. Subsidence after 1 year was 1.6 ± 1.55 mm and 1.93 ± 1.72 mm after 5 years. Cortical thinning was 46% after 1 year and 56% after 5 years, mainly in Gruen Zones 7 and 8. In the first year radiolucencies were found in 51% in all Gruen Zones, and in 20% after 5 years. Patient, implant, and surgical factors did not correlate with radiological outcomes except that larger stems had more CH. After 5 years, the Harris Hip Score had improved from 59 to 94 and the Oxford Hip Score from 22 to 41. Radiographic parameters, notably CH, were not associated with clinical outcomes except that cortical thinning correlated with lower outcome scores. Conclusions CH correlated neither with clinical outcome nor with patient, surgical or implant factors, except for a positive correlation with stem size. The Fitmore hip stems settled within the first year to a stable fixation and then remained almost unchanged. However, cortical thinning is common in Gruen Zone 7 and 8 meaning that there is stress-shielding.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prospective 5-year study with 96 short curved Fitmore™ hip stems shows a high incidence of cortical hypertrophy with no clinical relevance

et al. 2019

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Long-term results of the Wagner cone prosthesis

Schuh

Schraml²,

Hohenberger³

2007

International Orthopaedics (SICO

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The Wagner cone prosthesis is indicated in uncemented total hip replacement of cases with cylindershaped femurs, deformed femurs, femurs with increased antetorsion, and in conditions of intramedullary bony scar tissue after previous osteotomies. The objective of this study is to present long-term results. From January 1, 1993 to December 31, 1995, 132 implantations were made with the Wagner cone prosthesis. We report the clinical and radiographic results of 94 cone prostheses with a mean observation period of 11.5 years. The Merle d'Aubigné score improved from a preoperative mean value of 8.8 to a postoperative mean of 16.3. The radiographic evaluation revealed 32 cases with cortical hypertrophy, 73 cases with atrophy of the proximal femur, and 18 cases with complete pedestal formation. Radiolucencies over Gruen zones 1 and 7 occurred in 42 cases; only zone 1 was affected in 24 cases. Complications included three deep infections, three acetabular revisions, five total joint revisions, one recurrent luxation, and three heterotopic ossifications. In spite of the fact that the examined cohort often included patients who had undergone multiple previous operations (a maximum of six) of the proximal femur or the acetabulum, the long-term results of the Wagner cone prostheses were very promising.

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Cementless Vektor-Titan stem in total hip arthroplasty / Der zementfreie Vektor-Titanschaft in der Hüftendoprothetik des Hüftgelenkes

Abstract: The results of this study using the Vektor-Titan stem in cementless total hip arthroplasty showed that the principle of proximal fixation was optimized. Long term follow-up studies are needed to confirm these good results.

Cited by 2 publications

References 13 publications

Prospective 5-year study with 96 short curved Fitmore™ hip stems shows a high incidence of cortical hypertrophy with no clinical relevance

Prospective 5-year study with 96 short curved Fitmore™ hip stems shows a high incidence of cortical hypertrophy with no clinical relevance

Long-term results of the Wagner cone prosthesis

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