Clinical Performance, Patient Reported Outcome, and Radiological Results of a Short, Tapered, Porous, Proximally Coated Cementless Femoral Stem: Results up to Seven Years of Follow-Up

Ulivi, M.; Orlandini, Luca; Meroni, Valentina; Lombardo, M D M; Peretti, Giuseppe M.

doi:10.1016/j.arth.2017.11.046

Cited by 24 publications

(32 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To our knowledge, there are no similar studies on metaphyseal fitting short stems, reporting such high rates in the incidence of this complication. In agreement with previous studies [3,5,28], that have reported a low incidence of periprosthetic fractures with these types of stems, in this study, no cases of periprosthetic fractures were observed in neither group.…”

Section: Discussionsupporting

confidence: 93%

Short-term clinical and radiological results of two different design metaphyseal fitting femoral stems in total hip arthroplasty: a prospective, randomized trial

et al. 2021

View full text Add to dashboard Cite

Background There is great design variability on short femoral stems available on the market. This study aims to evaluate the short-term clinical and radiological results of two different design short femoral stems, both classified as shortened tapered stems. Methods From March 2016 to March 2018, a prospective, randomized, parallel-group design study was conducted to compare functional and radiological outcomes of 45 patients underwent THA using the Tri-Lock Bone Preservation Stem and 45 patients underwent THA with the Minima S stem at a minimum 2 years of follow-up. Patients were assessed clinically and radiographically prior to surgery as well as at 3, 6, 12, and 24 months postoperatively. Primary outcomes were the change in health-related quality of life assessed with Western Ontario and McMaster Universities Osteoarthritis Index and 36-Item Short Form Health Survey and also the incidence of all hip-related complications. Secondary aims included hip function evaluated with the Harris hip score, rates of patient satisfaction, and the outcomes of a detailed radiological analysis. Results There were no significant differences between the 2 study groups in terms of patient-reported outcomes measurements, satisfaction scores, and complication rates at any of the measurement times. In both groups, stable fixation and radiographic osseointegration were achieved. However, analysis of the calcar region showed that 57.8% and 28.9% of patients had grade 1 or 2 stress shielding, in Tri-Lock and Minima S implantation group, respectively (p=0.015). Regarding coronal alignment, stems were placed in slight varus, valgus, and neutral position in 51.1%, 13.3%, and 35.6% of patients, respectively, in Tri-Lock BPS group. The Minima S stem was implanted at slight varus and valgus in 60% and 40% of patients, respectively, and neither stem in the exact neutral position. Conclusions Both different design short femoral stems demonstrated excellent clinical performance at short-term follow up. Nevertheless, concerns were raised regarding the incidence of stress shielding phenomenon and mild discrepancies in coronal stem alignment during implantation. The clinical impact of these observations should be further evaluated through larger cohorts and longer follow-up. Trial registration ISRCTN registry, ISRCTN10096716. Registered on May 8, 2018—Retrospectively registered

show abstract

Section: Discussionsupporting

confidence: 93%

Short-term clinical and radiological results of two different design metaphyseal fitting femoral stems in total hip arthroplasty: a prospective, randomized trial

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In our study, we aim to conduct a comprehensive assessment, by means of a comparative clinical study as well as biomechanical testing and FEA of two different short femoral stems, which are theoretically classified in the same main category. For this reason, we decided to compare a newly introduced short stem, Minima S, for which clinical performance data are lacking with an older generation short stem, Trilock BPS, with an established performance record in short to midterm follow-up [72–74]. We can hypothesize that even these subtle variations in geometric design between these two stems, which are classified within the same subgroup, may create different loading characteristics and thus dissimilar biomechanical behaviors, which in turn could have an influence to their clinical performance.…”

Section: Discussionmentioning

confidence: 99%

Comparison of two metaphyseal-fitting (short) femoral stems in primary total hip arthroplasty: study protocol for a prospective randomized clinical trial with additional biomechanical testing and finite element analysis

Tatani

Panagopoulos

Diamantakos

et al. 2019

Trials

View full text Add to dashboard Cite

Background Total hip replacement has recently followed a progressive evolution towards principles of bone- and soft-tissue-sparing surgery. Regarding femoral implants, different stem designs have been developed as an alternative to conventional stems, and there is a renewed interest towards short versions of uncemented femoral implants. Based on both experimental testing and finite element modeling, the proposed study has been designed to compare the biomechanical properties and clinical performance of the newly introduced short-stem Minima S, for which clinical data are lacking with an older generation stem, the Trilock Bone Preservation Stem with an established performance record in short to midterm follow-up. Methods/design In the experimental study, the transmission of forces as measured by cortical surface-strain distribution in the proximal femur will be evaluated using digital image correlation (DIC), first on the non-implanted femur and then on the implanted stems. Finite element parametric models of the bone, the stem and their interface will be also developed. Finite element predictions of surface strains in implanted composite femurs, after being validated against biomechanical testing measurements, will be used to assist the comparison of the stems by deriving important data on the developed stress and strain fields, which cannot be measured through biomechanical testing. Finally, a prospective randomized comparative clinical study between these two stems will be also conducted to determine (1) their clinical performance up to 2 years’ follow-up using clinical scores and gait analysis (2) stem fixation and remodeling using a detailed radiographic analysis and (3) incidence and types of complications. Discussion Our study would be the first that compares not only the clinical and radiological outcome but also the biomechanical properties of two differently designed femoral implants that are theoretically classified in the same main category of cervico-metaphyseal-diaphyseal short stems. We can hypothesize that even these subtle variations in geometric design between these two stems may create different loading characteristics and thus dissimilar biomechanical behaviors, which in turn could have an influence to their clinical performance. Trial registration International Standard Randomized Controlled Trial Number, ID: ISRCTN10096716 . Retrospectively registered on May 8 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3445-x) contains supplementary material, which is available to authorized users.

show abstract

“…Stem alignment were measured by the method introduced by Michele Ulivi et al 25 ,. in which the angle were defined by the two intersected center lines of femoral stem and the medullary cavity were showed.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have demonstrated that the Tri‐Lock femoral stem has excellent clinical results and superior survivor rate even in more than 15 years’ follow‐ups 23, 24 . While there only two researches reported the stable fixation and satisfactory clinic outcome of the Tri‐lock (BPS) with 4–7 years follow‐up in THA 25, 26 . Furthermore, currently there are no published studies directly comparing the clinical outcome and survivor rate of the Tri‐lock (BPS) to the conventional standard stem Corail, which was proved to have excellent clinic outcome in THA 27–29 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of Tri‐Lock Bone Preservation Stem and the Conventional Standard Corail Stem in Primary Total Hip Arthroplasty

Guo

Tan

Lei

et al. 2021

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective To compare the clinical and radiographic outcomes between the Tri‐Lock Bone Preservation Stem (BPS) and the conventional standard Corail stem in primary total hip arthroplasty (THA). Methods From March 2012 to May 2014, we retrospectively reviewed 84 patients (104 hips) who received Tri‐Lock (BPS) and 84 patients (115 hips) who received conventional standard Corail stem in THA. Their mean ages were 53.12 ± 2.32 years and 52.00 ± 2.11 years, respectively. The clinical outcomes were assessed by Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Pain Visual Analogue Scale (VAS) and Harris Hip Score (HHS). The radiological outcomes were evaluated by the radiological examination. Accordingly, Intraoperative and postoperative complications were observed as well. Results The mean follow‐up time was 48.23 ± 2.91 months in the Tri‐Lock (BPS) group and 49.11 ± 2.11 months in the Corail group, respectively. The bleeding volumes in two groups were comparable (169.22 ± 58.11 mL vs 179.30 ± 59.14 mL, P = 0.003), with more bleeding volume in Corail group patients, while no statistically significance with respect to operation time was observed (65.41 ± 6.24 min vs 63.99 ± 6.33 min, P = 0.567). The rates of intraoperative fracture was 8% for the Corail group while 1% for the Tri‐Lock (BPS) group (8% vs 1%, P = 0.030). At final follow‐up, no statistical differences in regard to HHS, WOMAC, and Pain VAS were revealed between the two groups (P > 0.05). The rate of thigh pain was higher in Corail group than in Tri‐lock (BPS) group (5% vs 0%, P = 0.043). However, incidence of stress shielding in grade 1 was higher in Tri‐Lock (BPS) than in the Corail group (76% vs 23%, P < 0.01), while those in grade 2 and 3 were lower compared to the Corail stem (15% vs 28%, P < 0.01; 9% vs 16%, P = 0.008, respectively). Intriguingly, other assessments in relation to radiographic outcomes and postoperative complications were not comparable between the two groups. The Kaplan–Meier survival rate (revision surgery performed for any reason was defined as the end point) was similar between the two groups (P = 0.57), with 98.8% (95% confidence interval, 92.3%–100%) in Tri‐lock (BPS) group and 97.6% (95% confidence interval, 94.6%–100%) in Corail group. Conclusions The Tri‐Lock (BPS) has similar clinic performances compared to the Corail stem. Furthermore, the Tri‐lock (BPS) stem has some advantages in achieving lower incidence of thigh pain, stress shielding and intra‐operative fracture. Therefore, we recommend the Tri‐lock (BPS) stem as a good alternative in primary total hip arthroplasty, especially taking into account patient factors, including bone deficiency and convenience of extraction of the stem in hip revision.

show abstract

Clinical Performance, Patient Reported Outcome, and Radiological Results of a Short, Tapered, Porous, Proximally Coated Cementless Femoral Stem: Results up to Seven Years of Follow-Up

Cited by 24 publications

References 24 publications

Short-term clinical and radiological results of two different design metaphyseal fitting femoral stems in total hip arthroplasty: a prospective, randomized trial

Short-term clinical and radiological results of two different design metaphyseal fitting femoral stems in total hip arthroplasty: a prospective, randomized trial

Comparison of two metaphyseal-fitting (short) femoral stems in primary total hip arthroplasty: study protocol for a prospective randomized clinical trial with additional biomechanical testing and finite element analysis

Comparison of Tri‐Lock Bone Preservation Stem and the Conventional Standard Corail Stem in Primary Total Hip Arthroplasty

Contact Info

Product

Resources

About