Early femoral component loosening in DF-80 total hip arthroplasty

Robinson, Raymond P.; Lovell, Timothy P.; Green, Thomas M.; Bailey, Gloria A.

doi:10.1016/s0883-5403(89)80054-3

Cited by 54 publications

(19 citation statements)

References 16 publications

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“…The results of our study contrast reports with cases of early loosening and high loosening rates after cemented implantation of titanium alloy straight femoral prostheses [10,13,18,21]. A mechanism of crevice corrosion has been described as a mechanism of loosening in cemented titanium stems [23].…”

Section: Discussioncontrasting

confidence: 90%

Results of a cemented titanium alloy straight femoral shaft prosthesis after 10 years of follow-up

Eingartner

Volkmann²,

Winter

et al. 2001

International Orthopaedics (SICOT)

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Two-hundred fifty implantations of a cemented femoral stem made of titanium alloy in 239 patients were followed for 9.7 years (range 8.7-10.3 years). Eighty-nine patients with 93 hips have died and two could not be located. Five hips have been revised, two for infection, one for aseptic loosening and two during revision of the cup. Three stems showed radiological loosening but have not been revised. The average hip score was 85. The results are encouraging and comparable to other cemented femoral stems.Résumé 250 implantations d'une tige fémorale cimentée en alliage de titane chez 239 malades ont été suivies pendant 9.7 années (8.7-10.3 années). 89 malades avec 93 prothèses sont morts et deux sont perdus de vue. Cinq hanches ont été révisées, deux pour infection, une pour descellement aseptique et deux pour une révision de la cupule acétabulaire. Trois tiges ont présentés un descellement radiologique mais n'ont pas été reprises. Le score moyen était de 85. Les résultats sont encourageant set comparables à ceux des autres tiges fémorales cimentées.

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Section: Discussioncontrasting

confidence: 90%

Results of a cemented titanium alloy straight femoral shaft prosthesis after 10 years of follow-up

Eingartner

Volkmann²,

Winter

et al. 2001

International Orthopaedics (SICOT)

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“…This stem exhibited gross endosteal lysis, with over two thirds demonstrating some degree of lysis at 5.2 years [36]. The DF-80 monoblock ti-alloy stem (Zimmer, Warsaw, Indiana, USA) had a high rate of revision for aseptic stem loosening, with rates of 4.3% and 3% reported at short follow-up [16,28]. The ITH modular stem (Smith & Nephew Richards, Memphis, Tennessee, USA) had rapid and progressive aseptic stem loosening, with 7.7% revision rate at 5 years [13].…”

Section: Resultsmentioning

confidence: 99%

Mid-term results and migration behaviour of a ti-alloy cemented stem

Meek

Michos

Grigoris

et al. 2002

International Orthopaedics

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Between 1991 and 1994, 147 patients (154 hips) underwent a primary cemented total hip replacement using the Ultima ti-alloy, collarless, double-tapered stem and a UHMWPE cup. The average age at operation was 66.4 years. Ninety-one patients (97 hips) were available for review with an average follow-up of 76 months. The Harris hip score had improved from pre-operative average of 43.1 (12.5-65.0) to the latest score of 88.9 (67.5-100). There were 11 revisions in total, eight of which were for aseptic stem loosening. The results of Kaplan-Meier survival analysis, based on stem revision for aseptic loosening as an end-point, was 92% at 8 years. Early stem migration analysis at 2 years was possible in 114 cases using digitised radiographs analysed by the EBRA method. Sixty-three stems had not migrated and 35 migrated less than 2 mm with only one of these ending in failure. Sixteen stems showed early migration of more than 2 mm and five of these failed. Early stem migration is predictive of stem failure. Osteolytic lesions occurred in 12 femurs and four of these stems failed.Résumé Entre 1991 et 1994, 147 malades (154 hanches) ont subi une arthroplastie primaire cimentée qui utilise une tige à section décroissante Ultima sans collerette en alliage de Titane et une cupule de UHMWPE. L'âge moyen à l'opération était 66.4 ans. Quatre-vingtonze malades (97 hanches) étaient disponibles pour la révision avec une moyenne de suivi de 76 mois. Le score de Harris s'est amélioré de la moyenne préopératoire de 43.1 (12.5 à 65.0) au score le plus tardif de 88.9 (67.5 à 100). Il y avait 11 révisions, huit pour descellement aseptique de la tige. La survie selon KaplanMeyer, basée sur la révision de la tige pour descellement aseptique était 92% à huit années. L'analyse du descellement précoce de la tige à deux années était possible dans 114 cas utilisant des radiographies digitalisées analysées par la méthode EBRA. Soixante-trois tiges n'avaient pas migré et trente-cinq tiges avaient migré de moins de 2 mm avec seul cas évoluant vers un échec. Seize tiges ont montré une migration de plus de 2 mm avec finalement cinq échecs. La migration préco-ce de la tige est prédictif du descellement. Les lésions ostéolytique se sont produites sur 12 fémurs conduisant à quatre échecs par descellement fémoral.

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“…For series of cemented titanium stems, numerous authors have reported loosening rates of 10-49% at 3-5 years (Robinson et al 1989, Tompkins et al 1994, Rorabeck et al 1996a). We found cemented fixation to be inferior when titanium stems were used and superior when a stainless steel or cobalt-chrome stem was used.…”

Section: Discussionmentioning

confidence: 99%

“…These included study design (randomized vs. non-randomized), study site (registry vs. single institution), component followed (cup versus stem), and patient age range (≤ 55 versus > 55 years of age). We also tested the hypothesis that certain groups of implants that have performed poorly in observational studies could influence summary estimates, such as titanium stems and screw-fit or macro-ingrowth cups (Robinson et al 1989, Tompkins et al 1994, Rorabeck et al 1996b, Kubo et al 2001, Aldinger et al 2004, Fink et al 2004, Grant and Nordsletten 2004. Sensitivity analysis was performed to assess the contribution of each individual comparison to the summary estimate.…”

Section: Statisticsmentioning

confidence: 99%

Comparison of cemented and uncemented fixation in total hip replacement

et al. 2007

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Background The choice of optimal implant fixation in total hip replacement (THR)-fixation with or without cement-has been the subject of much debate.Methods We performed a systematic review and meta-analysis of the published literature comparing cemented and uncemented fixation in THR.Results No advantage was found for either procedure when failure was defined as either: (A) revision of either or both components, or (B) revision of a specific component. No difference was seen between estimates from registry and single-center studies, or between randomized and non-randomized studies. Subgroup analysis of type A studies showed superior survival with cemented fixation in studies including patients of all ages as compared to those that only studied patients 55 years of age or younger. Among type B studies, cemented titanium stems and threaded cups were associated with poor survival. An association was found between difference in survival and year of publication, with uncemented fixation showing relative superiority over time.Interpretation While the recent literature suggests that the performance of uncemented implants is improving, cemented fixation continues to outperform uncemented fixation in large subsets of study populations. Our findings summarize the best available evidence qualitatively and quantitatively and provide important information for future research.

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Early femoral component loosening in DF-80 total hip arthroplasty

Cited by 54 publications

References 16 publications

Results of a cemented titanium alloy straight femoral shaft prosthesis after 10 years of follow-up

Results of a cemented titanium alloy straight femoral shaft prosthesis after 10 years of follow-up

Mid-term results and migration behaviour of a ti-alloy cemented stem

Comparison of cemented and uncemented fixation in total hip replacement

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