Global radiological score for femoral cementless revision stem

Canovas, François; Putman, Sophie; Girard, Julien; Roche, Olivier; Bonnomet, F.; Béguec, Pierre Le

doi:10.1007/s00264-017-3654-4

Cited by 8 publications

(7 citation statements)

References 20 publications

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“…Radiolucent lines are described as a sign of stress shielding, which leads to aseptic loosening, as previously shown in studies of commonly used implants [6,9]. Current studies by Canovas et al [23,24] paid attention to the shape of press-fit implants for bone fixation. Good clinical outcomes were achieved in cases with proximal press-fit fixation with a smaller extent degree or with short diaphyseal press-fit stems.…”

Section: Discussionmentioning

confidence: 90%

High Revision Rates of a Cementless Beta-Titanium Alloy Stem with Contamination-Free Roughened Surface in Primary Total Hip Arthroplasty

Stenicka¹,

Hanreich²,

Babeluk³

et al. 2020

JCM

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Optimal osseointegration of cementless total hip arthroplasty is essential for high stability and long-term survival. The purpose of this follow-up study was to evaluate the clinical and radiological outcome, the complications, and survival rates of a beta-titanium alloy stem with a specific grit-blasted-free surface. In 192 patients (mean age of 64.4 years), 202 consecutive primary total hip arthroplasties were performed using a cementless Hipstar® stem (Stryker, Duisburg, DE). The Harris Hip Score (HHS) was assessed pre-operatively and post-operatively. Radiolucent lines were evaluated and the implant survival rate was calculated using Kaplan-Meier analysis. The mean follow-up was 7.71 years (range of 5.0–14.0 years). Overall, 15 revisions were performed. Early aseptic stem loosening was observed in six cases (2.97%). Radiolucent-lines adjacent to the stem were detected in 73 cases (83.02%), especially (70.46%) in the Gruen zones 1, 7, 8, and 14. The mean postoperative HHS was 92.65 points (range 42–100). The cumulative survival probability of the stem was 94.4% (95% CI 90.3 to 98.5%). Considering aseptic failure as an endpoint, the cumulative survival rate of the stem was 95.3% (95% CI 0.914 to 0.992) at six years of follow-up. Overall, an inferior mid-term implant survival was observed in comparison to well-established cementless stem designs.

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Section: Discussionmentioning

confidence: 90%

High Revision Rates of a Cementless Beta-Titanium Alloy Stem with Contamination-Free Roughened Surface in Primary Total Hip Arthroplasty

Stenicka¹,

Hanreich²,

Babeluk³

et al. 2020

JCM

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“…Actually, there is a lack of references about pre-operative bone defect estimation after a conservative femoral component failure. This new classification tries to give the first step to understand and plan effectively a Bconservative revision.Ê ven if it is in an embryonal phase, this classification shows a Bgood^interand intra-observer reproducibility [17], comparable to conventional classifications [18,19], in particular for experienced reconstructive surgeons.…”

Section: Discussionmentioning

confidence: 58%

A new classification for proximal femur bone defects in conservative hip arthroplasty revisions

Casella¹,

Favetti²,

Panegrossi³

et al. 2018

International Orthopaedics (SICOT)

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Introduction In the last three decades, total hip replacement in young patient became a habitual procedure. Principles of bone preservation are pushing many surgeons to implant conservative femoral components in patient younger than 65 years. Despite an overall good survivorship and clinical outcomes of conservative implants, failed cases are reported and the need to revise a conservative femoral component became an occasional procedure (with high prevalence of failed resurfacing implants). Methods During conservative femoral component revisions, we analyzed proximal bone stock preservation, considering the type of original component removed, etiology of failure, timing of revision, and femoral explantation technique. Results We identified four patterns of proximal femoral changes (types I-IV). We suggest, for each of them, a revision strategy directed toward a Bconservative revision procedure^using conservative or primary component. Out of our 21 cases, none underwent further revision due to mechanical failure (follow-up ranging from 6 to 152 months, mean 54 months). We had two case of re-operation: one for early septic loosening and one for prosthetic modular neck fracture. Conclusions If literature offers well-established guidelines to femoral revision of conventional stems, there is, on the other hand, a lack of data about revision strategies in presence of failed conservative implants. Although the mean follow-up of our procedures is still too short (4.5 years) to give final conclusions, we would leave a message: a conservative hip arthroplasty is not a Bone-time^opportunity for young and active people. A Bconservative revision^is a valid option for at least a part of them, when an early failure of primary procedure occurred.

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“…Component displacement (i.e., cranial for the acetabular side, distal and varus inclination for the femoral side), pedestal regression, and cement or component fractures are also indicators of loosening, but the only finding indicating definite loosening is excessive component movement, the others being associated with loosening but remaining nonspecific [ 37 ]. For those reasons, composite scores have been developed to assess prosthesis stability and fixation [ 93 , 94 , 95 ] but are beyond the scope of this paper.…”

Section: Complicationsmentioning

confidence: 99%

Imaging in Hip Arthroplasty Management Part 2: Postoperative Diagnostic Imaging Strategy

Lombard¹,

Gillet

Germain³

et al. 2022

JCM

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Hip arthroplasty (HA) is a frequently used procedure with high success rates, but 7% to 27% of the patients complain of persistent postsurgical pain 1 to 4 years post-operation. HA complications depend on the post-operative delay, the type of material used, the patient’s characteristics, and the surgical approach. Radiographs are still the first imaging modality used for routine follow-up, in asymptomatic and painful cases. CT and MRI used to suffer from metallic artifacts but are nowadays central in HA complications diagnosis, both having their advantages and drawbacks. Additionally, there is no consensus on the optimal imaging workup for HA complication diagnosis, which may have an impact on patient management. After a brief reminder about the different types of prostheses, this article reviews their normal and pathologic appearance, according to each imaging modality, keeping in mind that few abnormalities might be present, not anyone requiring treatment, depending on the clinical scenario. A diagnostic imaging workup is also discussed, to aid the therapist in his imaging studies prescription and the radiologist in their practical aspects.

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Global radiological score for femoral cementless revision stem

Abstract: The GRxS is reliable and reproducible. This information can be used by surgeons to adapt the surgical technique to bone characteristics (especially during revision cases) and to compare the outcomes of different implant designs.

Cited by 8 publications

References 20 publications

High Revision Rates of a Cementless Beta-Titanium Alloy Stem with Contamination-Free Roughened Surface in Primary Total Hip Arthroplasty

High Revision Rates of a Cementless Beta-Titanium Alloy Stem with Contamination-Free Roughened Surface in Primary Total Hip Arthroplasty

A new classification for proximal femur bone defects in conservative hip arthroplasty revisions

Imaging in Hip Arthroplasty Management Part 2: Postoperative Diagnostic Imaging Strategy

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