Gute langfristige Nachuntersuchungsergebnisse einer zementierten Titan-Geradschaftprothese

Abstract

A higher-than-average rate of aseptic loosening has been postulated to be associated with the combination of a titanium stem and bone cement. In this prospective follow-up study we therefore investigated our first consecutive series of 250 implantations of a cemented femoral shaft prosthesis made of titanium alloy (BiCONTACT((R)), Aesculap, Tuttlingen, Germany). Average time of follow-up evaluation was 9.7 years (range 8.7-10.3 years). At follow-up, mean patient age was 81 years; 89 patients with 93 hips have deceased and two could not be located. Follow-up rate was 98.7% for the patients still alive at time of follow-up evaluation. Five patients have been revised, two for infection and one for aseptic loosening of a varus-malaligned stem; two radiologically well-fixed stems had been revised during acetabular revision. Survival estimate showed a calculated cumulative survival rate of 97.5% after 11 years [confidence limits: 99.0% (upper) and 94.1% (lower)]. The average Harris hip score at time of follow-up was 82.25 points.Radiologically, signs of loosening could be detected in 3 stems: in one case varus malalignement deteriorated with time and in 2 cases osteolyses developed together with significant polyethylene wear. All 3 patients experienced only mild pain and revision had not been indicated so far. In conclusion, the long-term follow-up results with this cemented titanium femoral component are encouraging and are comparable to other successful cemented femoral components in primary total hip arthroplasty. No increased risk for aseptical loosening was associated to the combination of titanium and cement in this specific stem. Design parameters seem to play an important role in the development of aseptic loosening in cemented titanium stems.

In vivo assessment of TiO2 based wear nanoparticles in periprosthetic tissues

“…2 ). We do not exactly know why this THA failed by this mode as hundreds of such combinations were implanted at the site of authors and even much more especially in Germany with relatively good 10-year results [ 36 ].

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Biomedical Applications of Titanium Alloys: A Comprehensive Review

“…Results clearly show that titanium arthroprostheses have a high survival rate up to about 10 years of follow-up, but then show a steep decrease between 10 and 30 years. These devices are extremely reliable, and the failure is prevalently caused by patient-associated conditions, such as advanced age [ 372 , 373 , 374 , 375 , 376 , 377 , 378 , 379 , 380 , 381 , 382 , 383 , 384 , 385 , 386 , 387 , 388 ]. Most late failures are caused by osteoporosis and other risk factors that were not present (or not as advanced) at the time of implantation and, overall, mechanical failures and infections only account for about 15% of the total [ 389 ].…”