Immediate unrestricted versus graduated weight bearing following primary cementless total hip arthroplasty: a randomized controlled trial

Shabana, Magdy; Hafez, Mahmoud A.; Ayad, Khaled; Elfatah, Mohamed Abd; Zaky, Lilian Albert

doi:10.21037/aoj.2017.01.03

Cited by 4 publications

(2 citation statements)

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“…There was no indication to suggest the superiority of one method over the other. There is a dearth of evidence in the current literature comparing the two, though Fukumoto et al 28 and Shabana et al 29 agreed that FWB in the immediate post-operative period caused no complications with early radiological and clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Cemented vs. cementless fixation in primary total knee arthroplasty: a systematic review and meta-analysis

et al. 2020

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Over 100,000 total knee replacements (TKRs) are carried out in the UK annually, with cemented fixation accounting for approximately 95% of all primary TKRs. In Australia, 68.1% of all primary TKRs use cemented fixation, and only 10.9% use cementless fixation. However, there has been a renewed interest in cementless fixation as a result of improvements in implant design and manufacturing technology. This meta-analysis aimed to compare the outcomes of cemented and cementless fixation in primary TKR. Outcome measures included the revision rate and patient-reported functional scores. MEDLINE and EMBASE were searched from the earliest available date to November 2018 for randomized controlled trials of primary TKAs comparing cemented versus cementless fixation outcomes. Six studies met our inclusion criteria and were analysed. A total of 755 knees were included; 356 knees underwent cemented fixation, 399 underwent cementless fixation. They were followed up for an average of 8.4 years (range: 2.0 to 16.6). This study found no significant difference in revision rates and knee function in cemented versus cementless TKR at up to 16.6-year follow-up. Cite this article: EFORT Open Rev 2020;5:793-798. DOI: 10.1302/2058-5241.5.200030

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Section: Discussionmentioning

confidence: 99%

Cemented vs. cementless fixation in primary total knee arthroplasty: a systematic review and meta-analysis

et al. 2020

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“…While it has been recommended to limit postoperative activity, there is significant evidence that unrestricted weight bearing following THA does not adversely affect short-or long-term subsidence in comparison to partial weight bearing. 6,8,13,14 In addition, others have found that bone ingrowth will occur regardless of postoperative weight bearing. 15,16 These studies showed that the time until full weight bearing status did not affect postoperative stem subsidence and that initial postoperative stem fixation may play a larger role.…”

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confidence: 99%

The Effect of Age and Activity Level on Stem Subsidence in Total Hip Arthroplasty

Zak

Greenbaum

Singh

et al. 2020

The Journal of Hip Surgery

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The average length of hospital stay (LOS) following total hip arthroplasty (THA) is decreasing due to a variety of factors, including rapid patient mobilization. With increased early joint loading, certain populations, such as those with low systemic bone mineral density, may be at an increased risk for early stem instability. The purpose of this study was to determine whether activity level and patient age affect femoral stem stability and early subsidence. We retrospectively reviewed 821 patients who underwent primary cementless THA. Two cohorts were established based on LOS as a proxy for activity: (1) same calendar day discharge (SDD) and (2) multiple day stay (MDS). Descriptive patient characteristics as well as surgical and clinical data including surgical time, stem alignment, and Activity Measure for Post-Acute Care (AM-PAC) scores were collected. Stem subsidence was assessed by comparing immediate postoperative radiographs with follow-up radiographs taken no less than 3 months after surgery (9.79 ± 6.50 months). Our sample population consisted of 255 SDD (31%) and 566 MDS (69%) patients. Stem subsidence rate was significantly lower in the SDD than the MDS group (0.916 vs. 1.80 mm, p < 0.001). Increasing age was associated with a higher rate of stem subsidence (β = 0.823, p < 0.001). Increased LOS was also associated with increased age (odds ratio = 1.092, p < 0.001). Higher postoperative mobility determined by AM-PAC scores was not associated with shorter LOS (p = 0.630). The result of this study showed increased activity level does not increase rate of subsidence in THA patients, which supports the safety and efficacy of expedited recovery programs. Increased age was found to increase stem subsidence regardless of LOS.

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The effects of full weight-bearing mobilization on clinical outcomes and subsidence in cemented and uncemented hemiarthroplasty in osteoporotic patients: A retrospective single-center study

Başar

2022

BMR

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BACKGROUND: Early full weight-bearing mobilization is controversial in osteoporotic patients who have undergone uncemented hemiarthroplasty (CH). OBJECTIVES: The aim of the study was to compare the results of early full weight-bearing mobilization in CH and uncemented hemiarthroplasty (UCH). The effect of subsidence on the results was also evaluated. METHODS: Fifty-nine patients who underwent CH and UCH were evaluated. The mean age was 79.8 years (10 females, 15 males) for CH and 75.5 years (10 females, 24 males) for UCH. All patients started immediate full weight-bearing mobilization and weight-bearing exercises. RESULTS: There was no difference between the groups according to the Harris Hip Score. Both groups were evaluated in subgroups according to whether there is varus in the femoral stem. There was no difference between subgroups according to the Harris Hip Score. The femoral subsidence was not determined in CH group. In the UCH group, the subsidence was 1.13 ± 1.03 mm in varus femoral stem subgroup and 0.81 ± 0.85 mm in without femoral stem varus subgroup. There was no difference in subsidence between femoral stem with varus and without varus. The subsidence did not affect the Harris Hip Score. CONCLUSION: Full weight-bearing mobilization could be safely preferred in UCH, as in CH. Femoral stem varus below 5 degrees does not affect the results and subsidence.

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Immediate unrestricted versus graduated weight bearing following primary cementless total hip arthroplasty: a randomized controlled trial

Cited by 4 publications

References 0 publications

Cemented vs. cementless fixation in primary total knee arthroplasty: a systematic review and meta-analysis

Cemented vs. cementless fixation in primary total knee arthroplasty: a systematic review and meta-analysis

The Effect of Age and Activity Level on Stem Subsidence in Total Hip Arthroplasty

The effects of full weight-bearing mobilization on clinical outcomes and subsidence in cemented and uncemented hemiarthroplasty in osteoporotic patients: A retrospective single-center study

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