Improved Results Using Extensively Coated THA Stems at Minimum 5-Year Followup

Abstract

The Prodigy femoral component was extensively coated along its entire length, except for a smooth bullet-shaped distal tip. At a minimum 5 year followup we compared the results of that stem to those of a proximally coated first generation femoral component at comparable followup to address the question of which design performed better. For the extensively coated cohort, 86 patients (100 hips) underwent total hip arthroplasty by a single surgeon. At final followup, no patients were lost to followup and no hips were revised for aseptic loosening. Clinically, 3% of patients reported thigh pain (versus 15% in the proximally coated group). Radiographically, all hips had evidence of bone ingrowth (versus 94% in the PCA group). As expected with an extensively coated device there were fewer radiolucencies around the lower half of the prosthesis as well as less distal femoral lysis compared to the proximally coated stem.

Proximally Versus Fully Porous-coated Femoral Stems: A Multicenter Randomized Trial

“…We observed no differences in WOMAC, SF-12, HHS, or UCLA scores at any time interval between the cohorts. This finding was expected, as both stems have been used widely in clinical practice with good clinical track records [7][8][9][10].…”

“…While this may be considered higher than previously reported [7,9] for these stems (Table 11), it must be emphasized, in this study, the data were prospectively collected and patients were asked repeatedly and directly about the presence of thigh pain.…”

“…The reported incidence of thigh pain after THA with a fully coated femoral component varies between 3% and 20% [7,13,27]. While many surgeons presume proximally coated stems, or cemented stems, have a lower incidence of thigh pain than fully coated stems, this remains controversial [1,2,17,25,28,30,38].…”

Hip resurfacing in patients under thirty years old: an attractive option for young and active patients

“…In all these studies, the mean revision rate was significant at 27.4 % (13-43) with a mean follow-up of 10.6 years (5. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. All authors highlighted the greater risk of revision compared to an older and/or less active population [3,13,27,30,31,34,38].…”

“…The mean surface arthroplasty risk index was 3.16 (1)(2)(3)(4)(5). According to the University of California Los Angeles (UCLA) scoring system, patients were rated as grades 9 (one hip), 8 (four hips), 7 (one hip), 6 (nine hips), 4 (seven hips), 2 (one hip) and 1 (one hip).…”