Mid-Term Outcomes and Complications with Cementless Distal Locking Hip Revision Stem with Hydroxyapatite Coating for Proximal Bone Defects and Fractures

Carrera, Lluís; Haddad, Sleiman; Minguell, Joan; Amat, Carles; Corona, Pablo S.

doi:10.1016/j.arth.2015.01.026

Cited by 16 publications

(11 citation statements)

References 42 publications

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“…Reports of either canine or human proximal interlocking THA stem were not found in the literature. However, evaluation of mid term outcomes with use of a human cementless distal interlocking hip revision stem reported no significant stress shielding, osteolysis, or radiographic loosening and all patients showed radiological evidence of implant osseointegration . Clinical evaluation of the interlocking stem with long term followup is necessary to evaluate long term consequences of bolt addition.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Interlocking a Universal Hip Cementless Stem on Implant Subsidence and Mechanical Properties of Cadaveric Canine Femora

et al. 2016

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ObjectiveTo determine if an interlocking bolt would limit subsidence of the biological fixation universal hip (BFX®) femoral stem under cyclic loading and enhance construct stiffness, yield, and failure properties.Study DesignEx vivo biomechanical study.AnimalsCadaveric canine femora (10 pairs).MethodsPaired femora implanted with a traditional stem or an interlocking stem (constructs) were cyclically loaded at walk, trot, and gallop loads while implant and bone motions were captured using kinematic markers and high‐speed video. Constructs were then loaded to failure to evaluate failure mechanical properties.ResultsImplant subsidence was greater (P = .037) for the traditional implant (4.19 mm) than the interlocking implant (0.78 mm) only after gallop cyclic loading, and cumulatively after walk, trot, and gallop cyclic loads (5.20 mm vs. 1.28 mm, P = .038). Yield and failure loads were greater (P = .029 and .002, respectively) for the interlocking stem construct (1155 N and 2337 N) than the traditional stem construct (816 N and 1405 N). Version angle change after cyclic loading was greater (P = .020) for the traditional implant (3.89 degrees) than for the interlocking implant (0.16 degrees), whereas stem varus displacement at failure was greater (P = .008) for the interlocking implant (1.5 degrees) than the traditional implant (0.17 degrees).ConclusionAddition of a stabilizing bolt enhanced construct stability and limited subsidence of a BFX® femoral stem. Use of the interlocking implant may decrease postoperative subsidence. However, in vivo effects of the interlocking bolt on osseointegration, bone remodeling, and stress shielding are unknown.

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Section: Discussionmentioning

confidence: 99%

The Effects of Interlocking a Universal Hip Cementless Stem on Implant Subsidence and Mechanical Properties of Cadaveric Canine Femora

et al. 2016

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“…Technological progress decreased the occurrence of femoral fractures significantly. However, the prevalence may increase in complex revision situations (0.8%-2.3%) [2], [10], [11], [12]. Revision modular tapered stems have a known point of weakness at the modular interfaces [3], [4], [7].…”

Section: Discussionmentioning

confidence: 99%

“…Prior reports of monoblock revision stem failures most commonly describe fractures through stems with an outer diameter of <14 mm. In a consecutive series of 100 patients implanted with diaphyseal engaging revision stems, Carrera et al [10] reported 2 fractures, both at a stem diameter of 12 mm. Both were successfully revised with stems of 14 and 16 mm diameters.…”

Section: Discussionmentioning

confidence: 99%

Fracture risk of tapered modular revision stems: a failure analysis

et al. 2018

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Fractures of well-ingrown femoral components are a rare and often challenging complication after revision total hip arthroplasty. Prior series have documented catastrophic failure at the modular junction of revision femoral components. However, to the authors' knowledge, there has been only 1 report of a mid-stem fracture of a modular tapered revision stem. The present article reports 2 cases of fatigue fractures (14 months and 10 years after implantation) of a tapered modular revision stem. It presents the results of the fracture surface analysis, discusses the etiology of failure, and presents the authors' recommendations on how to best avoid this complication.

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“…However, surgeons seem to adapt stem size to gender, age, and height but not to body weight [14]. Prior reports of nonmodular revision stem failures most commonly describe fractures through stems with small diameters ranging from 12 to 14 mm [5], [15], [16]. Sotereanos et al [17] suggest that a primary reason for femoral component failure in primary THA is inadequate stem diameter due to undersizing.…”

Section: Discussionmentioning

confidence: 99%

Fracture of an S-ROM stem at the sleeve-stem junction

et al. 2018

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Fracture of a well-ingrown femoral component is a rare and often challenging complication. Modular junctions and sleeve interfaces have been identified as one potential point of weakness with corrosion and fretting being contributing factors to ultimate femoral component fracture. Stem fractures at the sleeve interface were reported occasionally for the proximal ingrowth modular Emperion System (Smith and Nephew, Memphis, TN). However, this failure mechanism has been reported infrequently, often associated with corrosion at the modular junction, for the similarly designed S-ROM system (DePuy Orthopedics Inc., Warsaw, IN). We present the case of a 52-year-old patient, with a body weight of 84 kg (185 lbs) and a body mass index of 30.6 kg/m2, who suffered a fatigue fracture of a 14 × 09 × 130 mm S-ROM stem 42 months after implantation. The present study presents the results of the surface analysis, discusses possible failure mechanisms, provides treatment guidelines, and a review of the literature revealing 15 cases of failure at the level of the stem-sleeve junction. In particular, modifiable risk factors for potential stem failure, including stem diameter, stem offset, and the resulting cantilever bending forces on the proximal sleeve-stem junction, are discussed in detail.

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Mid-Term Outcomes and Complications with Cementless Distal Locking Hip Revision Stem with Hydroxyapatite Coating for Proximal Bone Defects and Fractures

Cited by 16 publications

References 42 publications

The Effects of Interlocking a Universal Hip Cementless Stem on Implant Subsidence and Mechanical Properties of Cadaveric Canine Femora

The Effects of Interlocking a Universal Hip Cementless Stem on Implant Subsidence and Mechanical Properties of Cadaveric Canine Femora

Fracture risk of tapered modular revision stems: a failure analysis

Fracture of an S-ROM stem at the sleeve-stem junction

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