Migration and cyclic motion of a new short-stemmed hip prosthesis – a biomechanical in vitro study

Westphal, F.M.; Bishop, Nick; Honl, M.; Hille, E.; Püschel, Klaus; Morlock, Michael M.

doi:10.1016/j.clinbiomech.2006.04.004

Cited by 65 publications

(55 citation statements)

References 14 publications

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“…We showed that it is possible to obtain optimal fixation of a short metaphyseal-fitting anatomic cementless stem without diaphyseal fixation in young patients and that there was no thigh pain and little stress shielding with this approach. On the basis of hip scores, this implant seems comparable to others [11,[35][36][37][38][41][42][43] but without a controlled trial, there is no way to know for sure [1,2,7,18,19,[21][22][23][24][25][26][27][28]. A potential concern with the use of short, metaphyseal-fitting anatomic cementless femoral components is whether stable fixation can be obtained without diaphyseal fixation.…”

Section: Discussionmentioning

confidence: 99%

Long-term Results and Bone Remodeling After THA With a Short, Metaphyseal-fitting Anatomic Cementless Stem

Kim

Park

Kim

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Long-term results of standard total hip arthroplasty (THA) in young patients were not optimal. There are a number of reported disadvantages to longer cementless stems in THA including thigh pain and proximal stress shielding. However, it is unknown whether a short, metaphyseal-fitting anatomic stem without diaphyseal fixation, which represents a possible alternative, will maintain fixation over the longer term. Question/purposes We therefore evaluated long-term (1) clinical results using validated scoring instruments; (2) osseointegration and bone remodeling; (3) complications; and (4) rates of revision and osteolysis in patients younger than 65 years who underwent THA with a short, metaphyseal-fitting anatomic cementless stem.Methods We reviewed 500 patients (630 hips) younger than 65 years (mean age at surgery, 52.7 years) who underwent THA with the Immediate Postoperative Stability stem (IPS; DePuy, Leeds, UK) by one surgeon (Y-HK) from January 1995 to March 2002. Demographic data, Harris hip score, WOMAC score, UCLA activity score, and radiographic data were recorded. All patients underwent dual-energy x-ray absorptiometry scanning of the acetabulum and proximal femur at 2 weeks after the operation and at final followup to determine stress shielding. Thigh pain was specifically investigated and scored by patients on a visual analog scale. Other complications were recorded. We determined component survival rates at 15 years using revision and aseptic loosening as end points. Minimum followup was 11 years (mean, 15.8 years; range, 11-18 years). Results The clinical and functional results improved significantly for the Harris hip score, WOMAC, and UCLA activity scores (p \ 0.001). At latest followup, mean Harris hip, WOMAC, and UCLA activity scores were 94 (range, 71-100), 15 (range, 5-29), and 7.9 (range, 6-9) points, respectively. All hips had osseous integration of the acetabular and femoral components. No patients had thigh pain. Four hips (0.6%) had deep infection and four (0.6%) had a recurrent dislocation. No patients had Grade 3 stress shielding. Fifteen-year survival rates were 98.7% (95% confidence interval [CI], 0.95-1.00) for the acetabular component and 99.4% (95% CI, 0.97-1.00) for the femoral component with revision as the end point and 100% (95% CI, 0.98-1.00) for both components with aseptic loosening as the end point. Conclusions The short, metaphyseal-fitting anatomic cementless femoral stem provided stable fixation without relying on diaphyseal fixation in younger patients, suggesting metaphyseal fitting alone is sufficient in young

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Section: Discussionmentioning

confidence: 99%

Long-term Results and Bone Remodeling After THA With a Short, Metaphyseal-fitting Anatomic Cementless Stem

Kim

Park

Kim

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Prosthesis stem migration occurred at a faster rate in the first half-year compared to the second one (4.72 vs 3.49), which may be attributable to partial resorption of the spongy bone compressed during implant bed preparation. An in vitro study demonstrated that a short stem implant became stable when it came in contact with cortical bone or in the setting of sufficient spongy bone compression [21]. The hydroxyapatite or calcium phosphate coating of the implant and its porous structure additionally improve the stability of prosthesis positioning.…”

Section: Discussionmentioning

confidence: 99%

“…Mo żna to tłu ma czyć czę ścio wą re sorp cją, ubi tej w cza sie przy go to wy wa nia lo ży pod pro te zę ko ści gąb cza stej. Ba da nia in vi tro wy ka za ły, że implant krót ko trz pie nio wy sta je się sta bil ny w mo mencie, kie dy uzy ska ny zo sta nie kon takt z ko ścią ko ro wą lub doj dzie do wy star cza ją cej kom pre sji ko ści gąb -cza stej [21]. Po kry cie im plan tu hy drok sy apa ty tem/ fos fo ra nem wap nia wraz z je go po ro wa tą struk tu rą, dodat ko wo po pra wia ją sta bil ność osa dze nia en do pro te zy.…”

Section: Dys Ku Sjaunclassified

Postoperative Migration of Short Stem Prosthesis of the Hip Joint

Kaminski¹,

Szmyd²,

Ambroży³

et al. 2015

Ortop Traumatol Rehabil

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STRESZCZENIEWstęp. Alo pla sty ka sta wu bio dro we go jest po wszech nie sto so wa ną pro ce du rą da ją cą prze wi dy wal ne, dłu go trwałe do bre wy ni ki. En do pro te zy krót ko trz pie nio we po zwa la ją za cho wać nie na ru szo ną ja mę szpi ko wą oraz część bli ż -szą trzo nu. Wy ka za no, że w po rów na niu do en do pro tez ze stan dar do wym trzpie niem, da ją lep sze wy ni ki kli nicz ne. Ce lem pra cy by ła oce na mi gra cji trzpie nia en do pro te zy sta wu bio dro we go Pro xi ma. Mi gra cję okre śla no ja ko zmianę ką ta po ło że nia trzpie nia w kie run ku szpo ta wo ści.Ma te riał i me to dy. Do ba da nia włą czo no gru pę 164 cho rych (83 ko bie ty, 81 mę żczyzn) ope ro wa nych w latach 2007-2012 w Kra kow skim Cen trum Re ha bi li ta cji i Or to pe dii, u któ rych wy ko na no alo pla sty ki przy uży ciu 185 en do pro tez ty pu Pro xi ma.Wy ni ki. Pod da no ana li zie ra dio lo gicz nej se rię trzech zdjęć wy ko na nych u ka żde go cho re go w do bie "0", po 6 i po 12 mie sią cach. Stwier dzo no mi gra cję w kie run ku szpo ta we go usta wie nia trzpie nia w okre sie ob ser wa cji. Wy kaza no ko re la cję po mię dzy zmia ną ką ta szpo ta we go po ło że nia en do pro te zy a cza sem ob ser wa cji. Po 12 mie sią cach śred nia zmia na ką ta szpo ta wo ści wy no si ła 8,21º. Wy ka za no istot ną sta ty stycz nie ró żni cę w ką cie szpo ta we go po ło -że nia en do pro te zy w za le żno ści od płci pa cjen ta. Po 12 mie sią cach, zmia na łącz na wy no si ła u ko biet 6,82º, a u męż -czyzn 9,65º. Nie wy ka za no istot nej ko re la cji po mię dzy BMI pa cjen ta, wie kiem pa cjen ta oraz su ma rycz ną dłu go ścią szyj ki sto so wa ne go im plan tu a pro gre sją ką ta szpo ta we go po ło że nia en do pro te zy.Wnio ski. 1. Im plant krót ko trz pie nio wy Pro xi ma ule ga naj więk sze mu prze miesz cze niu w kie run ku szpo ta wo ści w okre sie pierw szych 6 mie się cy od za ło że nia. 2. Zmia na ką ta szpo ta we go po ło że nia en do pro te zy za le żna jest od wyj ścio we go osa dze nia en do pro te zy oraz płci. 3. Zmia na ką ta szpo ta we go po ło że nia en do pro te zy nie jest za le żna od wie ku cho re go oraz BMI.Słowa kluczowe: endoproteza krótkotrzpieniowa, całkowita aloplastyka stawu biodrowego, migracja trzpienia endoprotezy SUMMARY Background. Hip replacement surgery is a popular procedure that provides predictable, long-lasting and good effects. The use of short stem prostheses helps preserve an intact medullary cavity and proximal diaphysis. It has been demonstrated that the use of short stem prostheses leads to better clinical results compared to standard stem prostheses. The study aimed to assess the migration of the stem of the Proxima hip prosthesis. Migration was defined as a change in the angle of stem position towards a varus deformity.Material and methods. The study involved 164 patients (83 women, 81 men) who underwent hip replacement surgery with a total of 185 Proxima prostheses in the Cracow Rehabilitation Centre between 2007 and 2012.Results. Radiographic analysis included a ...

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“…The new implant has been described as incorporating the design philosophy of the previous device, while enhancing the fixation surface and removing the superfluous distal stem [11]. The potential benefits of these modifications are welcome, and other authors have presented sound rationale and in vitro evidence for the new generation implant [11,13,14]. However, even theoretically sound design changes that received regulatory approval may occasionally be prone to unexpected adverse events that become apparent only after unrestricted clinical use, as illustrated by a number of recent examples including symptomatic taper corrosion and catastrophic modular neck failures [1,10].…”

Section: Where Do We Need To Go?mentioning

confidence: 99%

CORR Insights®: Long-term Results and Bone Remodeling After THA With a Short, Metaphyseal-fitting Anatomic Cementless Stem

Zywiel

2014

Clinical Orthopaedics &Amp; Related Research

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Migration and cyclic motion of a new short-stemmed hip prosthesis – a biomechanical in vitro study

Cited by 65 publications

References 14 publications

Long-term Results and Bone Remodeling After THA With a Short, Metaphyseal-fitting Anatomic Cementless Stem

Long-term Results and Bone Remodeling After THA With a Short, Metaphyseal-fitting Anatomic Cementless Stem

Postoperative Migration of Short Stem Prosthesis of the Hip Joint

CORR Insights®: Long-term Results and Bone Remodeling After THA With a Short, Metaphyseal-fitting Anatomic Cementless Stem

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