Outcomes of Charnley total hip arthroplasty using improved cementing with so-called second- and third-generation techniques

Hirose, Shiro; Otsuka, Hiromi; Morishima, Takkan; Sato, Keiji

doi:10.1007/s00776-011-0180-x

Cited by 16 publications

(3 citation statements)

References 23 publications

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“…The application of modern bone cement filling techniques can help to reduce the rate of prostheses loosening after surgery [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Aseptic loosening of tumor prostheses in distal femur after revision surgery: a retrospective study

et al. 2023

World J Surg Onc

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Background Tumor prostheses of the distal femur after revision surgery is associated with high rates of aseptic loosening, which has introduced great challenges to the survival of patients, but only a few studies have evaluated their X-ray imaging. The purpose of this study was to analyze the risk factors for recurrence of aseptic loosening and make recommendations to reduce the incidence of aseptic loosening after revision surgery of tumor prostheses in the distal femur. Method A retrospective analysis was performed on 23 patients who had revision surgery for distal femur prostheses due to aseptic loosening between June 2002 and June 2021. They were divided into two groups based on the condition of the prostheses after revision surgery: loosening group (9 patients) and control group (14 patients). Following the initial replacement, the length and diameter of the prosthetic intramedullary stem were measured through the standard full-length anteroposterior X-ray imaging of both lower limbs. The osteotomy length, femoral length and diameter, femoral intramedullary stem diameter, hip-knee-ankle angle (HKAA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), and so on were measured as well. Following that, statistical analysis was performed. Results Patients in the loosening group had statistically significant differences in the ratio of prostheses length to femur length (71.89 ± 6.62) and the ratio of intramedullary stem diameter to femoral diameter (25.50 ± 6.90) (P < 0.05), when compared to the control group. The HKAA (175.58 ± 2.78), mLDFA (94.42 ± 2.57), and the deviation angle between the lower limb alignment and the tibial prostheses force line (2.23 ± 1.09) in the loosening group were significantly different from those in the control group (P < 0.05) on postoperative radiographs of the entire length of the lower limbs. The lowest score in intramedullary manubrium I indicated less osteolysis, while the highest score in intramedullary manubrium III indicated the most serious osteolysis, and the difference was statistically significant (P < 0.05). Conclusions Our study suggests that the use of longer and thicker intramedullary stems can effectively decrease the occurrence of aseptic loosening. Additionally, it is important to avoid using the original prostheses and reconstruct the standard line of lower limb force to further reduce the incidence of aseptic loosening. It is crucial to closely monitor the distal segment of the intramedullary stem for osteolysis after surgery.

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“…The application of modern bone cement filling techniques can help to reduce the rate of prostheses loosening after surgery [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Aseptic loosening of tumor prostheses in distal femur after revision surgery: a retrospective study

et al. 2023

World J Surg Onc

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“…The conversion to cemented THA was executed at every medical centre by 4–5 high-volume surgeons using the manufacturer’s instructions and recognized technical recommendations, as reported in previous studies [ 17 , 18 ]. All surgeries were carried out through a transgluteal lateral approach.…”

Section: Methodsmentioning

confidence: 99%

Favorable revision-free survivorship of cemented arthroplasty following failed proximal femoral nail antirotation: a case series with a median follow-up of 10 years

Zhang

et al. 2022

BMC Musculoskelet Disord

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Background Given the ever-increasing rate of failure related to proximal femoral nail antirotation (PFNA), it is expected that an increasing number of PFNA individuals will undergo conversion to total hip arthroplasty (THA). The long-term survivorship of conversion of the initial PFNA to cemented THA is still debated. The aim of this retrospective study was to assess the long-term revision-free survivorship of cemented THAs after initial failures of PFNA in geriatric individuals. Methods Consecutive geriatric individuals who underwent secondary cemented THA after initial PFNA fixation from July 2005 to July 2018, were retrospectively identified from three medical centres. The primary outcome was revision-free survivorship estimated using the Kaplan–Meier method and Cox proportional hazards regression with revision for any reason as the endpoint; secondary outcomes were functional outcomes and key THA-related complications. Follow-ups occurred at 3 months, 6 months, 12 months and then every 12 months after conversion. Results In total, 186 consecutive patients (186 hips) were available for study inclusion. The median follow-up was 120.7 months (60–180 months) in the cohort. Kaplan–Meier survivorship with revision for any reason as the end point showed that the 10-year revision-free survival rate was 0.852 (95% confidence interval [CI], 0.771–0.890). Good functional outcomes were seen, and the HHS decreased markedly over the 24th month to the final follow-up interval from 92.2 to 75.1 (each p < 0.05). The overall rate of key THA-related complications was 16.1% (30/186). Conclusion Cemented THA executed following initial PFNA failure may yield satisfactory revision-free survival and, at least for the initial 10 years after conversion, good functional outcomes and a 16.1% complication rate of key THA-related complications, which supports the trend towards increased use of cemented THA.

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“…11 However, additional clinical validation of the effects of centrifugation of bone cement on the clinical outcome of Charnley-type hip fixation have been slow to appear in the literature. 12 Fretting corrosion and modularity. Modularity of the femoral head-neck junction allowed the surgeon a large range of options for adjusting limb length and offset after stem implantation, which was an immediately perceived improvement with regard to the clinician and health care institution in terms of necessary inventory of femoral stems.…”

Section: Effects Of Sterilisation On Polyethylene Wearmentioning

confidence: 99%

If hip implant retrievals could speak, what would they tell us?

Cuckler¹

2012

The Journal of Bone and Joint Surgery. British volume

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Hip implant retrieval analysis is the most important source of insight into the performance of new materials and designs of hip arthroplasties. Even the most rigorous in vitro testing will not accurately simulate the behavior of implant materials and new designs of prosthetic arthroplasties. Retrieval analysis has revealed such factors as the effects of gamma-in-air sterilisation of polyethylene, fatigue failure mechanisms of polymethylmethacrylate bone cement, fretting corrosion of Morse taper junctions, third body wear effects of both hard-on-hard and hard-on-soft bearing couples, and the effects of impingement of components on the full spectrum of bearing surfaces, none of which was predicted by pre-implantation in vitro testing of these materials and combinations. The temporal sequence of the retrieval process is approximately six years from first implantation through retrieval analysis, laboratory investigation, and publication of results, and thus, in addition to rigorous clinical evaluation, represents the true development and insight cycle for new designs and materials.

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Outcomes of Charnley total hip arthroplasty using improved cementing with so-called second- and third-generation techniques

Cited by 16 publications

References 23 publications

Aseptic loosening of tumor prostheses in distal femur after revision surgery: a retrospective study

Aseptic loosening of tumor prostheses in distal femur after revision surgery: a retrospective study

Favorable revision-free survivorship of cemented arthroplasty following failed proximal femoral nail antirotation: a case series with a median follow-up of 10 years

If hip implant retrievals could speak, what would they tell us?

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