Partial weightbearing is not necessary after cementless total hip arthroplasty

Markmiller, Max; Weiß, Thomas; Kreuz, Peter; Rüter, Axel; Konrad, G.

doi:10.1007/s00264-010-1089-2

Cited by 22 publications

(15 citation statements)

References 33 publications

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“…Immediate weight bearing may in theory be beneficial regarding rehabilitation time and minimising bone mineral loss due to disuse but may jeopardise initial stability and prevent safe bone ingrowth. Previous controlled studies show no adverse effects of immediate weight bearing as assessed with radiographs [1], radiographs and scintigraphy [2] or radiostereometric analysis (RSA) [3]. Few studies, however, have used a randomised protocol to examine the effect of rehabilitation [3,4] and, to our knowledge, only Thien et al [3] have investigated acetabular cup stability in relation to the postoperative weight-bearing regime.…”

Section: Introductionmentioning

confidence: 99%

The effects of different weight-bearing regimes on press-fit cup stability: a randomised study with five years of follow-up using radiostereometry

Wolf

Mattsson

Milbrink

et al. 2011

International Orthopaedics (SICOT)

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Purpose There is little evidence to support immediate weight bearing after uncemented total hip arthroplasty (THA). Methods Thirty-seven patients with unilateral osteoarthritis of the hip received a press-fit cup. Cup stability was assessed with radiostereometry (RSA) over five years. Patients were randomised to immediate full weight bearing, or partial weight bearing for three months.Results At five years, we found no difference in micromotion as assessed with radiostereometry. Numerically, there was more proximal translation and increased inclination with immediate weight bearing, but these values barely exceeded the precision limit for the method. Pooled data for the two groups revealed translations of 0.1-0.3 mm and rotations of 0.2-0.3°over the five year follow-up period. Conclusions We found no adverse effects of immediate weight bearing after THA in relation to stability of these press-fit cups. Early mobilisation might have other advantages.

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Section: Introductionmentioning

confidence: 99%

The effects of different weight-bearing regimes on press-fit cup stability: a randomised study with five years of follow-up using radiostereometry

Wolf

Mattsson

Milbrink

et al. 2011

International Orthopaedics (SICOT)

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“…Although the results of modern cemented or cementless total hip arthroplasty (THA) are generally good [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15], thigh pain, stress shielding and periprosthetic fracture are still potential problems [2,[6][7][8][9]. In an effort to reduce the periprosthetic fracture, thigh pain, and stress shielding, an ultra-short, anatomic metaphyseal-fitting cementless femoral component was developed.…”

Section: Introductionmentioning

confidence: 99%

Behaviour of the ultra-short anatomic cementless femoral stem in young and elderly patients

Kim

Park

Kim

2013

International Orthopaedics (SICOT)

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Purpose The question arises as to whether it is possible to obtain rigid fixation of the ultra-short metaphyseal-fitting anatomic cementless stem without diaphyseal fixation in the elderly as well as younger patients. We investigated whether ultra-short, metaphyseal-fitting anatomic cementless femoral stem would provide similar functional improvements in the younger and elderly patients, radiographically secure implant fixation would be achieved in both groups, the bone content would be preserved in both groups, and complication rates would be similar in both groups. Methods A total of 100 patients (114 hips) in the younger patient group and 100 patients (112 hips) in the elderly patient group were included in the study. Their mean age was 43.9± 6.11 years (range, 31-65 years) in the younger patient group and 78.9±12.1 years (range, 66-91 years) in the elderly patient group. The mean duration of follow-up was 7.5 years (range, six to nine years) in the younger patient group and 7.6 years (range, six to nine years) in the elderly patient group. Results The mean postoperative Harris hip scores (95 points versus 91 points), WOMAC scores (11 points versus 15 points), thigh pain (none in either group), UCLA activity scores (6.5 points versus 4.5 points), and radiographic results were not significantly different between the two groups. No hip in either group had an aseptic loosening. No hip in either group had clicking or squeaking sounds or ceramic fractures. Conclusion The cementless ultra-short, metaphyseal-fitting anatomic cementless femoral component provides stable fixation without any need of diaphyseal fixation in both younger and elderly patients. Despite the concern, the poor bone quality in elderly patients did not compromise the stability, and osseointegration of this ultra-short, anatomic cementless femoral stem was achieved in all elderly patients.

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“…We read with interest the article by Markmiller et al [1] that discussed an important issue regarding time of weight bearing after cementless total hip arthroplasty. Although we agree with the conclusion drawn from their observations, we ask clarification on several points in their methods.…”

mentioning

confidence: 85%

Comment on: Markmiller M, Weiss T, Kreuz P, Rüter A, Konrad G. Partial weightbearing is not necessary after cementless total hip arthroplasty. Int Orthop. 2011 Aug;35(8):1139-43

Dhillon

Bachhal

Chouhan

et al. 2011

International Orthopaedics (SICOT)

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Partial weightbearing is not necessary after cementless total hip arthroplasty

Cited by 22 publications

References 33 publications

The effects of different weight-bearing regimes on press-fit cup stability: a randomised study with five years of follow-up using radiostereometry

The effects of different weight-bearing regimes on press-fit cup stability: a randomised study with five years of follow-up using radiostereometry

Behaviour of the ultra-short anatomic cementless femoral stem in young and elderly patients

Comment on: Markmiller M, Weiss T, Kreuz P, Rüter A, Konrad G. Partial weightbearing is not necessary after cementless total hip arthroplasty. Int Orthop. 2011 Aug;35(8):1139-43

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