Patterns of osteolysis around total hip components inserted with and without cement.

Zicat, B.; Engh, Charles A.; Gokcen, Eric

doi:10.2106/00004623-199503000-00013

Cited by 376 publications

(174 citation statements)

References 20 publications

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“…Radiolucent lines in the three acetabular zones of DeLee and Charnley [5] were recorded. When serial radiographs demonstrated a radiolucent line of more than 1 mm in width in all zones, the cup was considered probably loose [23]. Cups were considered as failed if they were revised for loosening or deemed mechanically unstable based on migration or change of inclination on radiographs.…”

Section: Methodsmentioning

confidence: 99%

Trabecular Metal™ Cups for Acetabular Defects With 50% or Less Host Bone Contact

Lakstein

Backstein

Safir

et al. 2009

Clinical Orthopaedics &Amp; Related Research

121

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Acetabular component revision in the context of large contained bone defects with less than 50% host bone contact traditionally have been treated with roof reinforcement or antiprotrusio cages. Trabecular Metal TM cups (Zimmer, Inc, Warsaw, IN) may offer a reasonable treatment alternative. We evaluated the clinical and radiographic outcome of this mode of treatment. We prospectively followed 53 hip revision acetabular arthroplasty procedures performed with Trabecular Metal TM cups for contained defects with 50% or less contact with native bone. All patients were clinically and radiographically evaluated for evidence of loosening or failure. Minimum followup was 24 months (average, 45 months; range, 24-71 months). Contact with host bone ranged from 0% to 50% (average, 19%). The mean postoperative Merle d'Aubigne-Postel score was 10.6 (range, 1-12), with a mean improvement of 5.2 (range, À4-10) compared to the preoperative score. Two failed cups (4%) were revised. Two additional cups (4%) had radiographic evidence of probable loosening. Complications included four dislocations and one sciatic nerve palsy. The data suggest treatment of cavitary defects with less than 50% host bone contact using Trabecular Metal TM cups, without structural support by augments or structural bone grafts, is a reasonable option.

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Section: Methodsmentioning

confidence: 99%

Trabecular Metal™ Cups for Acetabular Defects With 50% or Less Host Bone Contact

Lakstein

Backstein

Safir

et al. 2009

Clinical Orthopaedics &Amp; Related Research

121

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“…Osteolytic lesions were documented and classified on the basis of their size and their location (Gruen regions) according to previously published criteria (Zicat et al 1995). Scalloping, geographic loss of either cortical or trabecular bone was considered to be osteolysis (Hartley et al 2000).…”

Section: Methodsmentioning

confidence: 99%

No increased stem subsidence after arthroplasty in young patients with femoral head osteonecrosis:41 patients followed for 1–9 years

et al. 2006

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Background Poor bone stock in patients with osteonecrosis of the femoral head may be a reason for poor outcome after hip replacement. One way of studying bone quality is to measure implant migration. We thus investigated the clinical and radiographic results of cementless THR in younger patients with femoral head osteonecrosis.Patients and methods We studied hips in 41 patients (mean age 48 (25-63) years) with a cementless hip arthroplasty after late stage osteonecrosis. Clinical evaluation was by the Harris hip score, the WOMAC score and the SF-36 score. Stem subsidence was measured with the Ein Bild Roentgen Analyse femoral component analysis (EBRA-FCA) at 3, 12, 24, 60, and 72 months after operation. The average duration of follow-up was 7(1-9) years, with less than 2 years for 2 patients.Results There was no revision of any hip. No radiographic or clinical stem loosening was seen. After 60 months, the cementless stems showed a median subsidence of -0.7 mm (95% CI: -0.9 to -0.2). No femoral osteolysis occurred. Femoral radiolucent lines, all < 1 mm, were seen in 10 hips. At the latest follow-up the Harris hip score was 83 (23-100) points.Interpretation Our findings for porous-coated stems in patients with femoral osteonecrosis indicate no greater risk of stem subsidence and rate of osteolysis after an average of 7 years follow-up. Thus, we continue to use uncemented stems in younger patients with femoral osteonecrosis. However, continued follow-up will be necessary to evaluate the long-term outcome.

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“…This is less likely to happen in the acetabular bed as a result of the HA coating of the acetabular cup, which seals the implant-bone interface. Zicat et al [52] and Urban et al [50] have noted an increased risk of osteolysis in the periprosthetic bone of non-MoM implants that had an incomplete or no osseointegration with the uncemented implant as a result of deficient porous coating. Aspenberg et al [5,6] proposed an increased fluid pressure in the bone-implant interface that communicates with the hip (eg, as a result of deficient osseointegration) as an inducer of osteocyte death and bone resorption.…”

Section: Study Limitationsmentioning

confidence: 99%

Frequent Femoral Neck Osteolysis With Birmingham Mid-head Resection Resurfacing Arthroplasty in Young Patients

Asaad

Hart

Khoo

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Mid-head resection total hip resurfacing arthroplasty was promoted as an alternative to traditional total hip resurfacing for patients with poor femoral head bone quality or abnormal femoral head morphology, because those patients are at high risk of failure with traditional total hip resurfacing. It is a large-headed metal-onmetal device that uses a short, bone-conserving stem. Good performance of the implant has been reported at short-term followup, but no information on the implant performance in the mid-or long-term is available. Questions/purposes In this study, we report (1) on the mid-term implant survivorship and hip scores in a single nondesigner surgeon series. Because of the occurrence of femoral neck osteolysis and pseudotumor in a subgroup of patients, we also investigated the following: (2) Were there any preoperative parameters that are associated with osteolysis? (3) Could we differentiate the osteolysis group from the others on the basis of implant component sizes, positions, and radiologic parameters? (4) Could we differentiate the osteolysis group from the others on the basis of metal ion levels? Methods Between 2006 and 2011, one surgeon performed a total of 49 Birmingham Mid-head Resection total hip resurfacing arthroplasties in 47 patients. The general indications for this procedure were young patients who were considered suitable for hip resurfacing arthroplasty but had avascular necrosis, large cysts, or severe deformity of the femoral head. Clinical followup including Oxford Hip Score (OHS) and UCLA hip scores were available preoperatively and at a mean of 6 years (range, 3-8 years) on all patients (100%), radiographic followup on 45 of 47 (96%), MRIs on 18 (38%), and metal ion levels on 37 (79%). Mean age at surgery was 50 years. Spearman's correlation was used to test the association between femoral neck osteolysis and preoperative parameters, implant component sizes and positions, and blood metal ion levels. Results We found 100% survival. Patients' median OHS was 46 of 48 (range, 35-48) and UCLA 8 of 10 (range, 4-10). However, 16% of the hips (seven of 45) demonstrated osteolysis in the femoral neck. Of the preoperative parameters, the osteolysis was associated with low weight (r = À0.337, p = 0.031) and to a lesser degree with female sex (r = 0.275, p = 0.067). Radiologically, the osteolysis was strongly associated with the presence of a

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Patterns of osteolysis around total hip components inserted with and without cement.

Cited by 376 publications

References 20 publications

Trabecular Metal™ Cups for Acetabular Defects With 50% or Less Host Bone Contact

Trabecular Metal™ Cups for Acetabular Defects With 50% or Less Host Bone Contact

No increased stem subsidence after arthroplasty in young patients with femoral head osteonecrosis:41 patients followed for 1–9 years

Frequent Femoral Neck Osteolysis With Birmingham Mid-head Resection Resurfacing Arthroplasty in Young Patients

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