Radiographic Subsidence in Asymptomatic Patients After THR Using the Furlong Active HAP Stem

Cordero‐Ampuero, José; Peñalver, Pablo Arnaldo Calderón; Antón, Rodrigo; Galán, María; Cordero, Enrique

doi:10.1007/s11420-013-9342-z

Cited by 14 publications

(5 citation statements)

References 25 publications

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“…Published results on stem subsidence following cementless THA vary greatly with an average range of subsidence between 0.45 and 2.23 mm. 8,[29][30][31][32][33][34] Each cohort consisted of only patients that underwent THA with the DAA and the mean subsidence in our study was within the accepted range noted in the literature which suggests that approach does not affect subsidence outcomes. While excessive stem subsidence was not observed, there was a significant difference between cohorts with the less active MDS group experiencing greater subsidence than the SDD group (1.80 vs. 0.92mm, p < 0.001).…”

Section: Discussionsupporting

confidence: 56%

The Effect of Age and Activity Level on Stem Subsidence in Total Hip Arthroplasty

Zak

Greenbaum

Singh

et al. 2020

The Journal of Hip Surgery

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The average length of hospital stay (LOS) following total hip arthroplasty (THA) is decreasing due to a variety of factors, including rapid patient mobilization. With increased early joint loading, certain populations, such as those with low systemic bone mineral density, may be at an increased risk for early stem instability. The purpose of this study was to determine whether activity level and patient age affect femoral stem stability and early subsidence. We retrospectively reviewed 821 patients who underwent primary cementless THA. Two cohorts were established based on LOS as a proxy for activity: (1) same calendar day discharge (SDD) and (2) multiple day stay (MDS). Descriptive patient characteristics as well as surgical and clinical data including surgical time, stem alignment, and Activity Measure for Post-Acute Care (AM-PAC) scores were collected. Stem subsidence was assessed by comparing immediate postoperative radiographs with follow-up radiographs taken no less than 3 months after surgery (9.79 ± 6.50 months). Our sample population consisted of 255 SDD (31%) and 566 MDS (69%) patients. Stem subsidence rate was significantly lower in the SDD than the MDS group (0.916 vs. 1.80 mm, p < 0.001). Increasing age was associated with a higher rate of stem subsidence (β = 0.823, p < 0.001). Increased LOS was also associated with increased age (odds ratio = 1.092, p < 0.001). Higher postoperative mobility determined by AM-PAC scores was not associated with shorter LOS (p = 0.630). The result of this study showed increased activity level does not increase rate of subsidence in THA patients, which supports the safety and efficacy of expedited recovery programs. Increased age was found to increase stem subsidence regardless of LOS.

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Section: Discussionsupporting

confidence: 56%

The Effect of Age and Activity Level on Stem Subsidence in Total Hip Arthroplasty

Zak

Greenbaum

Singh

et al. 2020

The Journal of Hip Surgery

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“…Follow-up included a maximum of 5 postoperative radiographs: during hospital stay, 6 weeks, 6 months, 1 year and 2 years postoperatively. Subsidence was digitally measured in a standardised technique from the highest point of the greater and lesser trochanter to the most lateral point of the stem-shoulder according to Bieger et al (24) and Cordero-Ampuero et al (25). Therefore, a coordinate system was digitally included in every postoperative image on each hip.…”

Section: Methodsmentioning

confidence: 99%

Radiographic Alterations in Short-Stem Total HIP Arthroplasty: A 2-Year Follow-Up Study of 216 Cases

et al. 2016

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“…Various studies have reported on the subsidence of cementless hip stems, with some suggesting an inferior performance of short stem designs compared to conventional stems [9][10][11][12][13][14][15][16][17][18][19][20][21][22]. This could be detrimental for implant survivorship, as several authors suggested a correlation of early stem subsidence with aseptic loosening [23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Mid-term subsidence and periprosthetic radiolucency of the AMIStem: a 5-year EBRA-FCA analysis

et al. 2021

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Background There has been an evolution in cementless total hip arthroplasty (THA) with newer short stem designs aimed to preserve metaphyseal bone stock and facilitate implantation through minimally invasive approaches. While early subsidence has been correlated to aseptic loosening in conventional stems, there is a paucity of data regarding short stems. The current study aims to report on stem subsidence and mid-term clinical outcomes of a cementless, metaphyseal-anchored short femoral stem, specifically designed for the direct anterior approach (DAA). Methods Ninety-four consecutive patients (100 hips) with a minimum follow-up of 5 years following cementless THA were included in this single-center retrospective study. Subsidence was evaluated using the “Ein-Bild-Roentgen-Analyse” (EBRA). Periprosthetic radiolucency allocated to the zones of Charnley and Gruen was assessed. Additionally, demographic and implant-related factors potentially associated with increased subsidence and clinical outcomes were evaluated. Results At the last follow-up, the average stem subsidence was 1.98 ± 1.20 mm, with 48% of the implants demonstrating subsidence of > 2 mm. Periprosthetic radiolucency of > 2 mm was found in 26% of the implants in zone 1 and in 9% in zone 7, respectively. Neither the amount of subsidence nor proximal periprosthetic radiolucency was associated with aseptic loosening or worse clinical outcomes. Conclusions Comparable to other proximally fixed short stem designs, the highest subsidence was observed within the first 3 months following implantation. No demographic or implant-related factors were found to have a statistically significant influence on stem subsidence. Periprosthetic radiolucency and subsidence of the AMISstem is not correlated with worse clinical outcomes at 5-year follow-up.

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Radiographic Subsidence in Asymptomatic Patients After THR Using the Furlong Active HAP Stem

Abstract: Of the Furlong Active stems 61% subsided with initial weight bearing. Subsidence is higher in males, but no correlation has been found with age, stem diameter, morphology, osteopenia, or canal filling.

Cited by 14 publications

References 25 publications

The Effect of Age and Activity Level on Stem Subsidence in Total Hip Arthroplasty

The Effect of Age and Activity Level on Stem Subsidence in Total Hip Arthroplasty

Radiographic Alterations in Short-Stem Total HIP Arthroplasty: A 2-Year Follow-Up Study of 216 Cases

Mid-term subsidence and periprosthetic radiolucency of the AMIStem: a 5-year EBRA-FCA analysis

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