Radiological and Survival Comparison of Four Methods of Fixation of a Proximal Femoral Stem

Donnelly, William J.; Kobayashi, Akio; Freeman, Michael; Chin, Takafumi; Yeo, H.; West, Milly; Scott, G.

doi:10.1302/0301-620x.79b3.0790351

Cited by 45 publications

(27 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Calcium phosphate (CaP) coatings have been shown to promote early bone apposition at the surface of cementless orthopedic prostheses [1][2][3][4][5][6][7] and have given highly successful clinical results [8][9][10][11][12][13][14]. Plasma-sprayed hydroxyapatite (HA) coatings applied on to titanium implants have been shown to enhance the quality of bone apposition and the biomechanical fixation of prostheses [3,15].…”

Section: Introductionmentioning

confidence: 99%

Osteointegration of femoral stem prostheses with a bilayered calcium phosphate coating

Goyenvalle

Aguado

Nguyen³

et al. 2006

Biomaterials

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Osteointegration of femoral stem prostheses with a bilayered calcium phosphate coating

Goyenvalle

Aguado

Nguyen³

et al. 2006

Biomaterials

View full text Add to dashboard Cite

“…Although HA-coated implants have been investigated for more than a decade, only a few midterm results are published. 4,14 At first, our hypothesis was that we would have a lower percentage of stress-shielding with a new anatomic proximal HA-coated design of stem. We also thought that with using a HA-coated system to facilitate bone ongrowth, we would have a lower incidence of migration of PE particles and osteolysis.…”

mentioning

confidence: 99%

Seven to 10 Years Followup of an Anatomic Hip Prosthesis

Herrera¹,

Canales²,

Anderson³

et al. 2004

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Hypothetically, hydroxyapatite-coated anatomic-shaped femoral stems and hemispheric acetabular cups should improve biologic fixation of the implant and strength transmission to the bone, improving unsatisfactory results of the first cementless hip prosthesis focused on the stress-shielding phenomenon at the femur and failure of the threaded acetabular cups. A consecutive series of 312 patients who had primary Anatomique Benoist Giraud hip prostheses unilaterally implanted were followed up. We analyzed the clinical and radiographic results and report the outcomes 7-10 years after implantation. Two hundred thirty-two patients were assessed at 7-10 years. The survival rate for the implant was 96.8%; 77.2% of patients had no pain, 72.4% maintained total mobility, and 62.9% were able to walk without restrictions. However, radiologic assessment shows that problems improved but did not disappear. More than 55% of femurs had signs of proximal stress-shielding develop. More important, substantial polyethylene wear was observed in at least 62% of the acetabular inserts at 7-10 years followup.Cemented hip prostheses have been implanted with satisfying results since the 1960s. 7,8 However, the relatively frequent onset of pain and disability, secondary to loosening at the prosthesis-cement or cement-bone interfaces 26,28,36 has impaired long-term outcomes, particularly in young patients.The first cementless designs, characterized by straight and very stiff distally fixed cementless stems, had serious stress-shielding phenomenons. 30,34 Threaded acetabular cups also failed after 4-5 years. 30,34 To avoid these problems new fixation systems were developed, 15,16 and new models were designed. New hemispheric press-fit acetabular cups and new anatomic-shaped femoral stems transmitted load in the metaphyseal area, theoretically reducing the stress-shielding effect. However, this effect did not disappear, although it became weaker. 20,44 A new step to improve proximal fixation of the femoral stem consisted of using HA coating on its metaphyseal part to facilitate bone ongrowth. 1,19,21 Another problem detected in cemented prostheses was the appearance of osteolysis secondary to inflammatory reactions against polyethylene (PE) and cement particles. 29,36 The problem of osteolysis has not disappeared with new cementless implants, 37 although now its origin is PE wear. This probably is the most serious threat to implant survival according to Harris who stated, "the problem is osteolysis". 23 A prospective international study evaluated the midterm followup results of an anatomic proximal hydroxyapatite (HA)-coated stem and hemispheric HA-coated cup hip prosthesis. The aim of the study was to monitor the clinical and radiographic outcome of patients implanted with the ABG system. The early, 2-year, and 5-year results have been published, 48,49 and the 7-to 10-year results are presented here. Although HA-coated implants have been investigated for more than a decade, only a few midterm results are published. 4,14 At first, our hypothesis...

show abstract

“…Femurschaftprothese · Zementiertechnik · Intramedullärer Druck · Mikrosonde · Hüftendoprothese Die Entwicklung der Hüftendoprothe-sen hat in zunehmendem Maße die Vorteile einer proximalen Krafteinleitung am Femur gezeigt [2,3,8]. Ausgehend von der Überlegung, dass eine physiologische Krafteinleitung im Bereich des Femurs praktisch nur im proximalen Bereich (also im Bereich der Trabekel) erfolgt [3], nicht aber im Schaftbereich (also über das Endost) kommt man heute immer mehr dazu, zementierte als auch nicht zementierte Prothesen mit proximaler Krafteinleitung und proximalem Formschluss ohne Verankerung im Schaftbereich zu entwickeln.…”

Section: Schlüsselwörterunclassified

Einfluss des Prothesendesigns auf die intramedull�re Druckentwicklung bei der Femurschaftimplantation von zementierten H�ftendoprothesen

Beck¹,

Strecker²,

Gebhard³

et al. 2001

Der Unfallchirurg

View full text Add to dashboard Cite

The increase of intramedullary femoral pressure can lead to the intravasation of bone marrow and fat cells into the blood stream of the femoral vein and consequently into the pulmonary circulation. This effect is the same in intramedullary nailing and in the implantation of femoral stem prostheses. In a prospective study we evaluated the intraoperative, intramedullary pressure in the distal femur during the implantation of femoral stem prostheses with two different designs. In eight patients we implanted Müller straight stems and in another eight we implanted stem type Option 3000. Intramedullary pressure was recorded continuously by the implantation of a microtip pressure probe (piezoresistive principle, 50 Hz) in the distal femur. We found markedly higher pressure in Müller straight stem prostheses: range: 590-2,570 mmHg (median = 1,293, SD = 627 mmHg). Intramedullary pressure in stem prosthesis type Option 3000 was much lower: range: 59-574 mmHg (median = 289, SD = 219 mmHg). The differences were statistically significant (p = 0.0008). By changing the designs of femoral stem prostheses, the intramedullary pressure can be markedly reduced. In the case of elderly patients or those with pulmonary illness we recommend femoral stem prosthesis designs, which induce little increase in the intramedullary pressure, in order to reduce cardiopulmonary complications.

show abstract

Radiological and Survival Comparison of Four Methods of Fixation of a Proximal Femoral Stem

Cited by 45 publications

References 18 publications

Osteointegration of femoral stem prostheses with a bilayered calcium phosphate coating

Osteointegration of femoral stem prostheses with a bilayered calcium phosphate coating

Seven to 10 Years Followup of an Anatomic Hip Prosthesis

Einfluss des Prothesendesigns auf die intramedull�re Druckentwicklung bei der Femurschaftimplantation von zementierten H�ftendoprothesen

Contact Info

Product

Resources

About