Short-term Outcomes With a Second-Generation Uncemented Stem in Total Hip Arthroplasty

Sueyoshi, Tatsuya; Meding, John B.; Berend, Michael E.; BrunsMan, MaTThew J.; Ritter, Merrill A.

doi:10.3928/01477447-20160201-01

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…[ 31 32 ] So, further large-scale multicenter studies are required to confirm the rates of postoperative thigh pain using modern cementless stems. The authors reviewed some published literatures about cementless total hip replacement with 2nd-generation components in recent years, [ 31 33 ] and found cortical hypertrophy of the distal femoral stems may be the site of stress shielding and did not cause thigh pain, it was an adaptive bone remodeling response to mechanical stress. Obviously, the postoperative thigh pain is not necessarily to be applied in 2nd-generation cementless prosthesis.…”

Section: Discussionmentioning

confidence: 99%

Short-stem prostheses in primary total hip arthroplasty

et al. 2016

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Background:Short-stem (SS) prostheses require less resection of the femoral neck, produce a more physiological load pattern in the proximal femur, reduce stress shielding, and aid bone conservation and are, therefore, beneficial for young patients. Conventional cementless implants in total hip arthroplasty (THA) have shown excellent clinical results; however, it is unclear whether SS prostheses can obtain the same clinical and radiological outcomes. We conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate whether SS prostheses are superior to conventional implants after primary THA.Methods:We reviewed the literature published up to June 2016 from PubMed, Web of Science, and the Cochrane Library to find relevant RCTs comparing SSs and conventional stems in primary THA. Quality assessment was performed by 2 independent reviewers. The RevMan 5.3 software program of the Cochrane Collaboration was used to analyze the data. Random- or fixed-effect models were used to calculate standardized mean differences (SMDs) and 95% confidence intervals (CIs) for each comparison.Results:Six RCTs involving 552 patients with 572 hips were identified. Strong evidence indicated that SS prostheses were more effective for reducing thigh pain than conventional implants (I 2 = 46%, P = 0.002; risk ratio [RR], 95% CI 0.15, 0.04–0.49). However, there were no significant differences between the 2 groups in Harris Hip Scores (I 2 = 0%, P = 0.84; SMD, 95% CI 0.02, −0.15–0.18), Western Ontario and McMaster Universities Osteoarthritis Index Scores (I 2 = 0%, P = 0.35; SMD, 95% CI 0.09, −0.10–0.27), femoral offset of stem (I 2 = 0%, P = 0.57; SMD, 95% CI 0.06, −0.16–0.29), and leg-length discrepancy (I 2 = 79%, P = 0.88; SMD, 95% CI 0.04, −0.44–0.51).Conclusion:SS prostheses achieve the same clinical and radiological outcomes as conventional implants, and were superior in terms of reducing thigh pain. But whether the postoperative thigh pain applied in 2nd-generation cementless prosthesis still needs further large-scale multicenter studies with longer follow-up to confirm.

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Section: Discussionmentioning

confidence: 99%

Short-stem prostheses in primary total hip arthroplasty

et al. 2016

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“…Meding et al 22 showed the 100% survivorship for aseptic loosening at mean follow-up of 20 years after 157 primary THAs. Sueyoshi et al 23 also reported 100% survivorship with stem revision as the endpoint for more than 20 years (range, 0-26 years; mean, 7.9 years).…”

Section: Discussionmentioning

confidence: 98%

Effect of stem alignment on long-term outcomes of total hip arthroplasty with cementless Bi-Metric femoral components

Shishido

Tateiwa

Takahashi

et al. 2018

Journal of Orthopaedics

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We investigated the effects of varus-valgus alignment on the long-term outcomes after cementless total hip arthroplasty (THA) using a porous coated version of Bi-Metric femoral stems. The Kaplan-Meier survival analysis was performed in 71 hips. The survival rate with femoral revision for aseptic loosening as the end point was 100% at 17 years. Nevertheless, the initial stem alignment was more valgus in patients with the Engh grade III-IV stress shielding than patients with the Engh grade I-II. Our results suggest that valgus misalignment of cementless Bi-Metric stem might be a potential risk factor for the progression of stress shielding.

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“…Uncemented femoral stems have beeSn widely used in total hip arthroplasty for osteoarthritis, osteonecrosis, and rheumatoid arthritis or hemiarthroplasty for hip fracture [1][2][3][4][5][6][7][8][9][10][11]. When using uncemented femoral stems, achieving sufficient primary stability is crucial to ensure good long-term results.…”

Section: Introductionmentioning

confidence: 99%

The Trochanteric Wing of the Zweymüller Femoral Stem does Not Affect Rotational Stability: An Experimental Study Using a Resin Bone Model

Shigemura¹,

Omae²,

Mitsuhashi³

et al. 2017

IJCEMS

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Abstract:The Preserve stem is a modified Zweymüller femoral stem that omits the trochanteric wing. Omission of the trochanteric wing of the prosthesis might influence its rotational stability, but, there are no reports about the rotational stability of a modified Zweymüller femoral stem. The purpose of this study was to investigate the effect of the trochanteric wing on rotational stability by comparing the modified Zweymüller femoral stem and the original Zweymüller femoral stem. Computed tomography of the right femur was used to construct a resin model of the proximal femur. Three types of uncemented stems were used in this study: Preserve α, β, and exemplary Zweymüller stem. Preserve β is a modified Zweymüller-type of stem with a reduced trochanteric wing. Preserve α is also a Zweymüller-type of stem with a further reduced trochanteric wing. The resin bone model was mounted on a universal testing machine. The stem was inserted into the bone model manually and loaded vertically up to 600 N. Then the stem was rotated posteriorly by 1°/sec until angular rotation was achieved to 5°. The torque at 5° was compared among the three stems. Vertical displacement of the stem during rotation testing was also recorded as a correlative measure for prosthetic subsidence. The results showed that the mean torque at 5° was not significantly different among the Preserve α, β, and exemplary Zweymüller stem (Tukey-Kramer test). Furthermore, the mean vertical displacement amounts during rotation testing were not significantly different among the three stems (Tukey-Kramer test). This study indicate that the Preserve α and β, modified Zweymüller stems, are rotationally as stable as the exemplary Zweymüller stem.

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Short-term Outcomes With a Second-Generation Uncemented Stem in Total Hip Arthroplasty

Cited by 5 publications

References 17 publications

Short-stem prostheses in primary total hip arthroplasty

Short-stem prostheses in primary total hip arthroplasty

Effect of stem alignment on long-term outcomes of total hip arthroplasty with cementless Bi-Metric femoral components

The Trochanteric Wing of the Zweymüller Femoral Stem does Not Affect Rotational Stability: An Experimental Study Using a Resin Bone Model

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