Survival, Clinical and Radiological Outcome of the Zweymüller SL/Bicon-Plus Total Hip Arthroplasty: A 15-Year Follow-up Study

Ottink, Karsten D.; Barnaart, L. F. W.; Westerbeek, Robin E.; Kampen, Karin van; Bulstra, Sjoerd K.; Jonbergen, Hans-Peter van

doi:10.5301/hipint.5000231

Cited by 20 publications

(12 citation statements)

References 21 publications

(35 reference statements)

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“…Clinical evaluation (using the HHS and VAS for pain) showed that patients experienced substantial improvements in health, although not as good as afforded by their primary operations, in agreement with the data of others who have reported clinical outcomes following placement of the tapered rectangular femoral stem. 34,35…”

Section: Discussionmentioning

confidence: 99%

Revision total hip arthroplasty in patients with femoral bone loss using tapered rectangular femoral stem: a minimum 10 years’ follow-up

et al. 2020

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Background: Revision total hip arthroplasty (THA) remains a significant challenge when there is severe femoral bone loss. The purpose of this study was to evaluate the clinical and radiographic outcomes of revision THA in patients with femoral bone loss treated with Zweymüller SLR-Plus stem. Methods: A retrospective review of 82 patients who underwent revision THA using tapered rectangular femoral stem between 1997 and 2007 was undertaken. Of the 82 patients, 9 patients were lost to follow-up and were excluded from the study. The most common reason for revision was aseptic loosening (92%), periprosthetic femur fracture (5%), and infection (3%). Bone loss was categorised preoperatively according to the Paprosky classification. The mean clinical follow-up was 14 years (range 10–19 years). Their mean age at the time of index surgery was 54.7 ± 15.3 (range 30–82) years. Results: The mean Harris Hip Score was significantly improved at final follow-up (68.1 ±10.3) compared with that before the revision surgery (30.4 ± 7.7) ( p < 0.0001). Of the 75 stems, 69 (92%) stems were radiographically stable at the last evaluation. Among the 69 stems, 64 hips (85%) had radiographic evidence of bone ingrowth and 5 (5%) had stable fibrous fixation of the stem. Among the 7 hips that were re-revised, 5 hips were re-revised for aseptic loosening, whereas 2 were re-revised for an infection. Kaplan-Meier survivorship analysis, with removal of the stem for any cause as the endpoint, revealed that the 15-year rate of survival of the components was 90% (95% CI, 0.83–0.97). Conclusion: Revision THA in patients with proximal femoral bone loss using Zweymüller SLR-Plus stem led to a high rate of osseointegration of the stem and good clinical results at long-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Revision total hip arthroplasty in patients with femoral bone loss using tapered rectangular femoral stem: a minimum 10 years’ follow-up

et al. 2020

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“…A titanium biconical threaded cup is quick, reliable, and easy to implant and does not require cementation. 7 –9 In cementless total hip prostheses, the uncemented cup appears to be the component associated with increased risk of revision, compared to the stem. 18,27 It is stated that the common cause, for this problem, is increased polyethylene (PE) wear resulting in loosening.…”

Section: Discussionmentioning

confidence: 99%

Outcome of the Cementless Zweymüller BICON-PLUS Cup and SL-PLUS Stem in the Very Elderly Individuals

Veen

Schrier

Riet

et al. 2016

Geriatr Orthop Surg Rehabil

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Introduction:There is current debate about which type of total hip prosthesis implants are best for the elderly patient. Implanting uncemented total hip arthroplasty (THA) in elderly people remains contested. The aim of present study was to evaluate the outcome of the uncemented Zweymüller BICON-PLUS THA in those with a minimum of 80 years of age.Materials and Methods:A retrospective data collection was performed in a regional teaching hospital in the Netherlands. The primary outcome of interest was the operation-free period. Secondary outcomes included the revision rates of the femoral and acetabular components and postoperative complications of the procedure. After a follow-up of at least 7 years, the surviving patients were reviewed on functionality using validated scores (Hip Disability and Osteoarthritis Outcome Score, Timed Up and Go, and Harris Hip Score) and radiographic analysis.Results:Between January 1999 and September 2004, 124 patients (128 THAs), aged 80 years and older, received an uncemented THA with a BICON-PLUS cup and SL-PLUS stem. The overall operation-free period was 6.5 years. One case of loosening of the cup was found among participants, with a survival rate of 99.2% of the BICON-PLUS cup in the analyzed group. In all, 28.8% of this group could be followed for a postoperative period of at least 7 years. The remainder of the patients died prior to the end of the 7-year period. Of these, 16.0% were eligible for clinical review. This group showed good function without evident signs of prosthetic loosening.Conclusion:The uncemented Zweymüller THA system, with threaded BICON-PLUS cup and SL-PLUS stem, showed good results, compared to outcome of other THA systems in elderly individuals. Therefore, it is a reliable option in older patients requiring THA.

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“…Of 101 patients available for radiographic follow-up, the rate of aseptic loosening was 1.0% (1/101). Ottink K. et al also performed survival analysis of 13 to 15 years of follow-up and found the probability of stem survival with revision for aseptic loosening was 0.99 at 10 years and 0.95 after 15 years [16].…”

Section: Discussionmentioning

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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Survival, Clinical and Radiological Outcome of the Zweymüller SL/Bicon-Plus Total Hip Arthroplasty: A 15-Year Follow-up Study

Abstract: The "third generation" Zweymüller total hip arthroplasty consisting of the SL stem and the Bicon cup has good long term results in terms of survival, clinical and radiological outcome.

Cited by 20 publications

References 21 publications

Revision total hip arthroplasty in patients with femoral bone loss using tapered rectangular femoral stem: a minimum 10 years’ follow-up

Revision total hip arthroplasty in patients with femoral bone loss using tapered rectangular femoral stem: a minimum 10 years’ follow-up

Outcome of the Cementless Zweymüller BICON-PLUS Cup and SL-PLUS Stem in the Very Elderly Individuals

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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