Survivorship of a Low-stiffness Extensively Porous-coated Femoral Stem at 10 Years

Hartzband, Mark A.; Glassman, Andrew H.; Goldberg, Victor M.; Jordan, Louis R.; Crowninshield, Roy D.; Fricka, Kevin B.; Jordan, Louis C.

doi:10.1007/s11999-009-0950-3

Cited by 34 publications

(20 citation statements)

References 17 publications

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“…While the data of 5 years follow‐up suggest that this fully porous‐coated implant design provides fixation and better maintained peri‐prosthetic cortical thickness and density than conventional implants, a recent study has demonstrated a 10–20% loss in peri‐prosthetic bone at 7 years. This is very similar to that seen with a conventional stem . The authors concluded that that the merit of the Epoch stem in preserving bone mineral is only transient in nature.…”

Section: Discussionmentioning

confidence: 97%

“…Another composite implant is the EPOCH hip stem, which has a forged cobalt‐chromium‐molybdenum core section with an outer layer of pure titanium fiber metal mesh applied over a polyaryletherketone (PAEK) middle section . While the data of 5 years follow‐up suggest that this fully porous‐coated implant design provides fixation and better maintained peri‐prosthetic cortical thickness and density than conventional implants, a recent study has demonstrated a 10–20% loss in peri‐prosthetic bone at 7 years. This is very similar to that seen with a conventional stem .…”

Section: Discussionmentioning

confidence: 99%

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Fully porous 3D printed titanium femoral stem to reduce stress-shielding following total hip arthroplasty

et al. 2016

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Current hip replacement femoral implants are made of fully solid materials which all have stiffness considerably higher than that of bone. This mechanical mismatch can cause significant bone resorption secondary to stress shielding, which can lead to serious complications such as periprosthetic fracture during or after revision surgery. In this work, a high strength fully porous material with tunable mechanical properties is introduced for use in hip replacement design. The implant macro geometry is based off of a short stem taper-wedge implant compatible with minimally invasive hip replacement surgery. […] We show that the fully porous implant with an optimized material microstructure can reduce the amount of bone loss secondary to stress shielding by 75% compared to a fully solid implant. This result also agrees with those of the in-vitro quasi-physiological experimental model and the corresponding finite element model for both the optimized fully porous and fully solid implant These studies demonstrate the merit and the potential of tuning material architecture to achieve a substantial reduction of bone resorption secondary to stress shielding

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Fully porous 3D printed titanium femoral stem to reduce stress-shielding following total hip arthroplasty

et al. 2016

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“…Conventional cementless femoral stems are known to provide a high rate of satisfactory clinical and radiographic performance at long-term followups [1,7,12,14,15,18,33]. However, they may have potential clinical consequences related to stress shielding, thigh pain, periprosthetic fractures, proximodistal dimensional mismatch, and removal during revision [9, 11, 16, 17, 19, 21-23, 35, 38].…”

Section: Introductionmentioning

confidence: 99%

Ultrashort versus Conventional Anatomic Cementless Femoral Stems in the Same Patients Younger Than 55 Years

Kim

Park

Kim

2016

Clinical Orthopaedics &Amp; Related Research

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Background Because the clinical and radiographic performance of an ultrashort anatomic cementless stem has been investigated in only two randomized controlled studies, well-designed trials should aim for a thorough comparison of the outcomes of ultrashort anatomic cementless and conventional anatomic cementless stems. Questions/purposes The purposes of this study were to compare (1) the clinical results, including Harris hip score, thigh pain, and WOMAC index score, (2) radiographic results, (3) bone mineral density; and (4) proportions of patients undergoing revision of a THA using an ultrashort anatomic cementless stem versus a conventional anatomic cementless stem in the same patients who underwent bilateral sequential THAs under the same anesthetic. Methods Two hundred patients (mean age, 53 years; range, 26-54 years) who underwent bilateral sequential THAs received an ultrashort anatomic cementless stem in one hip and a conventional anatomic cementless stem in the contralateral hip. From January 2004 to December 2005, we performed 524 same-day bilateral short and conventional anatomic cementless THAs in 262 patients, of whom 212 (81%) participated in this study. Five patients were lost to followup before 2 years, five were lost between 2 to 10 years, and two were lost between 10 to 13 years, leaving 200 patients. Patients who had end-stage bilateral hip disease and were younger than 55 years were selected for inclusion. The predominant diagnoses were osteonecrosis (118 patients, 59%) and osteoarthritis (44 patients, 22%). One hundred thirty-eight were men and 62 were women. At the time of each followup, the patients were assessed clinically and radiographically. In addition, each patient completed the WOMAC and the University of California Los Angeles (UCLA) activity scores. The minimum followup was 10 years (mean, 11.8 years; range, 10-13 years). Followups were done in person, with all images and followup clinic notes. Based on the power analysis, we estimated a sample size of 178 hips was needed in each group to detect a 3-point difference in the Harris hip score with 80% power. Results At the latest followup, there were no differences between the two groups regarding the mean Harris hip scores (94 versus 94 points; p = 0.189), mean WOMAC scores (17 versus 16 points; p = 0.191), or mean UCLA activity scores (9 versus 9 points; p = 0.381). Two patients in the ultrashort stem group and one patient in the conventional stem group had severe (9 points) thigh pain, and

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“…During the last few years, there has been a great deal of interest in conventional cementless and ultrashort stems. Conventional cementless femoral stems demonstrated a good rate of clinical and radiographic performance at long-term follow-up [1][2][3] . Kim et al, in a level I study, compared the use of ultrashort and conventional cementless femoral stems in patients younger than 55, with a mean follow-up of 11.8 years, resulting in absence of significant differences of outcome scores 1 .…”

Section: Total Hip Replacement: New Evidencementioning

confidence: 99%

Lower limb joint repair and replacement: an overview

Aicale

Maffulli

2019

F1000Res

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In the last few years, much has been published concerning total joint arthroplasty, and debates and discussions to new questions and points of view started many years ago. In this commentary, we report the latest evidence of best practice in the field of lower limb arthroplasty; this evidence is based on a literature search conducted by using PubMed and Scopus databases with a time limit of five years. We found novel evidence regarding cemented and not cemented implant, implant design, anticoagulant use, tourniquets, and other aspects of joints replacement surgery that we consider a common part of modern orthopedic practice. We specifically focus on lower limb joint replacement.

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Survivorship of a Low-stiffness Extensively Porous-coated Femoral Stem at 10 Years

Abstract: Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Cited by 34 publications

References 17 publications

Fully porous 3D printed titanium femoral stem to reduce stress-shielding following total hip arthroplasty

Fully porous 3D printed titanium femoral stem to reduce stress-shielding following total hip arthroplasty

Ultrashort versus Conventional Anatomic Cementless Femoral Stems in the Same Patients Younger Than 55 Years

Lower limb joint repair and replacement: an overview

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