The Effect of Size for a Hydroxyapatite-Coated Cementless Implant on Component Revision in Total Hip Arthroplasty: An Analysis of 41,265 Stems

Hoskins, Wayne; Bingham, Roger; Lorimer, Michelle; Steiger, Richard N. de

doi:10.1016/j.arth.2019.10.060

Cited by 36 publications

(50 citation statements)

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“…While there only two researches reported the stable fixation and satisfactory clinic outcome of the Tri‐lock (BPS) with 4–7 years follow‐up in THA 25, 26 . Furthermore, currently there are no published studies directly comparing the clinical outcome and survivor rate of the Tri‐lock (BPS) to the conventional standard stem Corail, which was proved to have excellent clinic outcome in THA 27–29 . Whether the Tri‐lock (BPS) has some superiority with respect to reducing perioperative/posoperative complications compared to the Corail group is also not known.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Tri‐Lock Bone Preservation Stem and the Conventional Standard Corail Stem in Primary Total Hip Arthroplasty

Guo

Tan

Lei

et al. 2021

Orthopaedic Surgery

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Objective To compare the clinical and radiographic outcomes between the Tri‐Lock Bone Preservation Stem (BPS) and the conventional standard Corail stem in primary total hip arthroplasty (THA). Methods From March 2012 to May 2014, we retrospectively reviewed 84 patients (104 hips) who received Tri‐Lock (BPS) and 84 patients (115 hips) who received conventional standard Corail stem in THA. Their mean ages were 53.12 ± 2.32 years and 52.00 ± 2.11 years, respectively. The clinical outcomes were assessed by Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Pain Visual Analogue Scale (VAS) and Harris Hip Score (HHS). The radiological outcomes were evaluated by the radiological examination. Accordingly, Intraoperative and postoperative complications were observed as well. Results The mean follow‐up time was 48.23 ± 2.91 months in the Tri‐Lock (BPS) group and 49.11 ± 2.11 months in the Corail group, respectively. The bleeding volumes in two groups were comparable (169.22 ± 58.11 mL vs 179.30 ± 59.14 mL, P = 0.003), with more bleeding volume in Corail group patients, while no statistically significance with respect to operation time was observed (65.41 ± 6.24 min vs 63.99 ± 6.33 min, P = 0.567). The rates of intraoperative fracture was 8% for the Corail group while 1% for the Tri‐Lock (BPS) group (8% vs 1%, P = 0.030). At final follow‐up, no statistical differences in regard to HHS, WOMAC, and Pain VAS were revealed between the two groups (P > 0.05). The rate of thigh pain was higher in Corail group than in Tri‐lock (BPS) group (5% vs 0%, P = 0.043). However, incidence of stress shielding in grade 1 was higher in Tri‐Lock (BPS) than in the Corail group (76% vs 23%, P < 0.01), while those in grade 2 and 3 were lower compared to the Corail stem (15% vs 28%, P < 0.01; 9% vs 16%, P = 0.008, respectively). Intriguingly, other assessments in relation to radiographic outcomes and postoperative complications were not comparable between the two groups. The Kaplan–Meier survival rate (revision surgery performed for any reason was defined as the end point) was similar between the two groups (P = 0.57), with 98.8% (95% confidence interval, 92.3%–100%) in Tri‐lock (BPS) group and 97.6% (95% confidence interval, 94.6%–100%) in Corail group. Conclusions The Tri‐Lock (BPS) has similar clinic performances compared to the Corail stem. Furthermore, the Tri‐lock (BPS) stem has some advantages in achieving lower incidence of thigh pain, stress shielding and intra‐operative fracture. Therefore, we recommend the Tri‐lock (BPS) stem as a good alternative in primary total hip arthroplasty, especially taking into account patient factors, including bone deficiency and convenience of extraction of the stem in hip revision.

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Section: Introductionmentioning

confidence: 99%

Comparison of Tri‐Lock Bone Preservation Stem and the Conventional Standard Corail Stem in Primary Total Hip Arthroplasty

Guo

Tan

Lei

et al. 2021

Orthopaedic Surgery

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“…17 As demonstrated in this study and others, anterior THA can be successfully performed, [18][19][20] but is not without complications. [21][22][23][24] Concerns with THA utilizing the anterior approach have been with femoral sided complications, 12,13,17,25,26 including subsidence 27 and fracture 17,26,[28][29][30][31][32] ; resulting in early femoral stem revision. 25,26,31 The Swedish and Dutch Registries and the AOANJRR have shown this to be a cause of a higher revision rate.…”

Section: Discussionmentioning

confidence: 99%

“…10 The anterior approach theoretically has a lower risk of instability 6,7 through preserving the posterior capsule and early improvements in function through its inter-nervous, inter-muscular approach, 11 but is limited with its femoral exposure resulting in a higher rate of femoral sided complications. 6,12,13 The superior approach in theory has the potential advantages of stability and faster post-operative recovery preserving abductor and capsular attachments, but may be hampered by its limited exposure, difficulty with component positioning and a likely learning curve with a newer technique. Long term data is yet to indicate a specific approach to have a significant advantage over another with regards to revision rates, 9 or a subset of patients that may benefit from a particular approach.…”

Section: Introductionmentioning

confidence: 99%

“…The risk of instability has been partly mitigated through the advent of larger heads 10 . The anterior approach theoretically has a lower risk of instability 6,7 through preserving the posterior capsule and early improvements in function through its inter‐nervous, inter‐muscular approach, 11 but is limited with its femoral exposure resulting in a higher rate of femoral sided complications 6,12,13 . The superior approach in theory has the potential advantages of stability and faster post‐operative recovery preserving abductor and capsular attachments, but may be hampered by its limited exposure, difficulty with component positioning and a likely learning curve with a newer technique.…”

Section: Introductionmentioning

confidence: 99%

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Early surgical complications of total hip arthroplasty related to surgical approach

Hoskins

Dowsey

Spelman

et al. 2020

ANZ Journal of Surgery

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Background: Total hip arthroplasty (THA) can be performed through a number of surgical approaches. The aim was to compare the incidence of early surgical complications in THA related to approach. Methods: A retrospective review of prospectively recorded data extracted from St. Vincent's Melbourne Arthroplasty Registry was performed between January 2006 and December 2016. Surgical approach was identified: lateral, posterior, anterior and superior. Primary outcome measure was return to theatre (RTT) for any cause within 1 year. Age, comorbidity, body mass index and femoral fixation were assessed for potential confounding. Secondary outcomes were RTT for revision procedure and for specific complications: intra or post-operative fracture, dislocation/instability, aseptic loosening and prosthetic joint injection (PJI). Variables were assessed for their association with outcome using unadjusted and adjusted quantile median regression for continuous outcomes and Cox proportional hazards regression for binary time-to-event outcomes. Results: There were a total of 2906 consecutive THA's recorded, 1413 lateral, 1188 posterior, 233 anterior and 72 superior. A total of 140 cases (4.5%) required RTT within 1 year. No approach was associated with RTT on unadjusted analyses or multivariate modelling. There was no association between approach and revision, PJI or periprosthetic fracture. The posterior approach was associated with 2.90 times the rate of dislocation relative to the lateral (P = 0.005). Conclusions: There was no difference in the RTT rate between surgical approaches for THA. There was no difference in revision rates, PJI or periprosthetic fracture. The posterior approach was associated with a higher rate of dislocation relative to the lateral, but not the anterior.

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“…Существует определенная зависимость выживаемости от размера ножки. На основании анализа более 41 000 наблюдений из австралийского регистра артропластики W. Hoskins с соавторами установили, что частота ревизий ножки на протяжении 13 лет составила 7,7% для двух минимальных размеров и 3,0% -для остальных размеров, что может быть связано с недостаточной подготовкой костного лажа и оседанием слишком маленьких для соответствующей кости бедренных компонентов [88]. Другая группа авторов отметила, что 13% пациентов имеют рентгенопрозрачные линии в 7-й зоне Груэна, что, однако, не влияет на общие функциональные результаты и удовлетворенность пациентов [89].…”

Section: клиновидные ножки с гидроксиапатитовым покрытиемunclassified

Cementless Hip Implants: History and Current Status of the Issue

Шубняков

Риахи

Шубняков³

et al. 2020

Traumatology and Orthopedics of Russia

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Background. Total hip arthroplasty is an effective type of surgery with excellent survival rates of modern implants. From the very beginning of the widespread introduction of total hip arthroplasty, the cement technique of components fixing prevailed. However, many researchers associated the development of osteolysis and the following loosening with the reaction to cement. The subsequent studies clarified the situation regarding the nature of osteolysis, but there remained the problem of insufficient stability of the cemented stems to withstand the penetration of polyethylene wear particles into the distal part of the stem with the development of loosening. An ideal endoprosthesis should ensure the normal hip biomechanics, joint painless functioning and improve the quality of life of the patient without the need for revision. The optimal results of cementless femoral stems functioning depend on the achievement of initial stability, osseointegration and equable transmission of tension onto the femur. There are many factors that influence osseointegration processes and the subsequent behavior of the implant. Understanding these factors is the key to choosing the optimal implant for a particular patient, taking into account the anatomical features of the femur.The purpose of this article is to discuss upon the literature review the application of cementless femoral components, the possible causes of failure and its prevention from the point of view of the evidence-based practice.Materials. The search was conducted in the PubMed, eLIBRARY databases and through the Web of Knowledge. Survival rates and prevalence of various implants in the structure of primary arthroplasty were estimated on the basis of annual reports of a number of national registries, as well as the hip arthroplasty registry of the Vreden National Medical Research Center of Traumatology and Orthopedics. Among the factors discussed are the properties of the components material, the form of the implants, surface properties, and the influence of the anatomical features of the femur. Additionally, the most used types of cementless femoral components were assessed.Conclusion. Cementless femoral components demonstrated the excellent long-term survival and functional results. The currently prevailing type of the prosthesis intimate attachment to the bone is the biological fixation, especially in groups of young patients. Future studies of cementless implants should necessarily take into account the patient’s age, level of activity, type of bone canal, the presence of deformities, and the friction pair used. This will make it possible to draw clearer conclusions in what clinical situation it is advisable to use the femoral components of a particular design.

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The Effect of Size for a Hydroxyapatite-Coated Cementless Implant on Component Revision in Total Hip Arthroplasty: An Analysis of 41,265 Stems

Cited by 36 publications

References 5 publications

Comparison of Tri‐Lock Bone Preservation Stem and the Conventional Standard Corail Stem in Primary Total Hip Arthroplasty

Comparison of Tri‐Lock Bone Preservation Stem and the Conventional Standard Corail Stem in Primary Total Hip Arthroplasty

Early surgical complications of total hip arthroplasty related to surgical approach

Cementless Hip Implants: History and Current Status of the Issue

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