The Twenty to Twenty-five-Year Outcomes of the Harris Design-2 Matte-Finished Cemented Total Hip Replacement

Skutek, Michael; Bourne, Robert B.; Rorabeck, Cecil H.; Burns, Alexander; Kearns, Stephen; Krishna, Gajan

doi:10.2106/00004623-200704000-00017

Cited by 5 publications

(11 citation statements)

References 11 publications

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“…Cemented fixation of the femur provides a durable, reproducible, and cost-effective technique. Fixation of the femoral stems with modern cement techniques can last 20 to 30 years without loosening in a high percentage of patients [3,6,7,28,[31][32][33][34]. However, a growing body of evidence supports the use of cementless femoral components with many studies having long-term outcomes equal to those using contemporary cemented fixation [8,[23][24][25]36].…”

Section: Introductionmentioning

confidence: 99%

Cementless Femoral Prostheses Cost More to Implant than Cemented Femoral Prostheses

Unnanuntana

Dimitroulias

Bolognesi

et al. 2008

Clin Orthop Relat Res

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Prosthetic cost contributes greatly to the overall expense of THA. A key question, therefore, in the selection of implant technique is whether any price difference exists between a cementless and a cemented femoral prosthesis. We evaluated the price difference between the most commonly used cemented and cementless femoral stems at three high-volume academic medical centers. Each hospital's costs for prostheses from the manufacturers were recorded. The average cost of implanting a cementless femoral prosthesis was $296 more than the average cost of implanting a cemented femoral stem, even with the additional expense of two batches of bone cement and the accessories commonly used to achieve a third-generation cementing technique. The price difference was less variable if the cost of the prostheses from only the primary implant supplier for each institution was considered. As the number of THAs performed per year continues to escalate, implantation of a cemented femoral component remains an attractive method of fixation from an economic standpoint.

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Section: Introductionmentioning

confidence: 99%

Cementless Femoral Prostheses Cost More to Implant than Cemented Femoral Prostheses

Unnanuntana

Dimitroulias

Bolognesi

et al. 2008

Clin Orthop Relat Res

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“…Kaplan-Meier survivorship at 20 years for the endpoint of revision of the femoral component for aseptic loosening ranged from 86% to 98% survival for studies reporting this data [8,14,16,22,23]. Even in the worst-case scenario analysis performed by Ling et al [16], in which all hips with unknown revision status at minimum 20 years were considered to be revised for aseptic loosening, Kaplan-Meier survivorship at 20 years was still 85.6% at the endpoint revision of femoral component for aseptic loosening.…”

Section: Aseptic Looseningmentioning

confidence: 89%

“…No other studies that we found provided worst-case analyses, but had some done so, some survival estimates in the worst case would have been much lower, because loss to followup was as high as 16% (11 of 68 hips) [19]. Revisions for aseptic loosening of the stem ranged from 2% (six of 336 hips [14]) to 5% (18 of 333 hips [12]) of all hips studied in the minimum 20-year followup cohorts [12,14,16,22,23]. Revision rates for aseptic loosening for these same cohorts ranged from 3% (three of 94 hips [22]) to 5% (five of 91 hips [14]) when analyzing only hips with complete minimum 20-year followup.…”

Section: Aseptic Looseningmentioning

confidence: 94%

“…Only two studies speaking to our third research question (on surface finish) met our inclusion criteria [8,23]. These pertained to the Harris Design-2 (Howmedica) and the Müller straight stem (Zimmer, Winterthur, Switzerland), which have an average roughness (Ra) of 0.8 lm and 0.5 to 1.5 lm (mean, 1.0 lm), respectively, as opposed to the polished Charnley or Exeter stems in the remaining cohorts.…”

Section: Methodsmentioning

confidence: 99%

“…There were two different cohorts in this review that received a matte finished stem [8,23] as opposed to the polished Charnley or Exeter stems in the remaining cohorts. These stems were the Harris Design-2 (Howmedica) and the Müller straight stem (Zimmer, Winterthur, Switzerland), which have an average Ra of 0.8 lm and 0.5 to 1.5 lm (mean, 1.0 lm), respectively.…”

Section: Association Between Surface Finish and Stem Survivalmentioning

confidence: 99%

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Systematic Review of Literature of Cemented Femoral Components: What Is the Durability at Minimum 20 Years Followup?

Bedard

Callaghan

Stefl³

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Cemented femoral total hip arthroplasty may be one of the most successful surgical interventions of all time. However, although results are very encouraging over the early to mid-term followup, relatively few studies have analyzed the durability of these implants beyond 20 years followup. To evaluate the performance of contemporary implants, it is important to understand how previous implants perform at 20 or more years of followup; one way to do this is to aggregate the available data in the form of a systematic review. Questions/purposes (1) How durable is cemented femoral fixation in the long term (minimum 20-year followup) with respect to aseptic loosening? (2) Is the durability of cemented femoral fixation dependent on age of the patient? (3) Are the long-term results of the cemented femoral fixation dependent on any identifiable characteristics of the prosthesis such as surface finish? Methods A systematic review was performed to identify long-term studies of cemented femoral components. After application of inclusion and exclusion criteria to 1228 articles found with a search in PubMed and EMBASE, 17 studies with a minimum of 20-year followup on cemented femoral components were thoroughly analyzed in an attempt to answer the questions of this review. The quality of the studies reviewed was assessed with the Methodological Index for Nonrandomized Studies (MINORS) instrument. All studies were case series and cohort sizes ranged from 110 to 2000 hips for patients older than 50 years of age and 41 to 93 hips for patients younger than 50 years at the time of surgery. Results Among the six case series performed in patients older than 50 years of age, survivorship for aseptic loosening of the femoral component ranged from 86% to 98% at 20 years followup. There were no obvious differences for younger patients when analyzing the five studies in patients younger than age 50 years in which survivorship free from aseptic loosening for these studies ranged from 77% at 20 years in one study and 68% to 94% at 25 years in the other studies. Although data pooling could not be performed because of heterogeneity of the studies included here, it appeared that stems with a rougher surface finish did not perform as well as polished stems; survivorship of stems with rougher surface finishes varied between 86% and 87%, whereas those with smoother finishes ranged between 93.5% and 98% at 20 years. Conclusions Excellent long-term fixation in both older and younger patients can be obtained with cemented,

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The John Charnley Award: The Functional Outcome of Hip Resurfacing and Large-head THA Is the Same

Lavigne

Therrien

Nantel

et al. 2010

Clinical Orthopaedics &Amp; Related Research

116

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The Twenty to Twenty-five-Year Outcomes of the Harris Design-2 Matte-Finished Cemented Total Hip Replacement

Cited by 5 publications

References 11 publications

Cementless Femoral Prostheses Cost More to Implant than Cemented Femoral Prostheses

Cementless Femoral Prostheses Cost More to Implant than Cemented Femoral Prostheses

Systematic Review of Literature of Cemented Femoral Components: What Is the Durability at Minimum 20 Years Followup?

The John Charnley Award: The Functional Outcome of Hip Resurfacing and Large-head THA Is the Same

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