Thirteen year results of total hip arthroplasty using a tapered titanium femoral component inserted without cement in patients with type C bone

Reitman, Richard D.; Emerson, Roger H.; Higgins, Linda L.; Head, William C.

doi:10.1016/s0883-5403(03)00344-9

Cited by 59 publications

(67 citation statements)

References 37 publications

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“…It is important to note that the polyethylene used in this series consisted of either gamma-irradiated in air polyethylene (for the 68 HG-I acetabular components) or non-crosslinked polyethylene (for the 32 Duraloc acetabular components). These results are comparable to or better than the results of other cementless hip replacement reports (Table 4) [1,2,5,7,9,12,14,16,22,24,[26][27][28][29]31].…”

Section: Discussionsupporting

confidence: 80%

Second-generation Extensively Porous-coated THA Stems at Minimum 10-year Followup

Hennessy

Callaghan

Liu

2009

Clinical Orthopaedics &Amp; Related Research

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The relatively high prevalence of thigh pain and stress shielding associated with the AML porous-coated cementless femoral component led to the development of the Prodigy, a femoral component with more extensive porous-coating and a distal polished bullet tip with medial diaphyseal relief to potentially decrease the flexural rigidity. We prospectively evaluated a cohort of 100 consecutive cementless total hip arthroplasties performed using this device. The minimum followup was 10 years (mean, 11.4 years; range, 10-12 years). At 10-year followup, 69 of the 86 patients (82 hips) were living, 14 patients with 15 hips were deceased, and three patients with three hips were lost to followup. No hips required a stem revision. Two patients (two hips) complained of thigh pain. All hips were bone ingrown. Distal tip radiolucencies and osteolysis occurred in 13 hips (17%) and none, respectively. Twenty-one hips (28%) demonstrated moderate or severe stress shielding. Only further followup will determine if this could be a clinical problem or one with revision surgery. These results encourage the authors to continue using second-generation extensively coated stems in their primary total hip arthroplasty constructs.

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Section: Discussionsupporting

confidence: 80%

Second-generation Extensively Porous-coated THA Stems at Minimum 10-year Followup

Hennessy

Callaghan

Liu

2009

Clinical Orthopaedics &Amp; Related Research

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“…Using aseptic loosening as the end point, 100% survivorship was noted. Reitman et al [60] reported 72 cementless MalloryHead Porous implants in 62 patients age 65 and older. Nearly 50% were Dorr Type C bone [12].…”

Section: Discussionmentioning

confidence: 99%

“…Tapered stems of various designs have enjoyed a high degree of success (Tables 1, 2) [44,46,47]. They are appropriate in both Dorr Type A [12] bone typical of young patients [13,14,20] and Dorr Type C [12] bone typically seen in older patients [3,31,60]. They do not fail from varus malalignment (96% survival at 10 years) [4,32].…”

Section: Introductionmentioning

confidence: 99%

Survivorship of 2000 Tapered Titanium Porous Plasma-sprayed Femoral Components

Lombardi

Berend

Mallory

et al. 2009

Clinical Orthopaedics &Amp; Related Research

113

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Tapered titanium porous plasma-sprayed components have performed well in primary THA. To confirm the literature at longer followup we retrospectively reviewed all 1639 patients who underwent 2000 THAs in which a specific porous femoral component was used. One hundred fourteen patients (134 hips) were lost to followup leaving a cohort of 1525 patients (1866 THAs). The component is a tapered titanium plasma spray-coated design that remained relatively unchanged since its first implantation except for circumferential proximal porous coating added in 1986 and an offset option added in 1999. Minimum followup was 24 months (average, 119 months; range, 24 to 275 months). To date there have been 39 femoral revisions for an implant survival of 98%. Using the Kaplan-Meier method, cumulative survival with any stem revision as the end point was 98.6% at 5 years, 98.4% at 10 years, 97.1% at 15 years, and 95.5% at 20 years. Using aseptic revision for failure of ingrowth as the endpoint, stem survival was 99.1%. Kaplan-Meier cumulative survival with aseptic revision for failure of ingrowth as the endpoint was 99.4% at 5 years, 99.3% at 10, 15 and 20 years. Harris hip pain and total scores improved. This titanium, porous plasma spray-coated femoral component continues to demonstrate high long-term survival with a low rate of component revision for any reason or aseptic failure of ingrowth.

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“…A retrieval study of the Alloclassic [37] found that extensive bone-to-prosthesis apposition occurred at the interface along the stem between 6 weeks to 60 months. Other hip stem designs with tapered geometry have also shown excellent results at 5 years [38] and 10 years [39][40][41] post operatively. In this study, the models representing the three groups have been modeled in such a way that a proper comparison could be made between them.…”

Section: Discussionmentioning

confidence: 99%

“…The straight cylindrical stems normally rely on strong cortical support distally for stability, however, there are reports where fixation could be achieved proximally [4] . The tapered stems usually rely on a three-point fixation pattern and a gradual offloading distally [5] . Fixation can also be achieved proximally, such as the CLS stem (Zimmer), or distally, such as the Alloclassic (Zimmer).…”

Section: Introductionmentioning

confidence: 99%

Interface Micromotion of Cementless Hip Stems in Simulated Hip Arthroplasty

Kadir¹,

Kamsah²

2009

American J. of Applied Sciences

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Problem statement:The design of hip prostheses has evolved over time due to various complications found after hip replacement surgery. The currently commercially available cementless femoral stems can be categorized into one of three major types, straight cylindrical, tapered rectangular and anatomical. Each type proposes a unique concept to achieve primary stability-a major requirement for bone healing process. Virtual analyses have been made on individual implants, but comparison between the three major types is required to determine the strength and weaknesses of the design concepts. Approach: Three types of implants were modeled in three dimensions-the straight cylindrical, rectangular taper and anatomical. The size of the three implants was carefully designed to fit and fill the canal of a femur reconstructed from a computed tomography image dataset. Hip arthroplasty was simulated virtually by inserting the hip stem into the femoral canal. Finite element method was used in conjunction with a specialized sub-routine to measure micromotion at the boneimplant interface under loads simulating physiological walking and stair-climbing. Another subroutine was used to assign bone properties based on the grayscale values of the CT image. Results: All the three types of cementless hip stems were found to be stable under both walking and stair climbing activities. Large micromotion values concentrated around the proximal and distal part of the stems. Conclusion/Recommendations: The three major types of hip stems were compared in this study and all of them were found to be stable after simulated physiological activities.

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Thirteen year results of total hip arthroplasty using a tapered titanium femoral component inserted without cement in patients with type C bone

Cited by 59 publications

References 37 publications

Second-generation Extensively Porous-coated THA Stems at Minimum 10-year Followup

Second-generation Extensively Porous-coated THA Stems at Minimum 10-year Followup

Survivorship of 2000 Tapered Titanium Porous Plasma-sprayed Femoral Components

Interface Micromotion of Cementless Hip Stems in Simulated Hip Arthroplasty

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