Total hip arthroplasty for primary osteoarthrosis in younger patients in the Finnish arthroplasty register

Eskelinen, Antti; Remes, Ville; Helenius, Ilkka; Pulkkinen, Pekka; Nevalainen, Juha; Paavolainen, Pekka

doi:10.1080/00016470510030292

Cited by 135 publications

(120 citation statements)

References 36 publications

(46 reference statements)

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, the hazard ratio in the incidence of radiographic signs of loosening, adjusted for age and gender, was nearly twofold better for threaded titanium cups (0.16) than for press-fit titanium acetabular components (0.29), with cemented conventional PE acetabular components being defined as the reference level (1.00). This observation was also confirmed in the Finnish Arthroplasty Register, in which the risk of revision for aseptic loosening in patients younger than 55 years of age operated on for primary osteoarthritis was three times higher for all-PE cemented acetabular components than for press-fit porouscoated uncemented acetabular components [20]. A similar conclusion was drawn from the meta-analysis of the international literature conducted by Migaud et al [40].…”

Section: Discussionsupporting

confidence: 71%

THA Using Metal-on-Metal Articulation in Active Patients Younger Than 50 Years

Delaunay

Bonnomet

Clavert

et al. 2008

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

The main concern of patients with longer life expectancies and of patients who are younger and more active is the longevity of their total hip arthroplasty. We retrospectively reviewed 83 cementless total hip arthroplasties in 73 patients implanted with metal-on-metal articulation. All patients were younger than 50 years old (average age, 41 years) at the time of the index procedure, and 80% of the patients had an activity level graded 4 or 5 when measured with the system of Devane et al. A 28-mm Metasul articulation was used with three different cementless titanium acetabular components. At the most recent followup (average, 7.3 years), the average Merle d'Aubigné-Postel score improved from a preoperative 11

show abstract

Section: Discussionsupporting

confidence: 71%

THA Using Metal-on-Metal Articulation in Active Patients Younger Than 50 Years

Delaunay

Bonnomet

Clavert

et al. 2008

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…On the femoral side, the durability of cementless components may be at least as good as for cemented implants, particularly in young patients [23], but depend on the design, the material, or the type of coating used [6,9,10]. Several major issues must be addressed when using cementless stems: initial implant stability, durable long-term bone-implant fixation, strain transmission to the proximal femur, and restoration of hip mechanics (ie, the design of the extramedullary portion of the implant including variations of femoral anteversion, femoral offset, and neck-shaft angle).…”

Section: Introductionmentioning

confidence: 99%

Custom Cementless Stem Improves Hip Function in Young Patients at 15-year Followup

Flécher

Pearce

Parratte

et al. 2010

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

THA in young patients is challenging regarding restoration and survival because patients are young, active, and tend to have disturbed anatomy. We asked whether a three-dimensional custom cementless stem could restore hip function, decrease osteolysis and wear, and enhance stem survival in young patients. We retrospectively reviewed 212 patients (233 hips) younger than 50 years (mean, 40 years) at a followup of 5 to 16 years (mean, 10 years). The Merle D'Aubigné-Postel and Harris hip scores improved at last followup. No thigh pain was recorded for any of the patients; 187 of the 212 patients (88%) had full activity recovery, 206 had full range of motion, and 151 had a score greater than 80 points for all five categories of the Hip disability and Osteoarthritis Outcome score. Five patients had femoral osteolysis not associated with pain. With revision for any reason as an end point, the survivorship was 87% (range, 77%-97%) at 15 years, and considering stem revision only, the survivorship was 93% (confidence interval, 90%-97%) at 15 years. Our data compare favorably with those from series using standard cementless stems at the same followup with a high percentage of patients achieving functional restoration and a low rate of complications.

show abstract

“…Whereas this procedure has proven effective in the aging population, only a low percentage of young, active patients opt for THA. This is attributed to shortened projected lifetime of a hip implant for an active patient and the subsequent need for revision surgery, which is associated with significant complications, comorbidities, overall decreased effectiveness, and less patient satisfaction (4)(5)(6)(7)(8)(9). The ability to repair or regenerate cartilage using tissue-engineering strategies could have a tremendous impact on the treatment of OA for the growing population of active patients with hip OA.…”

mentioning

confidence: 99%

Anatomically shaped tissue-engineered cartilage with tunable and inducible anticytokine delivery for biological joint resurfacing

Moutos

Glass

Compton

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

Biological resurfacing of entire articular surfaces represents an important but challenging strategy for treatment of cartilage degeneration that occurs in osteoarthritis. Not only does this approach require anatomically sized and functional engineered cartilage, but the inflammatory environment within an arthritic joint may also inhibit chondrogenesis and induce degradation of native and engineered cartilage. The goal of this study was to use adult stem cells to engineer anatomically shaped, functional cartilage constructs capable of tunable and inducible expression of antiinflammatory molecules, specifically IL-1 receptor antagonist (IL-1Ra). Large (22-mm-diameter) hemispherical scaffolds were fabricated from 3D woven poly(ε-caprolactone) (PCL) fibers into two different configurations and seeded with human adipose-derived stem cells (ASCs). Doxycycline (dox)-inducible lentiviral vectors containing eGFP or IL-1Ra transgenes were immobilized to the PCL to transduce ASCs upon seeding, and constructs were cultured in chondrogenic conditions for 28 d. Constructs showed biomimetic cartilage properties and uniform tissue growth while maintaining their anatomic shape throughout culture. IL-1Ra–expressing constructs produced nearly 1 µg/mL of IL-1Ra upon controlled induction with dox. Treatment with IL-1 significantly increased matrix metalloprotease activity in the conditioned media of eGFP-expressing constructs but not in IL-1Ra–expressing constructs. Our findings show that advanced textile manufacturing combined with scaffold-mediated gene delivery can be used to tissue engineer large anatomically shaped cartilage constructs that possess controlled delivery of anticytokine therapy. Importantly, these cartilage constructs have the potential to provide mechanical functionality immediately upon implantation, as they will need to replace a majority, if not the entire joint surface to restore function.

show abstract

Total hip arthroplasty for primary osteoarthrosis in younger patients in the Finnish arthroplasty register

Cited by 135 publications

References 36 publications

THA Using Metal-on-Metal Articulation in Active Patients Younger Than 50 Years

THA Using Metal-on-Metal Articulation in Active Patients Younger Than 50 Years

Custom Cementless Stem Improves Hip Function in Young Patients at 15-year Followup

Anatomically shaped tissue-engineered cartilage with tunable and inducible anticytokine delivery for biological joint resurfacing

Contact Info

Product

Resources

About